The aim of the present study was to gain a deeper understanding of the experiences of the contact with the ”fear of childbirth”-team (called Aurora-team) made by women who feared childbirth. Qualitative content analyses according to Graneheim and Lundman was used to analyse 91 womens own written notes made at the end of a questionnaire which (with a quantitative approach) evaluated the counseling made by the Aurora-team at a hospital in the south of Sweden. The following five categories developed during the analyses; experience of the conversation, not knowing creates fear, thoughts regarding mode of delivery, the importance of how the birth plan is managed and the personnel´s standpoint regarding fear of childbirth. These categories can be seen as parts of the themes of experiences which made the fear of childbirth easier or which made it worse. This study shows the importance of meeting the individual woman in the Aurora-consultation in order for the woman to feel respected by the midwife. In order to do so education in communicative techniques should be offered to the Aurora-midwives. It would benefit the feeling of security of the women if the personnel would treat and acknowledge fear of childbirth in the same way, ie from a uniform and professional standpoint. Most women wanted someone to talk to about the delivery experience. This show of the preventive role the postpartum-consultation could have of fear of childbirth.

Uppsatsens syfte var att öka förståelsen för hur kuratorer inom vuxenhabiliteringen och barnmorskor på mödravårdscentraler förhåller sig till och arbetar med gravida kvinnor med intellektuella funktionsnedsättningar. Avsikten var även att undersöka likheter respektive olikheter mellan yrkesgrupperna. För att genomföra studien använde vi kvalitativ metod. Vi intervjuade två barnmorskor på mödravårdscentraler och tre kuratorer inom vuxenhabiliteringen. Intervjuerna analyserades med hjälp av de teoretiska perspektiven normalitet, juridisk diskurs och emotionell diskurs. Resultaten visar att barnmorskorna hade ett barnperspektiv medan kuratorerna ett föräldraperspektiv. Dessa perspektiv avspeglar olika förhållningssätt inom den emotionella och juridiska diskursen. Trots olika inriktningar och respondenternas olika yrkesroller, hade respondenterna liknande föreställningar gentemot kvinnor med intellektuella funktionsnedsättningar. Ifrågasättande av dessa kvinnors föräldraförmåga återkom i alla intervjuer. I detta avseende såg respondenterna dessa kvinnor som avvikare från det ”normala”. Att tala om målgruppen påtalar respondenterna vara känsligt och även tabubelagt, då det för inte så många decennier sedan inte var lagligt för dessa kvinnor att skaffa barn och familj. Varken kuratorerna eller barnmorskorna hade egentligen någon utarbetad arbetsmetod för arbetet med gravida kvinnor med intellektuell funktionsnedsättning, utan arbetade mycket utifrån egna erfarenheter. Kuratorerna menade att barnmorskorna hade otillräcklig kunskap om funktionsnedsättningar. / The purpose of this study was to increase the understanding of how social workers in adult habilitation and midwives in maternity clinics relate to and work with pregnant women with intellectual disabilities. The intention was also to examine the similarities and differences between the occupational groups. To conduct the study, we used qualitative methods. We interviewed two midwives at maternity clinics and three counselors in adult habilitation services. The interviews were analyzed by means of the theoretical concepts normality, legal discourse and emotional discourse. The results show that midwives had a child perspective while the curators had a parental perspective. These perspectives reflect different attitudes in the emotional and legal discourse. Despite the different approaches and respondents' various professional roles, the respondents had similar perceptions towards women with intellectual disabilities. Challenge of these women's parenting skills recurred in all interviews. In this regard the respondents saw these women as deviant from the "normal". To speak about the target group the respondents complains of being sensitive and even taboo when it is not so many decades ago, it wasn’t legal for these women to have children and family. Neither the curators nor the midwives really had any elaborate methodology for working with pregnant women with intellectual disabilities, but worked from their own experience. The curators implied that the midwives had insufficient knowledge of impairments.

Background: The incidence of caesarean section for breech presentation has reached approximately 90 % in Sweden. In many of these cases, by means of specific selection criteria, it would be as safe to plan for vaginal breech delivery.   Aim: The objective of this study was to investigate differences in management and to compare maternal and fetal outcomes according to delivery mode of breech presentation; vaginal vs. caesarian section. The study included breech presentation in full term singleton pregnancies at the UppsalaUniversityHospital, Uppsala, Sweden (UAS).   Method: The study was based on medical record data with a retrospective, descriptive, comparative design with quantitative approach. The method for data collection was a manual review of patient records using a structured questionnaire.   Results: Of the women with children in breech presentation during the period studied, 11 % gave birth vaginally. Mother's wish was the most common cause of caesarean section. The group with caesarean section included more first-time mothers, longer length of stay at the hospital, increased bleeding and need for pain medication, separation from the child, later lactation and earlier introduction of formula. Vaginally delivered mothers had increased incidence of straight urine catheterization postpartum and of infants with lower Apgar scores.   Conclusion: This study does not support the suggestion that it would be safer to give birth by caesarean section for breech presentation in cases where the woman at full term meets strict selection criteria. Instead of applying medical criteria, the decision regarding mode of delivery was more often left up to the mother.

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2017-01-05T17:15:36Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ramoci_leuchtenberger.pdf: 13836273 bytes, checksum: 357b05202ed703ff927ea55cb44804a4 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2017-01-31T14:01:35Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ramoci_leuchtenberger.pdf: 13836273 bytes, checksum: 357b05202ed703ff927ea55cb44804a4 (MD5) / Made available in DSpace on 2017-01-31T14:01:35Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ramoci_leuchtenberger.pdf: 13836273 bytes, checksum: 357b05202ed703ff927ea55cb44804a4 (MD5) Previous issue date: 2016 / Por s?culos mulheres de comunidades tradicionais quilombolas foram cuidadas na gesta??o, parto e puerp?rio por parteiras e mulheres de sua confian?a. Nas ?ltimas d?cadas passaram a dar ? luz em hospitais, onde procedimentos que n?o atendem ?s particularidades de cada caso acabam por transformar o parto em uma experi?ncia de dor, medo e abandono. As pr?ticas sociais do cotidiano das mulheres de um determinado territ?rio, classe social e inser??o ?tnico-racial constr?em um conjunto de representa??es do cuidado da gestante, da parturiente, e do rec?m nascido que contemplam suas necessidades espec?ficas nestas fases da vida. Este estudo tem por objetivo conhecer as pr?ticas de cuidado da sa?de reprodutiva realizadas por mulheres da comunidade quilombola Ausente, no Alto Vale do Jequitinhonha, Minas Gerais, e compreender suas necessidades durante a gesta??o, parto e puerp?rio, contribuindo para a humaniza??o da assist?ncia ao parto. A colheita de dados foi realizada durante incurs?es ? comunidade, por meio de observa??o participante e entrevistas abertas com gestantes, lactantes e pu?rperas. As mulheres quilombolas demonstram unanimidade na prefer?ncia por parto normal em rela??o ? ces?rea. O motivo ? o temor da recupera??o que a cirurgia exige , n?o havendo men??o ?s vantagens fisiol?gicas e emocionais proporcionada pelo parto normal para a m?e e a crian?a. Cumprir o resguardo no puerp?rio ? fundamental para a sa?de da mulher, e a ajuda prestada por outras mulheres na organiza??o da casa e no cuidado com outras crian?as permite que a m?e se dedique integralmente ao beb? rec?m nascido. Os rituais que se desenrolam nos primeiros dias de vida do beb? s?o determinantes de sua sa?de, al?m de promover a socializa??o e o sentimento de comunidade. A vida das mulheres quilombolas favorece sua capacidade de decis?o e protagonismo, mas o desconhecimento das diretrizes que regulamentam a assist?ncia humanizada ao nascimento e a resigna??o com as dificuldades comumente enfrentadas durante o parto as impede de exigir at? mesmo a presen?a de um acompanhante. A produ??o de material informativo sobre gesta??o, parto e amamenta??o, baseado em evid?ncias cient?ficas, precisa ampliar sua veicula??o e diversificar seu p?blico alvo, passando a incluir mulheres negras e rurais. Se fazem necess?rias a??es de dissemina??o destas informa??es que levem em considera??o a exist?ncia de m?ltiplas realidades e respeitem as caracter?sticas culturais das diferentes humanidades. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2016. / For centuries women in traditional 'quilombola' communities were cared for during pregnancy, childbirth and postpartum by midwives and women of their confidence. In recent decades they have come to give birth in hospitals where procedures that do not consider the particularities of each case end up turning delivery in an experience of pain, fear and abandonment. Social practices of the daily lives of women of a certain territory, social class and ethnic-racial influence builds a set of representations on the care of the pregnant woman, the woman in labor and the newborn that answer to their specific needs in these stages of life. This study aims to understand the reproductive health care practices performed by women of the Ausente Community, at Jequitinhonha Valley, Minas Gerais, and understand their needs during pregnancy, childbirth and the postpartum period, contributing to the humanization of delivery care. Data collection was conducted during visits to the community, through participant observation and open interviews with pregnant women and nursing mothers. 'Quilombola' women demonstrate unanimity in the preference for vaginal delivery compared to cesarean section. The reason is the fear of recovery that surgery requires, with no mention of the physiological and emotional benefits provided by normal delivery for the mother and the child. Rest at postpartum is critical to women's health, and the help provided by other women in the organization of home and at the care of other children allows the mother to fully dedicates to the newborn baby. The rituals that take place in the first days of the baby's life are critical to his health, and also help to promote the socialization and the sense of community. The life of 'quilombola' women favors its decisiveness and autonomy, but the lack of knowledge about legislation of humanized care at birth prevent them of require rights, as the presence of a companion. The production of informative material about pregnancy, childbirth and breastfeeding, based on scientific evidence, needs to expand its transmission and diversify its target audience to include black and rural women. Actions of dissemination of this information are essential, considering the existence of multiple realities and the cultural characteristics of diverse human groups.

Bakgrund: Efterfrågan på tidig fosterdiagnostik har ökat bland blivande föräldrar. KUB är den vanligast förekommande fosterdiagnostiska metoden men är inte diagnostiserande utan kalkylerar en sannolikhet för huruvida trisomi 13, 18 eller 21 föreligger. Detta är kvinnorna inte alltid medvetna om, varför förberedelse och noggrann information är viktigt. Denna studie utfördes därmed för att belysa kvinnors upplevelser relaterat till genomfört KUB. Syfte: Att beskriva kvinnors upplevelser relaterat till genomfört KUB. Metod: Kvalitativ innehållsanalys med induktiv ansats användes. 10 trådar från Internetforumet Familjeliv.se och 12 bloggar hittades under datainsamlingen och låg till grund för dataanalys. Resultat: Analysen mynnade ut ett sammanfattande tema: KUB ses som en möjlighet att bekräfta graviditeten men leder till varierande känslor som barnmorskor måste stödja på ett förtroendefullt sätt. De mest framträdande känslorna som beskrevs relaterat till KUB var oro och rädsla. Barnmorskor upplevdes inte ge det stöd som behövdes. Konklusion: KUB ses som ett sätt att bekräfta graviditeten. För att minska oron behöver barnmorskor ge individanpassad information till kvinnorna. Kvinnors oro relaterat till KUB tenderar att grumla graviditeten och kvarstå lång tid framöver. / Background: The demand on prenatal diagnosis increases among expecting parents. CUB is the most common method for the matter but doesn’t provide any diagnosis. CUB only calculates the probability of a fetus with trisomy 13, 18 or 21. Women aren’t always aware of this. Hence, careful preparations and information are necessary. This study was performed to enhance knowledge in women’s experiences in relation to have undergone CUB. Aim: To describe women’s experiences related to having undergone CUB. Method: A qualitative content analysis with an inductive approach was used. Internet was used for data collection. This collection resulted in 10 threads from bulletin board Familjeliv.se and 12 blogs which became the base for data analysis. Result: The analysis resulted in one theme: CUB is seen as an opportunity to confirm the pregnancy but leads to mixed feelings which the midwives need to support in a trustful way. Anxiety and fear are the most common emotions mentioned among women who have undergone CUB. Women felt that midwives didn’t always provide enough information or the requested information. The encounters with midwives during CUB were described as stressful and even unpleasant. Conclusion: CUB is seen as an early way to confirm the pregnancy. To reduce the anxiety, midwives need to give individualised information. Anxiety tends to obscure the pregnancy and remain a long time.

The objective of the work I am hereby presenting was to map pain by women during and after delivery with regards to age, number of births, attendance in prenatal courses and satisfaction of women in labour. The secondary objective was to find out the influence of interpersonal relationships during the hospitalization of the woman in labour and her perception of pain. Methodology: The set-up goals were accomplished through a quantitative research carried out in hospitals across the South Bohemian region with the use of a questionnaire consisting of two parts. The first part included a questionnaire of my own construction and the second part involved a standardized PCS questionnaire dealing with catastrophization of pain. The questionnaire was filled in by women after vaginal delivery with an interval of 48 - 72 hours after birth. Results: The testing sample involved 635 women giving birth in maternity hospitals in South Bohemian region. The average age of the respondents was 29,7. 49,1 % were primiparas and 50,9 % were women giving birth for the second or several times. The results of the research showed that the age of the woman in labour does not affect the perception of pain during the delivery, on the contrary the post-labour pain decreases with the increasing age of women in labour. Primiparas stated bigger pain than women who were giving births for several times. Undergoing the prenatal course did not prove any relationship with regards to pain during the labour. On the contrary the information they had gained in the prenatal course were proved to be beneficial for the evaluation of post-labour pain as respondents who participated in these courses stated lower level of pain in post-labour period. Statistically significant factors that respondents stated as the most helping in relieving pain, was the support of the midwife, communication with the midwife, staying in the shower, support of the doctor and communication with him/her, interpersonal relationships of the medical staff and the environment of the delivery room. The least satisfied with their delivery were women that used pharmacological treatment for reduction of pain. Women with lower stated labour pain described greater satisfaction with birth. The perception of pain during the delivery is influenced also with the interpersonal relationship at that given maternity hospital, on the contrary these relationships do not affect the evaluation of pain in the post-labour period. Conclusion: This thesis provides a view at the problematics of pain during and after delivery. The results of the research showed the important role of the midwife as well as the doctor's role in the process of care of woman in this uneasy period. The midwife not only evaluates the pain, but also offers the possibility of pain relieve and her behaviour can influence this pain.

Bakgrund: Förlossning är en del av transitionen till föräldraskap. Transitionen underlättas genom professionellt stöd. I barnmorskors ansvarsområde ingår det att ge stöd. Det som påverkar pappors förlossningsupplevelser är bland annat professionellt stöd och förväntningar. Förlossningsupplevelser påverkar pappors välmående och föräldraskap. Syfte: Beskriva blivande förstagångspappors förväntningar inför förlossningen. Metod: Kvalitativa semistrukturerade enskilda intervjuer utfördes med sex blivande förstagångspappor, vars kvinnor var i graviditetsvecka 29 till 35. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Blivande pappor har svårt att föreställa sig vad som kommer ske under förlossningen. Förstagångspappor förväntar sig en lugn stund med sin familj efter födseln för att kunna bearbeta att två blivit tre. Blivande pappor förväntar sig att de kommer ha en stödjande roll under förlossningen. De förväntar sig att det kommer vara mycket känslor under förlossningen och barnets första timmar. Barnmorskor förväntas inneha en stödjande roll gentemot både blivande pappor och födande kvinnor. Konklusion: Barnmorskor bör ge stöd till blivande pappor utifrån individuella behov. Professionellt stöd till blivande pappor möjliggör för dem att vara ett stöd till de födande kvinnorna under förlossningen. Förstagångspappor förväntar sig att stöd kommer vara viktigt för att de ska känna sig trygga under förlossningen. / Background: Childbirth is part of the transition to parenthood. The transition is eased by support from midwives. It’s within the midwives area of responsibility to offer support to parents. Childbirth experiences are affected by received support and expectations of labour. Fathers’ childbirth experiences affect their well-being and parenting. Aim: Describe expecting first-time fathers’ expectations of the labour. Method: Qualitative individual semi-structured interviews with six expecting first-time fathers, whose women were in gestational week 29 to 35. The interviews were analyzed using qualitative content analysis. Results: Expecting fathers’ find it hard to imagine what will happen during childbirth. They expect that after the delivery they will be able to have a quiet moment alone with their families to adjust to their new life-situation. Besides this, fathers expect that they will have an important supportive role during childbirth. Midwives are expected to support both the labouring mother and the father during childbirth. Conclusion: Midwives should support parental couples based on their individual needs of support. Support to expecting fathers enables them to be supportive during childbirth. First-time fathers expects support to be important during childbirth to create a feeling of security for themselves.

Bakgrund: Magmuskeldelningen mellan de två rectusbukarna benämns även rectusdiastas (RD) och ökar under graviditeten pga. hormonell och mekanisk inverkan. Återhämtning sker naturligt de första åtta veckorna postpartum men delningen kan kvarstå därefter. I denna studie benämns patologisk diastas för ökad RD. Kvinnor kan påverkas fysiskt och psykiskt av ökad RD och barnmorskor ska enligt ICM kunna identifiera tillstånd som avviker från det normala och vid behov kunna samverka och remittera till andra yrkeskompetenser.Syfte: Syftet med studien var att undersöka barnmorskors och fysioterapeuters erfarenheter av att möta kvinnor med ökad rectusdiastas efter graviditet.Metod: Kvalitativ innehållsanalys inspirerad av Malteruds (2012) analysmetod Systematisk textkondensering (STC) utfördes på data från semistrukturerade fokusgruppintervjuer med sammanlagt nio fysioterapeuter och sju barnmorskor runt om i Mellansverige.Resultat: Fyra övergripande områden identifierades; Ökad kroppsmedvetenhet i dagens samhälle, Syn på ökad RD som symtom på ohälsa, Kunskapsbrist kring ökad RD och inhämtning av kunskap genom eget intresse samt Syn på yrkesansvar och önskan om samarbete och riktlinjer.Slutsats: Barnmorskor och fysioterapeuter upplever låg erfarenhet och kunskapsbrist gällande ökad RD. För en mer patientsäker vård behövs nationella riktlinjer samt ett bättre samarbete.Klinisk tillämpbarhet: Studien kan inspirera arbetsplatser att satsa på interprofessionell fortbildning samt uppmanar till utformning av riktlinjer som grundas på mer omfattande forskning. / Background: The abdominal muscle separation between the two rectus abdominis muscles is also known as diastasis recti (DrA) and expands during pregnancy. The duration of the natural recovery takes approximately eight weeks postpartum, but for some people the separation will remain much longer. In this paper, the diastasis will be referred as an increased DrA. According to ICM, midwives should be able to identify what deviates from normal, and if necessary, to collaborate and refer to other professionals. Aim: The aim of the study was to explore midwives and physiotherapists experiences regarding meeting women with increased diastasis recti after pregnancy.Method: A qualitative content analysis with Malteruds method systematic text condensation (STC) of focus group interviews were conducted with a total of nine physiotherapists and seven midwives around Sweden.Results: Four overall areas were identified; Increased body awareness in today's society, Views of increased DrA as a symptom of illness, The lack of knowledge about increased DrA and the acquisition of knowledge through own interest and Views on professional responsibility and the desire for cooperation and guidelines.Conclusion: Midwives and physiotherapists say they lack experience and knowledge regarding increased DrA. National guidelines and a more improved collaboration is needed for safer patient care.Clinical application: The study can inspire workplaces to invest in interprofessional training and establish guidelines based on more extensive research.

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Submitted by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2017-01-25T14:52:26Z No. of bitstreams: 1 Dissertação - Luciana G. Santos.pdf: 13147155 bytes, checksum: d27c29f49b0af6a8e11de3f6813964cd (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2017-01-25T14:52:41Z (GMT) No. of bitstreams: 1 Dissertação - Luciana G. Santos.pdf: 13147155 bytes, checksum: d27c29f49b0af6a8e11de3f6813964cd (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2017-01-25T14:52:58Z (GMT) No. of bitstreams: 1 Dissertação - Luciana G. Santos.pdf: 13147155 bytes, checksum: d27c29f49b0af6a8e11de3f6813964cd (MD5) / Made available in DSpace on 2017-01-25T14:52:58Z (GMT). No. of bitstreams: 1 Dissertação - Luciana G. Santos.pdf: 13147155 bytes, checksum: d27c29f49b0af6a8e11de3f6813964cd (MD5) Previous issue date: 2016-06-15 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The research aims to understand the historical importance of the role of midwives in the Amazon. To analyze this knowledge / folk do that is the art of midwifery, past knowledge through oral tradition, observation and transmitted from generation to generation. And realize through reports / interviews as midwives learned their craft, identify the main difficulties in trying to ease labor pains, show the risks and complications that the mother and child are exposed at the time of delivery, examine working conditions midwives in the care home birth and the role of the health system in the service of a midwife. Giving voice to these women to be in communities and in urban areas the opportunity to tell their social work to trim child, assisting mothers in antepartum and postpartum care in the protection period, food, prayers and use of herbs as well as assistance to health. With the emergence of medicalization of childbirth, the craft of midwifery has become a formal and professionalized activity, according to the medical discourse to hold the office the midwife need to qualify. / A pesquisa tem por objetivo compreender a importância histórica do papel das parteiras no Amazonas. Analisar esse saber popular que é a arte de partejar, conhecimento passado através da oralidade, observação e transmitido de geração a geração. E perceber através dos relatos/entrevistas como as parteiras aprenderam seu oficio, identificar as principais dificuldades na tentativa de amenizar as dores do parto, mostrar os riscos e complicações que a mãe e o filho estão expostos na hora do parto, analisar as condições do trabalho das parteiras na assistência ao parto domiciliar e o papel do Sistema de Saúde ao serviço da parteira. Dando voz a essas mulheres, que estão nas comunidades e na área urbana, a oportunidade de narrar seu trabalho social de aparar criança, auxiliar as parturientes no pré-parto e pósparto, os cuidados no período de resguardo, alimentação, rezas e utilização das ervas, assim como assistência a saúde da população. Com o surgimento da medicalização do parto, o ofício da parteira passou a ser uma atividade formal e profissionalizada, de acordo com o discurso médico para exercer o ofício a parteira precisar se qualificar.