The aim with my study is to highlight, illuminate and examine the social and maternal health care motivational work of pregnant women with a risk or abuse of alcohol and / or drugs, and what actions can be considered for these women. In addition, the aim is to explore how social services and maternity care might interact in this type of case. The aim is to convey the subjective experience of each of the interviewees. For the purposes of this study, I have chosen to use the qualitative research method. I have interviewed social workers in individual and family care, and midwives. Study interview results show that pregnant misusers priority for both maternity care and social services. By the AUDIT, conducted by the maternal health care, shows that the woman has a risk and / or abuse woman offered a variety of activities that may be in the form of talks, drug testing and treatment. Cooperation is the key to success in this motivational work, and it's mainly collaboration between social services, maternal health and child health care. Cooperation seems to work fine, but could be improved with more time and more staff.

Lönearbete utgör en väsentlig del av de flesta människors liv. Därför är det viktigt för individen och samhället att det finns mening med arbetet, och att det upplevs som meningsfullt. Barnmorskor tillhör en yrkeskategori som upplever sitt arbete som meningsfullt. Syftet med denna kvalitativa intervjustudie var att undersöka vad sex kvinnliga barnmorskor upplever som meningen med sitt arbete ur ett individ- och samhällsperspektiv samt vad de upplever som meningsfullt i arbetet. Genom en fenomenologisk metod framställdes essensen från barnmorskornas upplevelser. Med begreppet Mening i studien avses syftet eller värdet med arbetet och begreppet meningsfull betyder att arbetet har en djupare innebörd. Den teoretiska och begreppsliga referensramen bygger på tre övergripande meningar med arbetet, att arbeta för: 1) Ekonomiska resurser. 2) Sociala behov och självförverkligande. 3) Andra människors behov. Resultatet av studien visar att ur ett individperspektiv upplevde barnmorskorna att meningen med arbetet var att det var omväxlande, vilket innefattar variation i arbetstempo och möten med olika kollegor och patienter. Meningen med arbete ur ett samhällsperspektiv var att skapa positiva upplevelser, som handlar om ett gott bemötande av patienter, vilket skapar positiva bilder i samhället av vården och att få barn. Upplevelser av meningsfullhet består av att det finns ett behov av barnmorskornas kompetens, och att de är involverade i andra människors unika händelse i livet. Barnmorskorna värdesätter att arbeta för andra människor och samhällets nytta, vilket gör att de intar en altruistisk attityd till arbetet. Barnmorskorna arbetar nära livet självt och med sin kompetens gör de viktig skillnad i människors liv, något som bidrar till upplevelsen av ett meningsfullt arbete. / Paid work is a major part of most people’s life. It is therefore important for individuals, and society as a whole, that there is meaning in the work being performed and it is perceived as meaningful. Midwives belong to a category of workers who perceive their work as meaningful. The intention of this qualitative interview study was to explore what six female midwives perceived as the meaning of work from an individual and society perspective. The aim was also to reveal what they perceived as meaningful in their work. By using a phenomenological method the essence of the midwives experiences was revealed. The concept of meaning in this study is to be understood as the aim or value of work. Meaningfulness is the concept used to describe a deeper meaning of work. The theoretical framework is based upon three generalised work aims, working for: 1) Financial resources. 2) Social needs and the need for self fulfilment. 3) Other people’s needs. The result shows that on an individual level the midwives experienced meaning in their work due to its changeable nature, which includes variations in tempo and encounters with different colleagues and patients. The meaning of work on a societal level was to create positive experiences among patients based on how there were treated. Good treatment generates positive images of the health care system and also of having children. Experiences of meaningfulness are based in the patient´s need for the midwives competence, and their involvement in other people’s unique life experience. Midwives value working for other people and benefiting society; this gives them an altruistic attitude towards work. They work with the intimacies of life, and their role influences other people’s lives, which contributes to the midwives feeling of having a meaningful job.

<p>Många studier om föräldraskap är mest fokuserade på mammors upplevelser av graviditet och förlossning. Även om mammorna föder barnen och är i behov av mer vård än papporna, är det två personer som blir föräldrar. Pappor behöver också uppmärksamhet och kunskap för att bli bra föräldrar. Svenska barnmorskor och sjuksköterskor saknar ibland kunskap om mäns upplevelser av graviditet och förlossning. Syftet med denna studie är att belysa blivande/nyblivna pappors upplevelser av barnmorskors/sjuksköterskors bemötande. En litteraturstudie valdes för denna studie. 14 artiklar analyserades och de svarade på studiens syfte. I resultatet framkommer två teman, att bli bekräftad och att få ett stöd och att vara ett stöd, med tillhörande sex underteman. Pappor verkar vara de bortglömda föräldrarna. Många pappor känner att de är utelämnade och känner sig ofta oförberedda på själva förlossningen. Det framkommer även att de pappor som får extra förberedelser känner sig mer säkra under förlossningen och nyföddhetsperioden.</p>

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Background: According to the Swedish Social Board induced abortions are increasing in the modern day society. Nurses who work with in the gynecological department can come across patients seeking care for an induced abortion. Theoretical framework: The findings of the study will be discussed in relation to Peplau's nursing theory, ethical concepts and nursing concepts. Aim: The aim of the literature review was to illuminate the experiences of nurses working with induced abortion. Method: A systematic literature review with an inductive approach was chosen. The findings are based on seven qualitative and two quantitative studies. The articles were assessed through two different modified templates based on qualitative or quantitative design. Findings: Nurses and midwives experienced their work with induced abortions as emotionally stressful. However, it was highlighted that all women have the right whether to choose abortion or to proceed with the pregnancy. Difficulties were identified in coping with abortion work. Such difficulties could easily occur when ethical dilemmas were caused by religion, personal values and experiences. Several coping strategies were identified. However, nurses and midwives aired their views concerning the need of more support from colleagues and the department head. Conclusion: It is clear that nurses are in need of assistance in various forms to ventilate and manage their emotions, in order to promote the professional approach and be able to offer a patient-centered care.

The purpose of this thesis was to explore a collaborative project between Sweden and India, a project that is working with improving maternal health care in India. I focused on investigating how the project worked in practice, how they worked for improving the situation for Indian midwives and for pregnant women. This investigation was performed during a two month fieldwork in India where I got the opportunity to meet and interview several people connected to the project. The focus has been primarily on the “Master Trainers”, i.e. Indian midwives who have taken part in a training program in Sweden and in India, and who will function as teachers to other Indian midwives, regarding their perceptions about the project and its achievements. / Syftet med denna uppsats var att undersöka ett samarbetsprojekt mellan Sverige och Indien, ett projekt som arbetar med att förbättra mödrahälsovården i Indien. Jag fokuserade på att undersöka hur projektet fungerat i praktiken, hur de arbetar för att förbättra situationen för indiska barnmorskor och för gravida kvinnor. Denna undersökning utfördes under ett två månaders fältarbete i Indien där jag fick tillfället att träffa och intervjua flera personer knutna till projektet. Fokus har främst varit på "Master Trainers”, dvs indiska barnmorskor som har deltagit i ett utbildningsprogram i Sverige och i Indien och som kommer att fungera som lärare till andra indiska barnmorskor, om deras uppfattningar kring projektet och dess insatser.

Labor market projections indicate a shortage of health care workers across Canada and around the world. The shortage of healthcare workers is more acute in developing nations, which grapple with weak health systems unable to address high disease burdens. This situation is made worse by the movement of health personnel in search of a better standard of living, access to advanced technology and more stable political conditions in developed countries such as Canada - a process known as ‘brain drain’. Brain drain has been described as ‘a perverse subsidy’ by scholars and identified as disconcerting by the World Health Organization, which calls for the ethical recruitment of internationally educated health professionals. Significant research on the migration and recertification experiences of internationally trained physicians and nurses exists but very little has been written on internationally educated midwives (IEMs). This study uses a social equity framework and insights from Foucauldian and post-colonial feminist research to explore practices of assessment and bridging programs for IEMs; the factors that impede IEM recertification; and the ways Canadian midwifery stakeholders mitigate international migration (brain drain) and poor labor integration (brain waste) of IEMs. Data collection was primarily through key informant interviews and document analysis. The study data - gathered and analyzed in 2011/12 – is reflective of the situation of midwifery during that period. Findings from the study indicate several inequities in the recertification process of IEMs, primarily in the application process to assessment and bridging programs and in financial and geographical constraints. The study also suggests a lack of discernment by midwifery stakeholders between active and passive recruitment, and tacit support of the passive recruitment of IEMs. Questions are also raised regarding the inclusivity of the Canadian midwifery model of practice and illustrate that further research is needed.

Father involvement benefits children, mothers, and themselves in a number of ways. Swedish legislation and Swedish society have promoted father involvement. At the same time, the Swedish child health field has also unequivocally states that both parents should feel welcomed and supported within that sphere. Despite these statements and policies, fathers feel neglected and invisible within and throughout the Swedish child health field, which includes prenatal clinics, birth and labor wards, postnatal clinics, child health centers, and parent support programs. Less is known however about the factors that influence father involvement in the child health centers, especially from the child health nurses’ perspective and the influence of the built environment. Additionally, parent support programs are another way through which parents receive support regarding their young child’s mental health, but very little research has focused on why fathers participate or the thoughts parents have regarding their participation, especially within a Swedish context. The overall aim of this dissertation was to better understand some of the barriers fathers have when trying to participate in the female-dominated world of the Swedish child health field, especially during the child’s preschool years. In Study I, 17 child health nurses were interviewed regarding their thoughts on fathers, and in Study II, 31 child health centers’ built environments were assessed to see how inclusive they were of fathers. In Study III, a parent support program was assessed to see if mothers and fathers had different background characteristics for participating, and Study IV sought to understand the extent to which parents appreciated and used the information from the program. These studies showed that child health nurses welcomed fathers, but did not actively invite them to participate. In addition, 75% of the child health centers did not have representations of fathers, but most child health centers had representations of mothers and/or children. Paternal behaviors positively changed if they were in an environment with either explicit paternal representations or only child representations. Mothers participated in the parent support program for several reasons, including if their child had perceived behavior problems, while fathers participated if they were stressed and perceived their child as having emotional problems. Parents believed the information they learned in the parent support program was valuable, and they continued using some strategies a year after the intervention. Swedish family policies can affect parental involvement within the child health field, but the child health field is less inclusive of fathers than mothers, and it fails to meet the needs of fathers, which can then, in turn, negatively affect maternal, paternal, and child outcomes. Therefore, the Swedish child health field needs to continue working on improving their practices of treating both parents equally.

Dagligen utsätts vi för en stor mängd kemikalier, som har visat sig vara mer eller mindre farliga. Många av dessa kemikalier har en negativ påverkan genom att förgifta miljön men också oss människor. Barn och foster är speciellt utsatta för skadliga kemikalier och främst hormonstörande kemikalier. Detta eftersom de befinner sig i ett kritiskt utvecklingsstadium från fostertiden fram till vuxen ålder. Idag fokuserar mycket av arbetet kring kemikalier på redan födda barn, men mycket lite eller inget arbete görs i förebyggande syfte för att skydda foster under graviditeten. Den yrkesgrupp som träffar gravida och ger råd kring graviditeten är barnmorskor. Därför syftar denna studie till att undersöka hur gravida och barnmorskor upplever kommunikationen mellan dem om skadliga kemikalier. Utöver upplevelsen undersöker också studien vilka hinder och möjligheter som finns för en god riskkommunikation mellan barnmorskor och gravida kring skadliga kemikalier. Det teoretiska perspektivet för uppsatsen är Ulrich Beck och hans teori om risksamhället samt teorier om riskkommunikation. Studien har en kvalitativ ansats och metoderna som har använts är intervju och enkät. Intervjuer för att undersöka barnmorskornas upplevelser och enkäten var en internetbaserad enkät som har figurerat på ett socialt media (Facebook) för att få svar på gravidas upplevelser. Resultatet visar på flera hinder som barnmorskan upplever till exempel tidsbrist, brist på arbetsrutiner, riktlinjer och arbetsmaterial, okunskap och ett bristande intresse hos kollegor och organisation. Upplevda möjligheter är att frågan har börjat väckas. Det finns möjligheter till att utveckla arbetsrutiner och riktlinjer och att alla intervjuade barnmorskor är positiva till att frågan får mer utrymme. Upplevelsen av kommunikationen är bland annat att både barnmorskorna och gravida upplever att debatten och vetenskapen är svår att tolka, det finns en känsla av att det mesta utgör en risk samt att debatten och kommunikationen behöver nyanseras och få en vetenskaplig grund. Studiens slutsatser är att att dagens obefintliga riskkommunikation mellan gravida och barnmorskor bör utvecklas då både barnmorskor och gravida efterfrågar en kommunikation kring riskerna. / We are on a daily basis exposed to a large amount of chemicals that have been shown to be more or less dangerous. Many of these chemicals have a negative effect by poisoning the environment, but also humans. Children and fetuses are especially vulnerable to harmful chemicals and particularly endocrine disrupting chemicals. This is because they are in a critical stage of development from the fetal period to adulthood. Today, much of the work on chemicals are concentrate to already born children, but very little or no work is done as a preventive measure to protect the fetus during pregnancy. Midwives are the profession that meet the pregnant women continuously during the pregnancy and already informs the pregnant woman about different risks associated with the pregnancy. Therefore is the aim of this study to explore how pregnant women and midwives are experiencing their communication on harmful chemicals during pregnancy. In addition to the experience, is the aim to explore obstacles and opportunities that are needed for a good risk communication between midwives and pregnant women about harmful chemicals. The theoretical perspective of this paper is Beck and his "risk society" and theories of risk communication. The study has a qualitative approach and methods that have been used are interview and questionnaire. Interviews to explore midwives’ experiences and the survey were an online survey that has appeared on a social media (Facebook). The result indicates several obstacles that the midwife experience, for example: lack of time, lack of guidelines, work routines and working material. Ignorance and a lack of interest among colleagues and organization. Perceived opportunities are that the question has begun to be brought into action, there are opportunities to develop operating procedures and guidelines and that the interviewed midwives have a positive attitude to give the issue more space. The experience of the communication is that both the midwives and pregnant women perceive that the debate and the science is difficult to interpret, there is a sense that almost everything represents a risk and that the debate and the communication needs to be qualified and have a scientific basis. The study's conclusions are that today's non-existent risk communication between pregnant women and midwives should be developed as both midwives and pregnant women ask for a communication about the risks.

Some scholars, in examining the debate which led up to the Midwives Act of 1902, have portrayed the conflict as a struggle between the monolithic medical profession and midwives. However, this thesis demonstrates that the late nineteenth-century medical profession was still very much divided on the issue of midwifery. There were tensions between various branches and between elite members and general practitioners. Further, the British Medical Association, the General Medical Council, the Lancet and the British Medical Journal all competed for the right to speak for the profession as a whole. In the course of the debate the medical profession caricatured the "mythical" untrained midwife while seeking to impress upon the public their own identity as skilled and caring practitioners. The 1902 Midwives Act, which reveals that Parliament, accepted some, but not all, of the medical profession's claims, signifies both the extent and the limits of the medical profession's influence.