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Article ; Online: Midwives' experiences of encountering immigrant women during labour and birth who do not master the host country's language. A lifeworld hermeneutic study.

Abdulle, Amran Ahmed / Borrego, Natalia / Lundgren, Ingela

2023 Volume 37, Issue 4, Page(s) 1136–1144

Abstract: Background: Immigrant women are in a vulnerable position during labour and birth due to language barriers. Communication with women who do not master the host country's language is difficult for midwives, but there are few studies about midwives' ... ...

Abstract	Background: Immigrant women are in a vulnerable position during labour and birth due to language barriers. Communication with women who do not master the host country's language is difficult for midwives, but there are few studies about midwives' experiences. Aim: To explore Norwegian midwives' experiences of encountering immigrant women during labour and birth who do not master the native language. Method: A hermeneutic lifeworld approach. Interviews with eight midwives working at specialist clinics and hospital maternity wards in Norway. Results: The findings were interpreted based on four concepts in the theory "Birth territory: A theory for midwifery practice" by Fahy and Parrat presented in five themes: language barriers can cause disharmony and prevent participation, language barriers can lead to midwifery domination and poorer care, midwives strive for harmony and to be a guardian, medicalisd birth due to language barriers, and disharmony can lead to crossing boundaries. The main interpretation shows that it is midwifery domination and disintegrative power that are prominent. However, the midwives strived to use their integrative power and be guardians, but in doing so they encountered challenges. Conclusion: Midwives need strategies for better communication with immigrant women involving the women and for avoiding a medicalised birth. To be able to meet immigrant women's needs and to establish a good relationship with them, challenges in maternity care need to be addressed. There are needs of care that focus on cultural aspects, leadership teams that support midwives, and both theoretical and organisational care models that support immigrant women.
MeSH term(s)	Female ; Pregnancy ; Humans ; Midwifery ; Hermeneutics ; Maternal Health Services ; Language ; Emigrants and Immigrants ; Qualitative Research ; Nurse Midwives
Language	English
Publishing date	2023-06-21
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	639217-9
ISSN	1471-6712 ; 0283-9318
ISSN (online)	1471-6712
ISSN	0283-9318
DOI	10.1111/scs.13187
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Article ; Online: Norwegian midwiveś experiences of encounter and support women with fear of childbirth during birth.

Bjørseth, Henrikke / Vinnes Kvarme, Cathrine / Lundgren, Ingela

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

2023 Volume 37, Page(s) 100881

Abstract: Objective: To describe midwiveś experiences of encountering and supporting women with fear of childbirth (FOC) during the birth.: Method: Qualitative study with a phenomenological approach, using 10 individual semi-structured interviews with midwives ...

Abstract	Objective: To describe midwiveś experiences of encountering and supporting women with fear of childbirth (FOC) during the birth. Method: Qualitative study with a phenomenological approach, using 10 individual semi-structured interviews with midwives who had cared for women with FOC during the birth. All midwives worked in birth clinics or maternity wards. The data was analysed using Malterud́s systematic text condensation (STC). Results: The findings present in three main themes: taking on a professional role as a midwife to take care of women; time matters for safety and trust; and to encounter and see women without prejudices. Themes to describe a 'professional midwife' included self-confidence, control, competence/experience, independence, promoting normal birth, and motivation. Time played a crucial role in enabling a calm approach and a relationship built on trust, as well as in creating a sense of continuity and being present. Individual care and equality among the women was of importance to prevent prejudices, as was having control of the term FOC. Self-awareness was also important for evaluating the quality of the relationship, and the midwives' wanted clear guidelines for handling women with FOC. Conclusion: Aspects related to professional midwifery skills, organisational factors such as time to establish safety and trust, and use of the concept of FOC, are all important for midwives when encountering and supporting women with FOC at birth. All these aspects need to be improved in the care of women with FOC, and clearly defined guidelines for handling such cases need to be developed.
MeSH term(s)	Infant, Newborn ; Female ; Pregnancy ; Humans ; Midwifery ; Parturition ; Delivery, Obstetric ; Fear ; Qualitative Research ; Norway
Language	English
Publishing date	2023-06-28
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541869-5
ISSN	1877-5764 ; 1877-5756
ISSN (online)	1877-5764
ISSN	1877-5756
DOI	10.1016/j.srhc.2023.100881
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Article ; Online: Women's lived experiences of induction of labour in late- and post-term pregnancy within the Swedish post-term induction study - a phenomenological study.

Nilvér, Helena / Lundgren, Ingela / Elden, Helen / Dencker, Anna

International journal of qualitative studies on health and well-being

2022 Volume 17, Issue 1, Page(s) 2056958

Abstract: Purpose: There is a trend worldwide to induce pregnant women earlier. However, few studies have focused on women's experiences. The aim was to gain a deeper understanding of women's lived experiences of induction of labour in late- and post-term ... ...

Abstract	Purpose: There is a trend worldwide to induce pregnant women earlier. However, few studies have focused on women's experiences. The aim was to gain a deeper understanding of women's lived experiences of induction of labour in late- and post-term pregnancy. Methods: Phenomenology with a reflective lifeworld approach was chosen as the method. Twelve women participating in a larger study in which women were randomized to either induction of labour in week 41 or to expectant management until week 42, were interviewed one to three months after giving birth. Results: The essence is described as follows: Conclusion: Induced labour presents a challenge to maternity personnel to support the birthing woman's normal progress, not to rush her through labour, and to involve her in the process.
MeSH term(s)	Female ; Humans ; Labor, Induced/methods ; Labor, Induced/psychology ; Labor, Obstetric/psychology ; Parturition/psychology ; Pregnancy ; Pregnant Women/psychology ; Sweden
Language	English
Publishing date	2022-04-10
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2232726-5
ISSN	1748-2631 ; 1748-2623
ISSN (online)	1748-2631
ISSN	1748-2623
DOI	10.1080/17482631.2022.2056958
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Article ; Online: Time-out in prolonged labour: development of a care model to prevent secondary fear of childbirth.

Ringqvist, Anna-Karin / Bergqvist, Liselotte / Brezicka, Thomas / Lundgren, Ingela

BMJ open quality

2022 Volume 11, Issue 4

Abstract: Background: During qualitative improvement work, the statistics at the hospital reveal prolonged labour as one of the major causes of secondary fear of childbirth (FOC). The aim of this improvement work was to develop and implement a care process for ... ...

Abstract	Background: During qualitative improvement work, the statistics at the hospital reveal prolonged labour as one of the major causes of secondary fear of childbirth (FOC). The aim of this improvement work was to develop and implement a care process for prolonged labour to prevent secondary FOC. Materials and methods: To explore the factors behind secondary FOC among multiparous women, a follow-up of referral reasons for 600 women with severe FOC was made between 2015 and 2017 at a Swedish University Hospital. In the group with the most common factor, namely prolonged labour, 41 women were interviewed. From their answers, further research and existing professional knowledge, a care process to prevent secondary FOC was designed, 'Time-out in prolonged labour' (the Time-out). To improve the quality of the care process, the functional resonance analysis method was used. The findings from the interviews were categorised into three themes: lack of involvement; lack of communication and information; and lack of care plan. The women explained that if these areas had been fulfilled, it may have reduced their FOC. Result: To prevent the above-mentioned themes, 'Time-out in prolonged labour' was developed with supporting factors such as gathering the interprofessional team, collecting information, dialogue within the team and the involvement of the women when deciding the care plan. Result after implementation shows a reduction of referral reason due to prolonged labour for women with severe FOC from 28% in 2016 to 8.5% in 2020. Conclusions: The Time-out is a good model to prevent secondary FOC. Central aspects of the model are to ensure women's involvement, good communication and a documented care plan for women in prolonged labour. The supporting factor of interprofessional teamwork is of importance when using the Time-out in practice.
MeSH term(s)	Delivery, Obstetric ; Fear ; Female ; Humans ; Labor, Obstetric ; Parturition ; Pregnancy ; Time Factors
Language	English
Publishing date	2022-10-09
Publishing country	England
Document type	Journal Article
ISSN	2399-6641
ISSN (online)	2399-6641
DOI	10.1136/bmjoq-2022-001853
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Article ; Online: Parents' experiences of the information provided at the antenatal clinic regarding foetal diagnostics - A qualitative interview study.

Carlsson, Ylva / Strömbäck, Pernilla / Lundgren, Ingela

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

2021 Volume 29, Page(s) 100652

Abstract: Objective: This study aimed to examine the pregnant women's and their partner's experience of the information given at the antenatal clinic regarding screening methods.: Methods: A qualitative interview study was conducted in the Gothenburg area in ... ...

Abstract	Objective: This study aimed to examine the pregnant women's and their partner's experience of the information given at the antenatal clinic regarding screening methods. Methods: A qualitative interview study was conducted in the Gothenburg area in Sweden. Ten women and seven partners expecting their first child were interviewed adjacent to the second-trimester ultrasound examination. The data were analysed using qualitative content analysis. Results: The findings present an overall theme, three main categories, and ten subcategories. The overall theme showed a nonhomogeneous and individually based picture concerning the meaning and purpose of the methods, need for improvement of information, parents own information seeking, and the encounter with the midwife was also experienced as an influential encounter. The main categories show that diversity relates to the level of information given, voluntariness, the possibility of abnormal findings, and varying needs to thorough information and pre-existing knowledge. The midwifés impact was related to attitude, openness for questions, time for explanations, and the balance between providing enough information to support without worrying the parents. Conclusions: Although previous research has pointed out a decade ago that information regarding foetal diagnostics is lacking, this study shows that these shortcomings still exist and that improvement is needed. The given information should be explicit concerning the purpose, limitations, and voluntariness of prenatal testing. Sufficient time for questions and discussion is as important as considering the parents' pre-existing knowledge, individual thoughts or questions, and a neutral attitude from the midwife is desirable.
MeSH term(s)	Attitude ; Female ; Humans ; Midwifery ; Parents ; Pregnancy ; Prenatal Diagnosis ; Qualitative Research
Language	English
Publishing date	2021-08-05
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541869-5
ISSN	1877-5764 ; 1877-5756
ISSN (online)	1877-5764
ISSN	1877-5756
DOI	10.1016/j.srhc.2021.100652
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Article ; Online: Working with home birth - Swedish midwives' experiences.

Ahl, Maria / Lundgren, Ingela

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

2018 Volume 18, Page(s) 24–29

Abstract: Objective: The aim was to describe Swedish midwives' experiences of working with home birth.: Methods: Two focus group interviews were conducted with eight home birth-attending midwives. Data were analysed with qualitative content analysis.: ... ...

Abstract	Objective: The aim was to describe Swedish midwives' experiences of working with home birth. Methods: Two focus group interviews were conducted with eight home birth-attending midwives. Data were analysed with qualitative content analysis. Results: Four main categories were identified: the birth as a meaningful moment; to fully focus on the birth; to practise the craft; and not to be part of the health care system. The midwives viewed childbirth as a significant moment that should be conducted on the woman's terms. Working with home birth enabled them to work at their own pace and focus fully on the woman. During home births, they learned more about normal birth, and developed their practical skills and professional knowledge with little reliance on technology. They did, however, not feel fully accepted in the maternity care system. Conclusion: This study contributes to the discussion about midwives' experiences of working with home birth in contexts where home birth is not covered by public health care. The study shows that the work environment influences how midwives perform their craft, how they follow and support normal birth, and how the birth setting influence valuing their work.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Female ; Focus Groups ; Holistic Health ; Home Childbirth ; Humans ; Learning ; Maternal Health Services ; Middle Aged ; Midwifery ; Nurse Midwives ; Pregnancy ; Professional Competence ; Qualitative Research ; Sweden ; Work ; Workplace
Language	English
Publishing date	2018-08-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541869-5
ISSN	1877-5764 ; 1877-5756
ISSN (online)	1877-5764
ISSN	1877-5756
DOI	10.1016/j.srhc.2018.08.006
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Article ; Online: Implementation of a midwifery model of woman-centered care in practice: Impact on oxytocin use and childbirth experiences.

Lundgren, Ingela / Dencker, Anna / Berg, Marie / Nilsson, Christina / Bergqvist, Liselotte / Ólafsdóttir, Ólöf-Ásta

European journal of midwifery

2022 Volume 6, Page(s) 16

Abstract: Introduction: Theoretical models for midwifery have been developed in different countries, but few have been evaluated. This study evaluated the implementation of a midwifery model of woman-centered care (MiMo) in practice.: Methods: A mixed method ... ...

Abstract	Introduction: Theoretical models for midwifery have been developed in different countries, but few have been evaluated. This study evaluated the implementation of a midwifery model of woman-centered care (MiMo) in practice. Methods: A mixed method study based on an implementation of MiMo was carried out in a labor ward at a university hospital in Sweden, with another labor ward as a reference. The qualitative core component was a secondary analysis of focus groups with midwives after the implementation. The supplemental quantitative components were oxytocin use for augmentation of labor and women's childbirth experiences before and after the implementation. Results: The midwives viewed MiMo as a useful tool for comprehending the birthing woman holistically, and for identifying what might disturb the birth process. Hindering factors were a lack of organizational stability and time, and midwives' unwillingness to understand the model. Oxytocin use decreased significantly only in the implementation ward (p=0.002) and a significant difference was found between wards in the post-implementation period (p=0.004). However, logistic regression analyses showed that the interaction between ward and time period, controlling for age, epidural use, and birth outcome, was not significant (p=0.304), indicating that the decrease was not significantly related to the implementation. Childbirth experience did not differ before and after the implementation. Conclusions: By using MiMo in practice, midwives have a tool for comprehending the woman holistically and identifying disturbing factors during the birth. However, more research is needed for further implementation that should focus on the potential as well as hindering factors.
Language	English
Publishing date	2022-04-01
Publishing country	Greece
Document type	Journal Article
ISSN	2585-2906
ISSN (online)	2585-2906
DOI	10.18332/ejm/146084
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Article ; Online: Job satisfaction in midwives and its association with organisational and psychosocial factors at work: a nation-wide, cross-sectional study.

Hansson, Malin / Dencker, Anna / Lundgren, Ingela / Carlsson, Ing-Marie / Eriksson, Monica / Hensing, Gunnel

BMC health services research

2022 Volume 22, Issue 1, Page(s) 436

Abstract: Background: Midwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial ... ...

Abstract	Background: Midwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives' job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks. Methods: This nation-wide, cross-sectional web survey study analysed midwives' assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives' results with Swedish benchmarks. Results: A multivariable regression model with 13 scales explained the variance in job satisfaction (R Conclusions: Midwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.
MeSH term(s)	Burnout, Professional/epidemiology ; Burnout, Professional/psychology ; Cross-Sectional Studies ; Female ; Humans ; Job Satisfaction ; Male ; Midwifery ; Personnel Turnover ; Pregnancy
Language	English
Publishing date	2022-04-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-022-07852-3
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Article ; Online: Swedish women's experiences of doula support during childbirth.

Lundgren, Ingela

Midwifery

2010 Volume 26, Issue 2, Page(s) 173–180

Abstract: Objective: to describe women's experiences of doula support during childbirth.: Design and setting: a qualitative study using a hermeneutic approach. Data were collected via tape-recorded interviews in the women's homes or at a place chosen by the ... ...

Abstract	Objective: to describe women's experiences of doula support during childbirth. Design and setting: a qualitative study using a hermeneutic approach. Data were collected via tape-recorded interviews in the women's homes or at a place chosen by the women, one to eight months after the birth. Participants: nine women, seven primiparous and two multiparous, aged between 15 and 40 years, who had received antenatal care at a special clinic for single mothers in Gothenburg, Sweden between 2006 and 2007. Key findings: the role of the doula lies between natural care and professional care, veering towards professional care. Professional aspects include being a mediator to the unknown, and a human life line to help the woman to play her part in the birth. Furthermore, the doula is a coach who mediates a belief in the woman's capacity to give birth. The midwives' supporting role is not clear to the women, which can be the result of doulas having a more professional supporting role than giving natural care. Midwives are unable to offer continuity of care and constant support during the birth. Implications for practice: the different supporting roles of doulas and midwives in maternity care should be addressed. Furthermore, maternity care should be organised in a way that gives the woman an opportunity to access continuity of care and constant support.
MeSH term(s)	Adaptation, Psychological ; Adolescent ; Adult ; Anecdotes as Topic ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Infant, Newborn ; Labor, Obstetric/psychology ; Midwifery/methods ; Mothers/psychology ; Mothers/statistics & numerical data ; Nurse's Role ; Nurse-Patient Relations ; Nursing Methodology Research ; Pregnancy ; Pregnancy Outcome/psychology ; Surveys and Questionnaires ; Sweden ; Young Adult
Language	English
Publishing date	2010-04
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1036567-9
ISSN	1532-3099 ; 0266-6138
ISSN (online)	1532-3099
ISSN	0266-6138
DOI	10.1016/j.midw.2008.05.002
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Article ; Online: Women's experiences of giving birth and making decisions whether to give birth at home when professional care at home is not an option in public health care.

Lundgren, Ingela

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

2010 Volume 1, Issue 2, Page(s) 61–66

Abstract: Objective: To describe women's experiences of giving birth and making decisions whether to give birth at home when professional care at home is not an option in public health care.: Method: A phenomenological study. Interviews with seven women; four ... ...

Abstract	Objective: To describe women's experiences of giving birth and making decisions whether to give birth at home when professional care at home is not an option in public health care. Method: A phenomenological study. Interviews with seven women; four of them gave birth at home without professional assistant and three at hospital. Results: The essential structure shows that women live with huge contrasts between an inner and outer image of birth. They express trust towards themselves and giving birth, as well as to their own decision whether hospital care is needed or not. Birth can be empowering and strengthening, and is of importance for bonding with the child. In contrast, an outer image coming from the public and healthcare is characterized by risk, danger and fear of childbirth. Birth is viewed as something draining. The women waited with their decision where to give birth, in some cases until the contractions have started. The women felt left alone and punished. They also met supportive midwives and physicians who represented a personal perspective. In contrast, as a group, they were experienced as insecure and representative for the healthcare system. Conclusion: The implication is to meet, and give a secure care to women with contrasting views of childbirth and not only to the large majority. Midwives and physicians should establish a trustful relationship with the women and know that they can be experienced as trustful even if they do not express a positive attitude towards giving birth at home.
MeSH term(s)	Attitude ; Decision Making ; Female ; Home Childbirth/psychology ; Humans ; Midwifery ; Pregnancy ; Social Support ; Spouses/psychology
Language	English
Publishing date	2010-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541869-5
ISSN	1877-5764 ; 1877-5756
ISSN (online)	1877-5764
ISSN	1877-5756
DOI	10.1016/j.srhc.2010.02.001
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