The purpose of the study was to analyse if the two year upgrading programme done at Malawi College of Health Sciences attended by Nurse Midwife Technicians (NMTs) is able to improve the competencies, knowledge, skills and attitude of the graduates when providing comprehensive nursing and midwifery care. The main objectives of this study were • to determine the effectiveness of the Upgrading Diploma in Nursing and Midwifery programme in preparing the competencies of State Registered Nurse Midwifes (SRNMs) • to make recommendations on the training of Upgrading Diploma in Nursing and Midwifery programme The researcher used a quantitative, exploratory, descriptive design. A questionnaire with closed and open-ended questions was used to collect data from SRNMs who completed the upgrading programme. The findings indicated that the upgrading programme has a significant impact to improve the competencies of the NMTs to work as SRNMs. / Health Studies / M.A. (Health Studies)

The aim of the study was to investigate motivation, job satisfaction and attitudes of nurses in the public health services of Botswana. The objective was to discover how nurses felt about a wide range of variables in their work environment and ultimately to distil them into what they conceived as the mainstay motivators, job satisfiers and positive attitudes. The non pariel (unrivalled, unique) role of the government in creating both the hardware and the software of national health services was acknowledged and recognised with a particular reference to the primacy it placed on developing the human resources in the form of nurses, in order to realize the goals of administering the public health services efficiently and effectively. It was noted that nurses were the change agents and the axis in promoting quality standards of healthcare but in partnership with the government, which must be seen to be responsive and proactive in discharging its fiduciary responsibilities, in respect of both the content and the context of nurses’ occupational ambience. For the purposes of constructing a database from which both the government and the nurses can draw, the most salient thematic details of the theories of motivation, job satisfaction and attitudes were studied and examined and were used as a scaffolding for the empirical survey of nurses. Nine hundred questionnaires were distributed to both registered and enrolled nurses with a minimum of two years work experience in the public health sector and 702 of these were returned constituting a return rate of 78%. The findings indicated that a majority of nurses enjoyed job satisfaction in certain areas of their work namely autonomy, participating in decision-making, choice of type of nursing, change of wards or departments or work units, interpersonal relationships amongst nurses themselves and between nurses and their supervisors. Nurses also perceived the hospital as an environment in which they could continually learn and they were moreover satisfied with the nursing job or the work itself. The other end of the spectrum revealed an overwhelming majority of 92.2% of nurses who were dissatisfied with the level of pay and 88.5% who were not happy with the fringe benefits including the provision of accommodation. Working conditions were viewed as generally disliked by 67.3% of the nurses. Low pay, workload, lack of viii recognition for outstanding performance and or delayed promotional chances were singled out as being particularly disliked by 67.2%, 64.9%, 42.6% and 44.4% of the nurses respectively. Interviews held with 31 nurses yielded similar results. The research further showed that the most important motivators to nurses were dominated by competitive salary which was mentioned by 80.9% of the respondents, attractive or sufficient working conditions which were stated by 71.2% of the nurses, opportunity for continuous education which was rated by 63.8% of the nursing candidates, reduced workload which was claimed by 59.3% of the nursing cadres, opportunity for the recognition of outstanding performance and opportunity for promotion which were scored by 54.1% and 53.4% of the nurse respectively. Job satisfiers were also represented by competitive salary which received 76.1% of the nurses’ votes. Risk allowance occupied the second position with 69.1% and competitive working conditions were awarded a third ranking by 68.2% of the nurses. Those nurses who derived job satisfaction from the fact of each nursing shift being manned by an adequate number of nurses accounted for 63.1% of the sample. Competitive fringe benefits attracted 60.1% of the nurses. Opportunity to attend workshops and the need for high morale in nursing team-work were chosen as job satisfiers by 53.7% and 49.6% of the nurses respectively. In the section on recommendations the government was exhorted to invoke corrective or remedial measures in view of the detailed exegesis of the satisfactions and dissatisfactions in the nurses’ work environment and the ensuing problematique (doubtful, questionable) of raising the standards of health care in the public health services. Living up to these sanguine expectations should be the cherished longterm vision of the government if it is to meet and quench the soaring aspirations of its modernizing society for quality health care delivery and the escalating needs of the nurses. / Public Administration / D.P.A.

Background: Today, most of the sex education takes place in school. Studies shows shortcomings in this education and that students experience shortage of the knowledge wanted regarding this subject. Research has also shown that young people prefer to accomplish sex education with someone who feels comfortable and has good knowledge of the subject. The main subject of midwifery is sexual and reproductive health and rights. However, there is a limited amount of studies conducted regarding midwives involvement in sex education in schools. Purpose: The aim of this study was to highlight the role of the midwife in health-promoting public health work with sex education for adolescents in school. Method: Semi-structured telephone interviews were conducted with four teachers who taught sex education at high school and five midwives with experience of sex education. The collected material was analyzed according to Malterud's systematic text condensation. Result: The result showed that the midwife's health promotion work in school was conducted in a few different ways. Partly through lectures and partly by students visiting the youth health center (ungdomsmottagning). The way in which the work was done was due partly to the school's demand and partly to the availability of the midwife. The average time that the midwife was teaching students were between 30-120 minutes, which were distributed on one and the same occasion. The midwife's role in school was described as being proficient, competent and comfortable talking about sex. The fact that the midwife was unacquainted meant that the students felt comfortable and it was easier to ask questions about sensitive subjects. Conclusion: The conclusion of the study is that there is a need for midwifery skills at school and that, in spite of this, there is no clear and obvious role of the midwife in school education. Clinical applicability: This study can be used to support the midwife's work in sexual education in school. The study can also be used as a basis for establishing cooperation between midwife and school. / Bakgrund: Idag sker den övervägande delen av sex- och samlevnadsundervisningen i skolan och undersökningar visar på brister i denna undervisning samt att elever inte upplever sig få de kunskaper de önskar inom ämnet från skolan. Forskning har också visat att ungdomar föredrar att prata om sex och samlevnad med någon som känner sig bekväm och besitter goda kunskaper i ämnet. Barnmorskans huvudämne är sexuell och reproduktiv hälsa och rättigheter. Det finns dock begränsat med studier gjorda på hur barnmorskan involveras i skolans sex- och samlevnadsundervisning. Syfte: Syftet med den här studien var att belysa barnmorskans roll i det hälsofrämjande folkhälsoarbetet med sex och samlevnadsundervisning för ungdomar i skolan. Metod: Semistrukturerade telefonintervjuer gjordes med fyra lärare som undervisade i sex och samlevnad på högstadiet och fem barnmorskor med erfarenhet av sex och samlevnadsundervisning. Det insamlade materialet analyserades enligt Malteruds systematiska textkondensering. Resultat: Resultatet visade att barnmorskans hälsofrämjande arbete i skolan genomfördes på lite olika sätt. Dels genom föreläsningar och dels genom att elever kom på besök till ungdomsmottagningen. Hur arbetet var upplagt berodde dels på skolans efterfrågan och dels på hur tillgången till barnmorskan såg ut. Tiden som barnmorskan lade på att undervisa elever var i genomsnitt mellan 30-120 minuter som låg fördelat på ett och samma tillfälle. Barnmorskan beskrevs som kunnig och hade spetskompetens inom sitt område samt kände sig bekväm att prata om sex och samlevnad. Att barnmorskan var utomstående gjorde att eleverna också kände sig bekväma och hade lättare att ställa frågor angående känsliga ämnen. Slutsats: Slutsatsen av studien är att det finns ett behov av barnmorskans kompetens i skolan men att det inte finns någon tydlig och självklar roll för barnmorskan i skolans sexualundervisning. Klinisk tillämpbarhet: Denna studie kan användas som stöd för att främja barnmorskans insatser i skolans sex- och samlevnadsundervisning. Studien kan också användas som underlag vid upprättande av samarbetsformer mellan barnmorska och skola.

The purpose of the study was to analyse if the two year upgrading programme done at Malawi College of Health Sciences attended by Nurse Midwife Technicians (NMTs) is able to improve the competencies, knowledge, skills and attitude of the graduates when providing comprehensive nursing and midwifery care. The main objectives of this study were • to determine the effectiveness of the Upgrading Diploma in Nursing and Midwifery programme in preparing the competencies of State Registered Nurse Midwifes (SRNMs) • to make recommendations on the training of Upgrading Diploma in Nursing and Midwifery programme The researcher used a quantitative, exploratory, descriptive design. A questionnaire with closed and open-ended questions was used to collect data from SRNMs who completed the upgrading programme. The findings indicated that the upgrading programme has a significant impact to improve the competencies of the NMTs to work as SRNMs. / Health Studies / M.A. (Health Studies)

The aim of the study was to investigate motivation, job satisfaction and attitudes of nurses in the public health services of Botswana. The objective was to discover how nurses felt about a wide range of variables in their work environment and ultimately to distil them into what they conceived as the mainstay motivators, job satisfiers and positive attitudes. The non pariel (unrivalled, unique) role of the government in creating both the hardware and the software of national health services was acknowledged and recognised with a particular reference to the primacy it placed on developing the human resources in the form of nurses, in order to realize the goals of administering the public health services efficiently and effectively. It was noted that nurses were the change agents and the axis in promoting quality standards of healthcare but in partnership with the government, which must be seen to be responsive and proactive in discharging its fiduciary responsibilities, in respect of both the content and the context of nurses’ occupational ambience. For the purposes of constructing a database from which both the government and the nurses can draw, the most salient thematic details of the theories of motivation, job satisfaction and attitudes were studied and examined and were used as a scaffolding for the empirical survey of nurses. Nine hundred questionnaires were distributed to both registered and enrolled nurses with a minimum of two years work experience in the public health sector and 702 of these were returned constituting a return rate of 78%. The findings indicated that a majority of nurses enjoyed job satisfaction in certain areas of their work namely autonomy, participating in decision-making, choice of type of nursing, change of wards or departments or work units, interpersonal relationships amongst nurses themselves and between nurses and their supervisors. Nurses also perceived the hospital as an environment in which they could continually learn and they were moreover satisfied with the nursing job or the work itself. The other end of the spectrum revealed an overwhelming majority of 92.2% of nurses who were dissatisfied with the level of pay and 88.5% who were not happy with the fringe benefits including the provision of accommodation. Working conditions were viewed as generally disliked by 67.3% of the nurses. Low pay, workload, lack of viii recognition for outstanding performance and or delayed promotional chances were singled out as being particularly disliked by 67.2%, 64.9%, 42.6% and 44.4% of the nurses respectively. Interviews held with 31 nurses yielded similar results. The research further showed that the most important motivators to nurses were dominated by competitive salary which was mentioned by 80.9% of the respondents, attractive or sufficient working conditions which were stated by 71.2% of the nurses, opportunity for continuous education which was rated by 63.8% of the nursing candidates, reduced workload which was claimed by 59.3% of the nursing cadres, opportunity for the recognition of outstanding performance and opportunity for promotion which were scored by 54.1% and 53.4% of the nurse respectively. Job satisfiers were also represented by competitive salary which received 76.1% of the nurses’ votes. Risk allowance occupied the second position with 69.1% and competitive working conditions were awarded a third ranking by 68.2% of the nurses. Those nurses who derived job satisfaction from the fact of each nursing shift being manned by an adequate number of nurses accounted for 63.1% of the sample. Competitive fringe benefits attracted 60.1% of the nurses. Opportunity to attend workshops and the need for high morale in nursing team-work were chosen as job satisfiers by 53.7% and 49.6% of the nurses respectively. In the section on recommendations the government was exhorted to invoke corrective or remedial measures in view of the detailed exegesis of the satisfactions and dissatisfactions in the nurses’ work environment and the ensuing problematique (doubtful, questionable) of raising the standards of health care in the public health services. Living up to these sanguine expectations should be the cherished longterm vision of the government if it is to meet and quench the soaring aspirations of its modernizing society for quality health care delivery and the escalating needs of the nurses. / Public Administration and Management / D.P.A.

L'enfant de la natalité (Arendt) est libre, le monde s'ouvre à lui dès sa naissance : il peut commencer une nouvelle histoire, et donner sa chance à l'humanité.Mais le petit humain, prématuré dans sa forme même, est séparé brutalement de ses enveloppes, de son double placentaire, de l'utérus maternel. Il est jeté au mon-de (Heidegger) dans l'angoisse de sa finitude et s'il ne rencontrait dans l'instant même de sa naissance ses médiateurs humains, en premier lieu sa mère, il ne pourrait affronter le négatif, l'Autre, et ne survivrait pas.Pour que s'ouvre l'espace de la naissance, pour que la mère puisse accueillir son enfant à travers les épreuves de séparation, pour qu'elle puisse laisser venir la langue maternelle, et que puisse s'incarner l'esprit dans ce nouveau-venu, elle doit pouvoir rencontrer elle aussi les médiateurs de la naissance. Certains s'évanouissent après avoir permis ce passage d'un état à un autre, d'autres persistent sous la forme d'un double —protecteur ou menaçant—. Ils accompagnent chaque naissance et le commencement de toute vie humaine. Les mythes et les rites les reconnaissent dans toutes les cultures.Cependant la médecine technicienne contemporaine qui s'est emparée de la naissance redoute la séparation, le travail du négatif, et pratique le déni, celui de la grossesse, de l'autre femme, des médiateurs de la naissance. Elle s'appuie sur l'expertise technique et mathématique, sur l'imagerie et la statistique pour créer un double imaginaire de l'enfant, celui du projet de la science, immortel et par-fait, masqué par le projet parental.La sage-femme traverse ces espaces, elle connaît les médiateurs. Fille de la médecine mais aussi guérisseuse ou sorcière elle pratique la maïeutique, l'art d'accoucher les corps et leurs âmes. Son art est difficile, sa sagesse est indicible, elle passe d'un monde à l'autre au risque de disparaître, broyée par l'arraisonnement de la Technique triomphante, aspirée par la démesure du désir de l'homme qui voudrait se créer lui-même ou par la tentation des arrière-mondes qui la condamne à rester en marge dans l'ombre archaïque des mystères. / The child of natality (Arendt) is free; the world opens up for him from his birth. He is the beginning of a new story, and he can give humankind a chance.But this little human being, whose very existence is premature, is brutally separated from his ‘placenta double' and from his mother's womb. He is thrown into the world (Heidegger), into the angst of his finiteness. If he does not meet his human mediators upon his birth, and his mother in the first place, he will not survive and will not be prepared to face negativity and the Other.The mother needs to meet the birth mediators to make room for the birth space, and to welcome her child through their separation. She needs to meet the mediators to let the mother tongue come to the child, and to let a soul enter this newcomer. Some mediators will vanish after having played a part in crossing one world to the next; others will remain as – protecting or threatening – doubles. They are present for each birth, and are there to see the beginning of new human lives. Myths and rites identify them in all cultures.But contemporary medicine, based on new technologies and techniques, has taken control of the birth process. It fears the separation and is in denial – of the pre-gnancy and of the other woman as well as of the birth mediators. Contemporary medicine is based on technical and mathematical expertise. It uses medical imaging and statistics to create an imaginary double of the child-to-be-born: this child becomes a scientific project, immortal and perfect, hidden behind the parenting project.Midwives cross these worlds, and they are in contact with the mediators. A mid-wife is not only the daughter of medicine but also a healer or a witch, practising maieutic and the art of delivering bodies and souls. Her art is a complex one, her wisdom is unspeakable and when she crosses those worlds, she is always threate-ned of disappearing, choked by the enframing (Gestell) of the forever-winning Technique. Midwives are carried away by the excessive desire of men to create themselves or by the temptation of the ‘backworlds' to leave them behind, in the obscurity of archaic mysteries.

Bakgrund: Antalet kejsarsnitt ökar såväl globalt som i Sverige. Kejsarsnitt är ett kirurgiskt ingrepp som innebär risker för såväl kvinna som barn. Trots risker önskar förstföderskor att genomgå ingreppet istället för en vaginal förlossning. Barnmorskors professionella stöd är av stor vikt för förstföderskors upplevelse inför, under samt efter sin förlossning. Studien utfördes för att förstå orsakerna till att förstföderskor önskar elektivt kejsarsnitt. Syfte: Var att fördjupa förståelsen kring förstföderskors önskan om elektivt kejsarsnitt. Metod: Kvalitativ innehållsanalys med en induktiv ansats. Datainsamlingen resulterade i 14 bloggar från sökmotorn Google.se som analyserades. Resultat: Analysen resulterade i tre teman: Sökandet efter trygghet inför sin förlossning, Tankar på en vaginal förlossning väcker varierande känslor och Val av förlossningsmetod - en rättighet samt sju subteman. Mest framträdande var känsla av brist på kontroll och otrygghet inför en vaginal förlossning. Möjligheten att få välja förlossningsmetod ansågs vara en mänsklig rättighet. Konklusion: Förstföderskor som önskar elektivt kejsarsnitt sökte trygghet inför sin förlossning. Elektivt kejsarsnitt ingav trygghet då det uppfattades som en mer kontrollerad och säker förlossningsmetod både för kvinnan och barnet. Föreställningen av att genomgå en vaginal förlossning skapade rädsla och obehag. / Background: The number of caesarean sections increases both globally and in Sweden. Although caesarean section is a surgical procedure that involves risks for both women and child, first-time mothers wish to undergo the procedure instead of a vaginal delivery. The midwife's professional support is important for first-time mothers before, during and after childbirth. This study was conducted to understand the reasons why first-time mothers want elective caesarean section. Aim: To deepen the understanding of first-time mothers wish for elective caesarean section. Method: A qualitative content analysis with an inductive approach was used. Google.se was used for data collection, the collection resulted in 14 blogs. Result: The analysis resulted in three themes: The wish for security during childbirth, Thoughts on a vaginal delivery raises a variety of emotions and Choice of birthing method - a right and seven sub-themes. Most prominent was the feeling of lack of control and insecurity for a vaginal delivery. Choice of birthing method was considered a human right. Conclusion: First-time mothers strive for security during childbirth. Elective caesarean section was described as a safe and controlled birthing method. Thoughts on a vaginal delivery raises fear and discomfort for first-time mothers.

Bakgrund: Barnmorskor bör eftersträva en god vårdrelation för att överbrygga den sårbarhet och osäkerhet graviditeten skapar. Inskrivningsbesöken vid graviditet är omfattande, det är mycket information som ska hanteras, vilket försvårar möjligheten till en god vårdrelation. Syfte: Belysa hur barnmorskor vid mödrahälsovården genomför inskrivningsbesöken för att skapa en god vårdrelation. Metod: Datamaterial samlades in via intervjuer och analyserades genom kvalitativ innehållsanalys med induktiv ansats. Resultat: Barnmorskorna beskriver vikten av att skapa balans mellan graviditeten i fokus och de medicinska riktlinjerna i inskrivningsbesöken. Graviditeten är den centrala anledningen till besöken så fokus behöver ägnas åt att stärka den gravida/partnern i övergången till föräldrablivandet. Inskrivningsbesöken innebär hantering av medicinska uppgifter, vilka är centrala för vårdplaneringen men kan försvåra den gravidas/partnerns fokus på graviditeten. Den gravidas/partnerns möjlighet till delaktighet vid inskrivningsbesöken beskrivs som central. Avgörande för delaktighet är möjligheten till berättande, kroppsspråk, miljön och stöd av metoder för att främja besökens genomförande. För att främja samtalet används olika former av mallar och fraser samt strategier kring hur dokumentationen handhas. Konklusion: Barnmorskorna beskriver strategier och metoder som centrala för att främja den gravidas/partnerns delaktighet i inskrivningsbesöken. / Background: Midwives should strive for a secure care relationship to overcome the vulnerability of pregnancy. Booking interviews contains lot of information which makes it harder to accomplish a secure care relationship. Purpose: To illustrate how midwives at antenatal care conducts the booking interviews to create a secure care relationship. Method: The data was collected by interviews and analyzed by qualitative content analysis with inductive approach. Result: Midwives describe the importance to create balance between keeping the pregnancy in focus and the medical guidelines during the interviews. The pregnancy is the central reason for the interviews, thus the focus needs to be aimed strengthen the transition to parenthood. The booking interviews involve gathering medical information which is central for the care planning, but it can complicate the pregnant/partners focus on the pregnancy. It’s described as central that the pregnant/partner participates in the interviews. Crucial for participation is the possibility of narration, body language, the environment and support of methods to carrying through the visit. Various templates and phrases are used to help the conversation, and also various strategies how the documentation are handled. Conclusion: Midwives describe strategies and methods as central to promoting the pregnant/partners participation in the booking interviews.

Bakgrund: Förlossningsrädsla drabbar ungefär en femtedel av alla gravida kvinnor och barnmorskor möter dessa i sitt arbete. Syfte: Syftet var att analysera begreppet förlossningsrädsla ur ett barnmorskeperspektiv. Metod: En begreppsanalys med en hybridmodell. Först en teoretisk fas med litteratursökning, därefter en fältstudiefas där fem barnmorskor intervjuades följt av en sammanfattandes syntes med resultatet från den teoretiska fasen och fältstudiefasen. Resultat: Förlossningsrädsla är något som kan drabba kvinnor innan, under eller efter graviditet och förlossning. Förlossningsrädsla kan vara primär eller sekundär. Vid primär förlossningsrädsla kan kvinnan sakna tilltro till sin förmåga att föda barn och vid sekundär förlossningsrädsla har kvinnan haft en tidigare traumatisk förlossningsupplevelse. Barnmorskorna beskrev förlossningsrädsla som ett komplext begrepp. Kvinnorna använde oftast inte ordet förlossningsrädsla utan barnmorskorna tolkade vad de märkte eller såg hos kvinnan som yttringar av förlossningsrädsla. Slutsats: Barnmorskor använder begreppet på olika sätt och efterlyser en tydligare definition och arbetssätt kring förlossningsrädsla. Förlossningsrädsla innebär ett stort lidande för den gravida kvinnan och därför anser författarna till detta examensarbete att det förebyggande arbetet är viktigt och att barnmorskan har en central och betydelsefull roll. Kliniks tillämpbarhet: Barnmorskor kan använda sig av studien för att utveckla sin kunskap kring förlossningsrädsla samt se hur andra barnmorskor ser på begreppet förlossningsrädsla. / Background: Fear of childbirth affects about one-fifth of all pregnant women and midwives face these in their work. Aim: The aim was to analys the concept fear of childbirth from a midwife perspective. Methods: A concept analysis with a hybrid model. First a theoretical phase with a search for literature, thereafter a fieldwork phase where five midwifes where interviewed followed by a final analytic phase. Results: Fear of childbirth is something that can affect women before, during or after pregnancy and childbirth. Fear of childbirth for primiparous women can be a lack of confidence in her ability to give birth, and for multiparous women have had a previous traumatic birth experience. The midwives described that fear of childbirth was a complex concept. Women did not usually use the word fear of childbirth, but the midwives interpreted what they noticed or saw in the woman as manifestations of fear of childbirth. Conclusion: Midwives use the concept in different ways and call for a clearer definition and way of working with fear of childbirth. The fear of childbirth is a great suffering for the pregnant woman and therefore the authors of this thesis consider that preventive work is important and that the midwife has a central and important role. Clinical Applicability: Midwives can use this study to develop their knowledge of fear of childbirth and see how other midwives view on the concept fear of childbirth.

Bakgrund: Förlossningsrädsla kan vara påfrestande för kvinnor, förekommer i varierande allvarlighetsgrad och kan leda till negativ förlossningsupplevelse. Förekomsten av förlossningsrädsla varierar mellan olika länder vilket till viss del kan förklaras av olika mätmetoder. Barnmorskan är en betydelsefull person för kvinnor med förlossningsrädsla. Syfte: Syftet med denna studie var att undersöka kvinnors upplevelser och erfarenheter av barnmorskans stöd vid förlossningsrädsla. Metod: Kvalitativ metasyntes med meta-etnografisk analysmetod, där artiklar söktes i databaserna PubMed, CINAHL, Google Scholar, Scopus, Web of Science och PsycINFO. Efter kvalitetsgranskning kom 15 artiklar att analyseras. Resultat: Tre kategorier med tillhörande mönster identifierades; En närvarande barnmorska och En kompetent barnmorska där kvinnornas upplevelser av barnmorskans stöd bidrog till att minska förlossningsrädslan. Kategorin En distanserad barnmorska med tillhörande mönster visar upplevelser som istället ökade förlossningsrädslan. Slutsats: Resultatet påvisar betydelsen av att kvinnor upplever att barnmorskan är närvarande och kompetent för att kvinnan ska känna sig trygg och våga lita på att hon kan föda. Kontinuerligt stöd vid förlossning och fortbildning till personalen som möter förlossningsrädda kvinnor behövs. Caseload kan vara en modell som ytterligare behöver implementeras i barnmorskans arbete. / Background: Fear of childbirth can be stressful for women, occurs in varying degrees of severity and can lead to negative birth experience. The incidence of fear of childbirth varies between different countries, which to some extent can be explained by different measurement methods. The midwife is a person of significance for women with fear of childbirth. Objective: The purpose of this study was to investigate women's experiences of a midwife's support during fear of childbirth. Method: Qualitative meta synthesis using meta-ethnographic analysis method, where articles were searched in the databases PubMed, CINAHL, Google Scholar, Scopus, Web of Science and PsycINFO. After a quality review, 15 articles were analyzed. Result: Three categories with correlating patterns were identified; A present midwife and a competent midwife where the women's experience of the midwives support contributed to alleviate childbirth fear; Category a distant midwife with correlating patterns displays experiences that tended to increase childbirth fear. Conclusion: The results display the importance of the women's experience of a present and competent midwife for the women to feel safe and dare trust that she can give birth. A continuous support at childbirth and education for the staff that encounters women with fear of childbirth is needed. Caseload could be one model that needs to be implemented in the midwives work.