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Sammanfattning Bakgrund: Senaste tjugo åren har en succesiv minskning av andelen helammade barn i Sverige skett. Kvinnor kan uppleva ett outtalat krav från samhället att amma sitt barn, att hon är en sämre mamma om hon inte lyckas med amningen. Amning kan beskrivas som naturlig och lätt men många kvinnor upplever problem under amningsperioden. Amningsvägledningen tycks inte i tillräckligt stor utsträckning betona de komplikationer som kan uppstå och hur dessa kan hanteras. Syfte: Att kartlägga kvinnors erfarenheter av bristande amningsvägledning i relation till utebliven eller tidigt avslutad amning. Metod: Kvantitativ metod genom webbaserad enkätundersökning. Dataanalys med deskriptiv statistik. Resultat: Totalt inkluderades 116 kvinnor. Majoriteten (75%) rapporterade en positiv inställning till att amma. Tidigare amningserfarenhet har betydelse för amningen av nästkommande barn. Amningsvägledningen från barnmorskan upplevs som bristfällig genom hela vårdkedjan. Över hälften av kvinnorna (55%) ammade inte sitt barn alls eller upp till en månad. Slutsatser: Amningsvägledningen saknade information om eventuella problem som kan uppstå och hur dessa kan hanteras, konkreta tips för att få till en fungerande amning samt stöd och närvaro av barnmorskan vid amningssituationerna. Resultatet kan ge ökad kunskap och förståelse kring kvinnors erfarenheter av amning vilket kan stärka barnmorskor i deras arbete och bemötande av kvinnor. Nyckelord: amningsvägledning, avslutad amning, barnmorska, kvantitativ metod / Abstract Background: Over the past twenty years, there has been a gradual decrease in the proportion of fully breastfed children in Sweden. The woman may experience an unspoken demand from society to breastfeed her baby, that she’s not as good mother if she doesn’t succeed in breastfeeding. Breastfeeding can be described as natural and easy but many women experience problems during the breastfeeding period. The breastfeeding guidance might not sufficiently emphasize the complications that may arise and how these can be addressed. Purpose: To identify women's experiences of lack of breastfeeding guidance in relation to no breastfeeding or early cessation of breastfeeding. Method: Quantitative method through a web-based survey. Data analysis with descriptive statistics. Results: A total of 116 women were included in the study. A majority (75%) reported having positive attitudes towards breastfeeding. Previous breastfeeding experience is important for the outcome of breastfeeding the next child. The breastfeeding guidance from the midwife is perceived as deficient throughout the care chain. Over half of the women (55%) didn´t breastfeed their baby at all or up to a month. Conclusion: The breastfeeding guidance lacked information about problems that may arise and how these can be handled, concrete tips for getting a functioning breastfeeding and support and presence of the midwife in breastfeeding situations. The result can provide increased knowledge and understanding of women's experiences of breastfeeding which can strengthen the midwives in their work and treatment of the woman. Keywords: breastfeeding support, breastfeeding cessation, midwife, quantitative method

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Thesis (M.P.H.M.)--Mahidol University, 1999.

Thesis (M.A. (Population and Reproductive Health Research))--Mahidol University, 1999.

Thesis (M.A. (Health Social Science))--Mahidol University, 2007. / LICL has E-Thesis 0024 ; please contact computer services.

The topic of the diploma thesis is the determination of parenthood in the light of the current status of reproductive medicine. The importance of reproductive medicine is increasing in contemporary society in connection with the growing number of people suffering from infertility. Many infertile couples who have undergone reproductive medicine treatment have become parents through these methods. The question of legal parenthood in connection with the issue of assisted reproduction is the core part of the diploma thesis. The diploma thesis aims to perform a legal analysis of the determination of parenthood to a child born through assisted conception, to point out possible shortcomings in legal regulation and to recommend legislative amendments from the perspective of de lege ferenda. The first chapter explores effective legal regulation of maternity and paternity determination, defining the fundamental kinds of parenthood, because biological, genetic, social and legal parenthood should not be confused. The second chapter deals with assisted reproduction, which specifically manipulates human gametes. Attention is drawn to international and national legal regulation, including the question of legal parenthood of a child that has been conceived in this way. The next part of the thesis deals with...

ABSTRACT Background: In the late 1980s the possibility was raised that periodontal infections could constitute maternal infections so it could influence adversely birth outcomes. Adversely birth outcomes such as preterm infants (born before 37 weeks of gestation). Low birth weight (LBW) (<2500g) is also usual with preterm infants. Transient bacteraemia commonly occurs in subjects with inflamed gingiva (Kinane et al. 2005) and may reach the tissues of the placenta, which could cause inflammatory impetus for labour induction  Aim: The aim of this study was to review published articles during the last ten years to summarize the current research field to elucidate if there is an association between periodontitis and some adverse birth outcomes, specifically low birth weight, pre-eclampsia and pre-term birth. Methods: A literature search was conducted in the database PubMed with the aim to find published articles in which the association between periodontitis and adverse birth outcomes was examined. Human clinical studies that were published within the last ten years, had an abstract available and a minimum of 200 subjects were included. Studies published before 2012 were excluded. Results: Results of the primary search presented 280 articles. Twentyone of these articles fulfilled the inclusion criteria. Two thirds of the included studies could show an association between periodontitis and adverse birth outcomes.  Conclusions: Within the limitations of this paper there is very likely to be an association between periodontitis and adverse birth outcomes in some populations, and under some conditions such as diagnostic criteria for periodontitis.

Internationally as well as in Sweden, efforts for improvement in gynaecological surgery in recent decades have mainly focused on three new treatment concepts: (1) Use of minimally invasive procedures: since there is an interdependency between the extent of surgical trauma and the risk for adverse outcome, increased use of supposedly atraumatic endoscopic procedures has revolutionized several aspects of surgical care (2) A multimodal approach to eliminate harmful procedures in the peri-operative process based on evidence-based principles (3) Introduction of implants to support damaged tissue with synthetic mesh in incontinence and pelvic organ prolapse patients. Research question 1: Is introduction of a minimally invasive operation enough per se or is the measured improvement mediated by elimination of harmful procedures in the perioperative process? Findings: Our study (Paper I) indicates that by applying a multimodal intervention programme for the pre- and postoperative care of patients undergoing supravaginal hysterectomy, the surgical procedure per se is of less importance than generally considered. Patient-related parameters such as length of postoperative hospital stay, number of days at home with need of painkillers, number of days before return to normal activities, and patient satisfaction did not differ between patients undergoing the laparoscopic procedure and patients undergoing abdominal supravaginal hysterectomy. When evaluating a new and presumably improved operative procedure against an established standard procedure, it is mandatory and of fundamental importance that the two methods are aligned in terms of perioperative care provided. Research question 2: Under which circumstances can it be assumed that a new surgical procedure showing promising efficacy in one setting can be reproduced with similar results in a different clinical setting (Paper I)? Findings: The operating surgeons concluded that, in their hands and under local conditions, laparoscopic technique for supravaginal hysterectomy was not superior to traditional open hysterectomy and stopped using laparoscopic technique. It seems necessary, prior to routine use, to monitor, using scientific tools, whether the advantages described in the literature are achievable under local conditions. Research question 3: Do expected advantages of implants outweigh the unwanted effects and complications caused by implants in operations for recurrent cystocele (Paper II)? Findings: Mesh has better durability but more (minor) complications. It is not possible to determine whether mesh is "generally better" than native tissue operation. Some may focus on the improved durability, others on the increased risks. The surgeon must make a risk assessment for each individual case. The patient must be sufficiently informed to understand the risks and make a personal, informed decision whether she wants an augmentation by implant. Essential for this process is a clear, comprehensible picture of both desired and unwanted effects of the planned surgery. In this context, studies like ours might be of use.

abstract: In the last 200 years, advancements in science and technology have made understanding female sexual function and the female body more feasible; however, many women throughout the US still lack fundamental understanding of the reproductive system in the twenty-first century. Many factors contribute to the lack of knowledge and misconceptions that women still have. Discussing sexual health tends to make some people uncomfortable and this study aims to investigate what aspects of somewhat recent US history in women’s health care may have led to that discomfort. This thesis examines the question: what are some of the factors that shaped women’s reproductive medicine in the US from the mid 1800s and throughout the 1900s and what influence could the past have had on how women and their physicians understand female sexuality in medicine and how physicians diagnose their female patients in the twenty-first century. A literature review of primary source medical texts written at the end of the 1800s provides insight about patterns among physicians at the time and their medical practice with female patients. Factors like gendered expectations in medical practice, misconceptions about the female body and behaviors, and issues of morality in sex medicine all contributed to women lacking understanding of sex female reproductive functions. Other factors like a physician’s role throughout history and non-medical reproductive health providers and solutions likely also influenced the reproductive medicine women received. Examining the patterns of the past provides some insight into some of the outdated and gendered practices still exhibited in healthcare. Expanding sexual education programs, encouraging discussion about sex and reproductive health, and checking gendered implicit bias in reproductive healthcare could help eliminate echoes of hysteria ideology in the twenty-first century medicine. / Dissertation/Thesis / Masters Thesis Biology 2019