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Nujni carski rez ima za žensko lahko veliko negativnih psiholoških posledic. Eden ključnih dejavnikov, ki vplivajo na doživljanje poroda, je okolje, v katerem ženska rodi. Pomembno je tako širše okolje, kultura, iz katere porodnica izhaja, kot tudi specifično okolje porodnišnice, v kateri rodi. Ženske namreč svojo predstavo o porodu zgradijo na podlagi javnega diskurza o porodu, ki je v Sloveniji bolj naklonjen vaginalnemu porodu, v porodnišnici pa prevladuje biomedicinski diskurz, ki zagovarja rabo medicinskih intervencij, med katere spada tudi carski rez. Zaradi neizpolnjene predstave o porodu pogosto pride do občutka izgube nadzora, ki je najpomembnejši dejavnik za slabši psihološki izid poroda. V magistrskem delu sem raziskovala pomen predstav o porodu in različne porodnišnične prakse pri izkušnji carskega reza. V kvalitativni raziskavi sem uporabila kavzalno neeksperimentalno metodo. Opravila sem tri skupinske intervjuje s skupno 11 ženskami, ki so rodile z nujnim carskim rezom v ljubljanski, postojnski ali jeseniški porodnišnici. Ugotovila sem, da so ženske po carskem rezu občutile veliko različnih čustev, kot so strah, žalost, jeza, razočaranje, stres, nesposobnost in manjvrednost, kljub temu pa je bilo najbolj pogosto čustvo veselje. Porodnice so največji vpliv pripisovale odnosu zdravstvenih delavcev do njih, pa tudi porodnišničnim protokolom, kot sta sprožanje in pospeševanje poroda, vrsti uporabljene anestezije, prvemu stiku z otrokom po porodu in bivanju v porodnišnici. Prav tako so se vse spoprijemale z neizpolnjenimi pričakovanji o porodu, saj so si vse predstavljale, da bodo rodile vaginalno. Doprinos magistrskega dela vidim v osvetlitvi konteksta izvajanja nujnega carskega reza in možnih negativnih posledic, k čemur lahko prispevajo porodnišnice s svojimi praksami. Psihološke posledice carskega reza vplivajo tako na delovanje mame kot tudi otroka, zato je tej tematiki pomembno posvetiti pozornost. Emergency cesarean section can have a lot of negative psychlogical consequences for a woman. One of the key factors, that effect woman's birth experience is the enviroment in which she gives birth. Both the enviroment she comes from and the enviroment she gives birth in are important for her experience. Women build their expectations of their birth experience on publick discourse about birth, and in Slovenia public discourse is more on the side of vaginal birth. And the discours in the maternity ward is biomedical, which means it promotes the use of medical interventions such as cesarean section. If the woman's expectations of her birth experience aren't met it can often lead to the sense of loss of control and the loss of control is the most important factor for poor psychological outcome of birth. in my masters thesis I am going to explore the impact of women's expectations about birth experience and different maternity hospital practices on woman's experience of cesarean section. Empirically I researched this with three group interviews with 11 women who gave birth via emergency cesarean section in maternity hospitals in Ljubljana, Postojna and Jesenice. Women felt a lot of different emotions after cesarean, such as fear, sorrow, anger, disapointment, stress, incompetence and inferiority, the most common emotion was joy. Medical staff and hospital protocols had the biggest impacts on the emotional outcome. All of them also faced unmet expectations about their delivery, because they all imagined giving birth vaginaly. But despite all the negative emotions and having given birth via cesarean section non of them suffered from psichological disorders such as postpartum depression, PTSD or postpartum psychosis. This subject is important, because the psychological consequences of cesarean section impact functioning of mother and baby. The importance of this masters thesis is enlightening the context of emergency cesarean section and possible negative outcomes of it on which maternity hospitals have a great impact with their protocols.

Porod in rojstvo otroka je občutljivo in ranljivo obdobje za žensko, novorojenčka in celotno družino. Rojstvo prvega otroka pomeni vzpostavitev družinskega sistema, v katerem se na sistemski, interpersonalni in intrapsihični ravni odzrcalijo koncepti in mehanizmi, s katerimi se ukvarja relacijska družinska terapija. Ta zmore z njimi poiskati pot razrešitve bolečih psihičnih vsebin in privesti do razbremenitve sistema. Ob prehodu v starševstvo prihajajo boleča afektivna občutja posebej do izraza, vendar je navadno v središču pozornosti zunanjega sveta rojstvo otroka, in ne počutje njegovih staršev ter vzdušje v družini. Središče raziskovalnega polja v doktorskem delu pa je prav ženska, ki s porodom kot točko prehoda stopi v svet nežnega, sočutnega in čustveno kompetentnega materinstva ali pa se v vrtincu različnih dejavnikov tveganja znajde v globini porodne travme, ki se kaže na različne načine disfunkcionalnega čutenja, odzivanja in vedenja. Porodni proces lahko pusti nezadovoljive občutke, ki pa kmalu izzvenijo, a se zgodi, da porod sproži tudi potlačene in nezavedne vsebine preteklosti, ki se ob intenzivni fizični in psihični preizkušnji poroda aktivirajo in vodijo v disfunkcionalne odnose. Doktorsko disertacijo z naslovom Doživljanje materinstva in podporni model terapevtske obravnave na prehodu v starševstvo pri ženskah z izkušnjo rojstva otroka s carskim rezom sestavljata teoretični in empirični del. V doktorskem delu je prikazan in kritično ovrednoten praktični preizkus celostne zdravstveno-terapevtske obravnave s PMTO. Iz celotne doktorske disertacije izhaja ugotovitev, da gre za inovativno obravnavo žensk in novorojenčkov po porodu, saj zajema dognanja in strategije več strokovnih področij oz. metod: zdravstvene obravnave, babištva, NBO ter relacijska družinska terapija. Dokazana je njena učinkovitost v primeru mater, ki so rodile s carskim rezom, in hkrati nakazana možnost za uporabo tudi pri drugih načinih poroda in prehoda v starševstvo. Njena uporaba v klinični in terapevtski praksi je prispevek h krepitvi duševnega zdravja nosečnic, porodnic in otročnic, njihovih novorojenih otrok ter družin. The birth of a child is a delicate and vulnerable time for the woman, the newborn and the whole family. The birth of the first child creates a family system in which the concepts and mechanisms that Relational Family Therapy deals with are reflected at the systemic, interpersonal, and intrapsychic levels. This therapy is used to help family members find a way to resolve painful psychological content and liberate the system. Painful affective emotions are especially pronounced during the transition to parenthood, but the attention of the outside world is usually focused on the birth of the child rather than on the well-being of the parents and the family atmosphere. The focus of the research field of this dissertation is the woman who enters the world of tender, compassionate, and emotionally competent motherhood with childbirth as a transition point or who finds herself in the depths of birth trauma in a vortex of various risk factors that manifests itself in various types of dysfunctional feelings, reactions, and behaviours. The birth process usually leaves unsatisfactory feelings and experiences that are temporary in nature, but it also happens that birth triggers repressed and unconscious contents of the past that are activated by the intense physical and psychological ordeal of birth and lead to dysfunctional relationships. The dissertation, entitled »Experience of Motherhood and a Supportive Therapeutic Model in the Transition Period to Parenthood in Women with the Experience of Giving Birth by Caesarean Section« consists of a theoretical and an empirical section. The dissertation presents and critically evaluates a practical test of integrated medical-therapeutic treatment with PMTO. The dissertation concludes that it is an innovative approach to the treatment of postpartum women and newborns because it integrates the knowledge and strategies of several professional fields or methods: Midwifery, NBO, and Relational Family Therapy. It has been shown to be effective with mothers who have delivered by caesarean section, but also demonstrates the possibility of using it with other delivery methods and in the transition to parenthood. Its use in clinical and therapeutic practice contributes to the mental health of pregnant and postnatal women, their newborn children, and families.

Uvod: Medtem ko se na porod ženske in pari veliko pripravljajo, se poporodnemu obdobju posveča veliko manj pozornosti. Zato bi bilo pomembno, da se zagotovi poporodna oskrba, ki bi zajemala predvsem pogovor o porodu ali t. i. »poporodni debriefing« ta bi ženskam pomagal predelati porodno izkušnjo, v sodelovanju z usposobljenim strokovnjakom. Namen: Namen diplomskega dela je raziskati, kakšno potrebo imajo ženske po pogovoru o svoji porodni izkušnji, koliko žensk se je o svojih porodih pogovarjalo in s kom. Namen dela je tudi pomagati zdravstvenim delavcem pri razumevanju žensk in njihovih potreb, s ciljem zagotavljanja najboljše poporodne pomoči. Metode dela: Izveden je bil pregled literature po svetovnih podatkovnih bazah, Medline, Science Direct, CINAHL in Pubmed ter metaiskalnikih Google učenjak in DiKul. Na podlagi pridobljenih informacij je bilo zastavljeno raziskovalno vprašanje, s štirimi hipotezami. Odgovore smo pridobili s pomočjo spletne ankete 1ka. Sledila je analiza rezultatov z osnovno deskriptivno statistiko. Rezultati: Anketo je v celoti izpolnilo 1762 anketirank. Največ anketirank je spadalo v starostno skupino 26-30 let (39 %), najmanj pa je bilo tistih v starostnih skupinah do 18 let in nad 46 let. Anketiranke so v 87 % odgovorile, da so se o svojem porodu pogovarjale. Med tistimi, ki se niso, pa si jih je 87 % vseeno želelo pogovora o svoji porodni izkušnji. Kot najbolj zaželen sogovornik so bili označeni prijatelji in družina. Tiste anketiranke, ki se o svojem porodu niso pogovarjale, pa so si najbolj želele pogovora z babico. Po pričakovanju je večina anketirank svoj prvi porod ocenila kot srednje težek. Razprava in zaključek: Dve hipotezi sta bili potrjeni in dve ovrženi. Večina žensk je rada slišanih in razumljenih, predvsem rade pa govorijo o pomembnih življenjskih preizkušnjah in prelomnicah, kot je porod. Pomembno je, da se preko predelave porodne izkušnje z usposobljenim zdravstvenim delavcem žensko opolnomoči in se ji pomaga pri razumevanju dogajanja med porodom. Ravno tako je pomembno nadaljnje raziskovanje, ki bi ponudilo boljši uvid v problematiko pomanjkanja strokovno vodenih pogovorov po porodu. Introduction: Although women and couples often prepare for birth, not much of attention is given to the postpartum period. That is why it is important to establish postpartum care which includes postpartum debriefing. This would give women an opportunity to process their birth experiance with the help of a professional. Purpose: Purpose of this diploma work is to explore the need for postpartum debriefing, how many women talk about their birth experiance and with whom. Purpose is also to help health workers undertstand the women's needs so that they can help them postpartum in the best way they can. Methods: First, a literature review was conducted with sources from the databases Medline, Science Direct, CINAHL, Pubmed, Google scholar and DiKul. Then a questionnaire was made based on the literature review and the four hipotheses were formed. The questionnaire is an original work and was not based on any other questionnaires. Furthermore, an analysis of the results was performed with basic descriptive methods. Results: Questionnaire was fully completed by 1762 women. Most of the women who completed the questionnaire were aged between 26 and 30 years (39 %), the lowest proportion of women were aged below 18 years or over 46 years. 87 % of women answered that they did talk about their birth experiance. Among those who did not talk about it, 87 % of them wished they would have. People who were most desired to talk to were friends and family. Among those who did not talk about birth experiance but wanted to, a midwife was most desirable to talk to. Like expected, most of the women rated their first birth as medium hard. Among women who rated their first birth as exteremly hard or traumatic many of them still decided to have more kids. Discussion and conclusion: Big desire and wish for the conversation about birth experiance confirmed our hipotheses. Most women like to be heard and listened to, especially when it comes to a big life events such as birth. It is important that with a talk with health care professional - midwife – women get empowered and understand what was happening during birth. It is important to do further research on the topic which would help us further evaluate importance of postpartum debriefing.

Uvod: Množični mediji so ena od redkih priložnosti, ko lahko ženska porod vidi, preden ga doživi sama. Porod je v množičnih medijih pogosto prikazan nerealistično, s tem pa vpliva na vedenje in dejanja posameznikov v porodnem procesu. Namen: Namen diplomskega dela je raziskati reprezentacijo poroda v množičnih medijih na podlagi pregleda znanstvene literature, cilj pa ugotoviti kakšen je način reprezentacije poroda v množičnih medijih, kateri dejavniki vplivajo nanjo in kakšne so posledice tovrstne reprezentacije poroda za ženske ter njihove porodne izkušnje. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda dela s pregledom strokovne in znanstvene literature, ki obravnava reprezentacijo poroda v množičnih medijih. Znanstveno literaturo smo iskali s funkcijo naprednega iskanja v spletnih bibliografskih podatkovnih bazah DiKUL, EBSCO Information Services, Google Scholar, ProQuest, PubMed, ResearchGate, ScienceDirect in SpringerLink v obdobju od 2. decembra 2021 do 8. marca 2022. Kriteriji izbire so bili vsebinska ustreznost in relevantnost ter polna dostopnost do vsebine virov v slovenskem ali angleškem jeziku, s časom objave med letoma 2012 in 2022. Rezultati: V pregled literature je bilo vključenih 26 raziskav, ki so ustrezale vsem vključitvenim kriterijem. Večina raziskav je bila presečnih, najpogosteje sta bili uporabljeni deskriptivna metoda dela in analiza virov. Reprezentacije poroda v množičnih medijih postavljajo normativ medikaliziranega poroda, alternativne možnosti pa so prikazane redko in nejasno, na kar lahko pomembno vpliva sodelovanje babiške stroke z medijskimi producenti. Množični mediji s svojimi reprezentacijami poroda vplivajo na pričakovanja in odločitve, ki se jih ženske poslužujejo v nosečnosti in med porodom ter v njih pogosto vzbujajo strah. Razprava in zaključek: V prevladujočih reprezentacijah poroda, ki jih ponujajo množični mediji, so prisotne mnoge vrzeli in manjkajoče informacije. Pomembno je ozaveščanje žensk, babiške in porodniške stroke ter medijskih producentov za kritično in odgovorno delovanje na področju reprezentacije poroda v množičnih medijih, s širjenjem verodostojnih in strokovnih informacij, ki bodo ženskam omogočile pozitivne in na znanju temelječe porodne prakse, brez nepotrebnega strahu. Introduction: Mass media is one of the few opportunities a woman has to see childbirth before she experiences it by herself. Childbirth in the mass media is often portrayed in an unrealistic way which influences the behaviour and actions of individuals in the birthing process. Purpose: The aim of the thesis is to investigate the representation of childbirth in mass media, based on a review of the scientific literature. The objective is to find out how childbirth is represented in the mass media, what factors influence this representation and what the consequences of this representation of childbirth are for women and their experiences of childbirth. Methods: The descriptive method of work was used in the thesis, focusing on a review of professional and scientific literature of the childbirth representation in the mass media. The online bibliographic databases DiKUL, EBSCO Information Services, Google Scholar, ProQuest, PubMed, ResearchGate, ScienceDirect and SpringerLink were used from December 2nd 2021 to March 8th 2022. The advanced search function was used. The criteria for selecting the scientific literature were relevance and pertinence of the content and full accessibility to the content of the sources in Slovenian or English, with a publication time between 2012 and 2022. Results: The literature review included 26 studies that met all the criteria. Most of the studies were cross-sectional, with descriptive methods and source analysis being the most commonly used. Representations of childbirth in the mass media set the norm for medicalised childbirth, alternatives are rarely and ambiguously portrayed. This may be significantly influenced by midwifery's engagement with media producers. Mass media representations of childbirth influence women's expectations and choices during pregnancy and childbirth and often provoke fear. Discussion and conclusion: There are many gaps and missing information in representations of childbirth, offered by the mass media. It is important to raise awareness among women, midwifery and obstetric professionals and media producers to act critically and responsibly in the field of representation of childbirth in the prevailing mass media, by disseminating credible and expert information that will enable women to have positive and knowledge-based childbirth practices, without unnecessary fear.

Uvod: Babiška nega v zdravstvenem sistemu obravnava ženske med nosečnostjo, porodom, poporodnim obdobjem ter novorojenčka in dojenčka s ciljem, da se ohrani oziroma doseže najboljše zdravje, posega pa tudi na področje ginekologije in načrtovanja družine. Klinične poti je mogoče opredeliti kot dokumentirano zaporedje kliničnih posegov, umeščeno v ustrezen časovni okvir, ki ga je napisala in odobrila multidisciplinarna ekipa. Pomagajo pacientu s specifičnim stanjem ali diagnozo pri postopnem premikanju skozi klinično obravnavo do želenega izida. Klinične poti predstavljajo idealne poti pacientov. Navajajo določeno zaporedje zdravstvene obravnave, ki jo tudi dokumentirajo. Namen: Namen diplomskega dela je bil pregledati literaturo in se usmeriti na to, kakšna je vloga babice pri izvajanju kakovostne babiške nege v porodni sobi s pomočjo klinične poti. Metode dela: Uporabljena je bila deskriptivna metoda dela s kvalitativnim pristopom pregleda domače in tuje strokovne literature v obdobju od 2012 do 2022. Rezultati: V pregled literature je bilo vključenih šest člankov. Babice s svojim širokim spektrom znanja, s kompetencami in veščinami skrbijo za starše in novorojenčka. Cilj klinične poti je podpreti babice pri spodbujanju fiziološkega poroda, s končnim namenom zmanjšanja nepotrebnih porodniških posegov, pomaga k babiškemu pristopu s podpiranjem fiziološkega poroda, manj dokumentacije in zagotavlja podporo diplomiranim babicam pri sprejemanju kliničnih odločitev. Klinična pot za normalen porod vodi izvajalca babiške nege/babico pri obravnavi zdrave nosečnice, zdrave porodnice z zdravim novorojenčkom, s fiziološkim poporodnim potekom in omogoča prepoznavo zapletov. V vsakem koraku je možen izstop iz klinične poti za normalen porod v intenzivnejšo zdravstveno obravnavo. Razprava in zaključek: Klinične poti so lahko osredotočene na specifične perinatalne epizode, kot je poporodna obravnava ali popolna babiška obravnava od sprejema do odpusta. Porod je zapleten, večplasten dogodek s kompleksnimi rezultati. Klinične poti v porodni sobi povečujejo zaupanja babic v podporo normalnemu porodu in legitimizacijo običajnega babiškega pristopa k porodu. S klinično potjo babice dobijo občutek, da imajo svobodo pri babiški obravnavi, zato je prisoten občutek večjega zaupanja, zlasti pri mladih diplomiranih babicah. Introduction: Midwifery care in the health care system treats women during pregnancy, childbirth, the postpartum period, and newborns and babies with the goal of maintaining or achieving the best health, and also intervenes in the field of gynecology and family planning. Clinical pathways can be defined as a documented sequence of clinical interventions, placed in an appropriate time frame, written and approved by a multidisciplinary team. They help a patient with a specific condition or diagnosis move step by step through clinical management to a desired outcome. Clinical pathways represent ideal patient pathways. They indicate a certain sequence of medical treatment, which they also document. Purpose: The purpose of the thesis was to review the literature and focus on the role of the midwife in the implementation of quality midwifery care in the delivery room with the help of the clinical pathway. Work methods: A descriptive work method was used with a qualitative approach of reviewing domestic and foreign professional literature in the period from 2012 to 2022. Results: Six articles were included in the literature review. Midwives take care of parents and newborns with their wide spectrum of knowledge, competences and skills. The goal of the clinical pathway is to support midwives in promoting physiological birth, with the ultimate aim of reducing unnecessary obstetric interventions, it helps the midwifery approach by supporting physiological birth, less documentation and provides support to graduate midwives in making clinical decisions. The clinical pathway for a normal birth guides the midwife/midwife in dealing with a healthy pregnant woman, a healthy woman in labor with a healthy newborn, with a physiological postpartum course and enables the recognition of complications. At each step, it is possible to leave the clinical path for a normal birth to a more intensive medical treatment. Discussion and conclusion: Clinical pathways can be focused on specific perinatal episodes, such as postnatal care or full midwifery care from admission to discharge. Childbirth is a complex, multifaceted event with complex outcomes. Clinical pathways in the delivery room increase midwives' confidence in supporting normal birth and legitimizing the normal midwifery approach to birth. Through the clinical pathway, midwives get the feeling that they have freedom in midwifery, so there is a sense of greater trust, especially among young graduate midwives.

Različne feministične analize naravne procese nosečnosti, poroda in plodnosti širše obravnavajo na izrazito heterogen način pomembno vlogo pri tem ima odnos do znanosti in tehnologije, ki predstavljata možnost nadzorovanja in obvladovanja teles. Magistrsko delo se osredotoči na očitke medikalizacije in problematizira ideal naravnega poroda. Vloga znanosti je obravnavana z vidika objektivnosti, nezdružljivosti paradigem in pomensko zaznamovanih simptomov. Odklonilen odnos do zdravstvene obravnave je povezan s problemom paternalizma v medicini, ob katerem naravni porod predstavlja alternativo nadzoru. Različne oblike paternalizma niso omejene na odnos med zdravstvenim osebjem in pacientom prisotne so tudi v gibanjih za naravni porod. Podoba kiborga ni obravnavana kot grožnja in skrajna posledica pretirane uporabe tehnologije, pač pa je sprejeta kot ena od možnih strategij preseganja vprašljive dihotomije med naravo in tehnologijo. Feminist analyses offer widely different approaches to the natural processes of pregnancy, childbirth, and fertility in general, with a key question being the attitude towards science and technology as a way to monitor and control bodies. The thesis focuses on the accusations of medicalization and questions the ideal of natural childbirth. The role of science is examined in terms of objectivity, incompatible paradigms, and symptoms inscribed with meaning. Reluctance to accept medical care is associated with the issue of paternalism in medicine, resulting in natural childbirth being presented as an alternative to control. Various forms of paternalism are not limited to the patient's relationships with healthcare staff they are present in advocacy for natural childbirth. The image of a cyborg is not treated as a threat or the extreme result of technology (over)use – it is instead embraced as a possible strategy for overcoming the questionable nature/technology dichotomy.

Uvod: Porodna bolečina je za razliko od druge akutne ali kronične bolečine nekaj popolnoma fiziološkega in najbolj osnovna človeška izkušnja. Porodno bolečino vsaka ženska dojema in doživlja drugače. Doživljanje intenzivnosti bolečine ni enako doživljanju neprijetnosti bolečine. Porod je sam po sebi kompleksen proces in je izkušnja bolečine pri ženskah pogojena tudi z dejavniki iz njenega življenja ter podporo med porodom. Namen: Namen diplomskega dela je s pomočjo pregleda literature obravnavati porodno bolečino in raziskati doživljanje porodne bolečine pri ženskah v času rojevanja ter identificirati dejavnike, ki vplivajo na porodno izkušnjo. Metode dela: Uporabljamo deskriptivno metodo dela s pregledom znanstvene in strokovne literature na temo porodne bolečine ter doživljanja poroda in porodne bolečine z vidika žensk. Iskanje literature smo omejili na deset let, med leti 2012 in 2022. Literaturo smo zajeli po različnih podatkovnih bazah: MEDLINE, PubMed, Science Direct, CINAHL in Google Učenjak. Za odgovarjanje na raziskovalna vprašanja smo opravili sistematični pregled literature, ki je bila ovrednotena po štiristopenjski lestvici glede na moč dokazov. Rezultati: V končno vsebinsko analizo smo vključili 11 virov. Rezultati kažejo, da na doživljanje poroda in porodne bolečine vpliva priprava ženske na porod, njeno dojemanje že pred začetkom poroda in kakšen pomen tej bolečini poda. Ženske, ki so imele glede poroda pozitivna pričakovanja, so doživljale porod bolj pozitivno, lažje so prenašale porodno bolečino in sledile navodilom babice. Ženske, ki so imele hud strah pred porodom, so bolečino težje prenašale, pogosteje so prosile za farmakološko lajšanje bolečine. Na pozitivno ali negativno izkušnjo poroda vplivajo ženskini notranji dejavniki in zunanji dejavniki okolja. Najpomembnejši dejavnik je tako odnos zdravstvenih delavcev kot tudi vključevanje žensk v odločanje glede obravnave med porodom in prisotnost partnerja. Razprava in zaključek: Pomembna je predporodna priprava in izobraževanje žensk o poteku poroda. Ženske, ki so imele veliko informacij že pred porodom, so porodno bolečino lažje prenašale in so imele boljšo izkušnjo poroda. Zdravstveni delavci lahko pomembno vplivajo na izkušnjo poroda, s pozitivnim odnosom do ženske in z upoštevanjem njenih želja glede poroda. Introduction: Childbirth pain is unlike other acute or chronic pain, something completely physiological and the most basic human experience. Every woman perceives and experiences childbirth pain differently. Experiencing the intensity of pain is not the same as experiencing the discomfort of pain. Childbirth is in itself a complex process and the experience of pain in women is also conditioned by factors from her life and support during childbirth. Purpose: The purpose of the diploma thesis is to present labour pain with the help of a literature review and to investigate the experience of labour pain in women during childbirth and to identify factors that affect the birth experience. Methods: We use a descriptive method of work with a review of scientific and professional literature on the topic of childbirth pain, and the experience of childbirth and childbirth pain from the perspective of women. We limited the search for literature to ten years, between 2012 and 2022. We searched the literature in various databases: MEDLINE, PubMed, Science Direct, CINAHL and Google Scholar. To answer the research questions, we prepared a systematic review of the literature, which was evaluated on a four-point scale according to the strength of the evidence. Results: 11 sources were included in the final content analysis. The results show that the experience of childbirth and childbirth pain is influenced by a woman's preparation for childbirth, her perception before the birth and what importance she gives to this pain. Women who had positive expectations about childbirth, experienced childbirth more positively, tolerated labour pain more easily and followed the midwife’s instructions. Women who had a severe fear of childbirth found the pain more difficult to tolerate and more often asked for pharmacological pain relief. The positive or negative experience of childbirth is influenced by a woman’s internal and external environmental factors. The most important factor is the attitude of health professionals, as well as the involvement of women in decision-making regarding treatment during childbirth, and the presence of a partner. Discussion and conclusion: Prenatal preparation and education of women about the course of childbirth is important. Women who had a lot of information before childbirth found it easier to tolerate childbirth pain and had a better birth experience. Healthcare professionals can have a significant impact on the experience of childbirth by having a positive attitude towards women and by taking into account her wishes regarding childbirth.

Uvod: Posttravmatska stresna motnja je duševna motnja, ki se lahko pojavi pri osebah po izpostavljenosti travmatični izkušnji ali dogodku. Tudi porod se lahko razume kot povod za posttravmatsko stresno motnjo, če ga ženska tako doživi. Porodna travma je lahko objektivna, ko pride pri porodu do zapletov, ali pa subjektivna, ko ženska porod dojema kot stresni dogodek, čeprav poteka brez zapletov. Ta stresna motnja ovira ženskino vsakodnevno delovanje uničevalen vpliv ima tudi na medsebojne odnose, predvsem na odnos s partnerjem ter otrokom. Namen: Z diplomskim delom smo želeli opredeliti pojem manj poznane poporodne posttravmatske stresne motnje ter določiti vlogo medicinske sestre pri bolj okrnjenih temeljnih življenjskih aktivnostih. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo in pregledali literaturo, objavljeno med leti 2009-2022. Uporabili smo vse dostopne članke, objavljene v angleškem ali slovenskem strokovnem jeziku, ki so bili skladni z vsebino teme. Do njih smo z oddaljenim dostopom Univerze Ljubljana dostopali v podatkovnih bazah Cinahl, Medline, ScienceDirect, Wiley online library ter v spletnem brskalniku Google učenjak. Iskanje literature je potekalo od februarja do aprila 2022 za diplomsko nalogo smo na koncu uporabili 50 enot literature. Razprava in zaključek: Identifikacija pacientk, ki so ogrožene v smislu razvoja poporodne posttravmatske stresne motnje je ključnega pomena. Medicinske sestre, zaposlene na perinatalnih področjih, so postavljene v položaj, da jih z opazovanjem ter ustrezno komunikacijo prepoznajo in omogočijo nadaljnjo oskrbo tudi po odpustu iz porodnišnice. S pacientko moramo vzpostaviti zaupljiv odnos, v katerem se bo počutila varno in nam lahko opisala svojo porodno izkušnjo. Če se poporodna posttravmatska stresna motnja razvije, se pri teh pacientkah pojavljajo težave predvsem pri življenjskih aktivnostih spanja, čustvovanja ter medsebojnih odnosih, gibanja in rekreacije ter prehranjevanja. Medicinska sestra mora v tej fazi izvajati predvsem svetovanje ter zdravstveno-vzgojno izobraževanje, da se bo pacientka lahko s simptomi posttravmatske stresne motnje učinkovito spopadala in ta ne bo prizadela kvalitete njenega življenja. Introduction: Post-traumatic stress disorder is a mental disorder that can occur in individuals after exposure to a traumatic experience or event. Childbirth can be a cause of post-traumatic stress disorder too if a woman perceives it to be traumatic. Childbirth trauma can either be objective or subjective. Complications in birth are not necessary for a woman to perceive birth as a traumatic experience as it can be a matter of personal experience as well. This stress-related disorder interferes with a woman's daily activities and has a devastating effect on interpersonal relationships, especially with her partner and child. Purpose: The purpose of the bachelor’s thesis was to define the concept of lesser-known postpartum post-traumatic stress disorder and to determine the role of a nurse in the basic life activities of a patient with this illness. Methods: We used the descriptive method and reviewed the literature published between 2009-2010. We used fully accessible articles published in English or Slovenian language. Articles also had to be relevant to the topic of our bachelor’s thesis. We used remote access to the University of Ljubljana to browse databases Cinahl, Medline, Wiley online library, Science direct, and web browser Google Scholar. The literature search took place from February to April 2022. For the bachelor’s thesis, we finally used 50 units of literature. Discussion and conclusion: Identification of patients at risk for developing postpartum post-traumatic stress disorders remains crucial. Perinatal nurses are placed in an ideal position to recognize such patients and enable further care even after discharge from maternity wards. The nurse needs to establish a trusting relationship in which patients feel safe and can describe and express their feelings about their birth experience. In patients with postpartum post-traumatic stress disorder, problems, such as sleeping disorders, damaged relationships, eating disorders, and a lack of exercise, occur. At this stage, the nurse provides counseling and health education primarily so that women can improve their quality of life and deal with symptoms of post-traumatic stress disorder effectively.

Uvod: Po vsem svetu je v zadnjih desetletjih v porastu trend, ki nakazuje, da se vse več žensk odloča za materinstvo šele po 35. letu starosti. Razlogov za to je veliko, v veliki meri pa so si med seboj zelo podobni in stremijo k enakim stališčem. Nosečnost po 35. letu velja za bolj tvegano nosečnost, saj obstaja večja možnost za številne potencialne negativne izide, ki lahko ogrožajo žensko in otroka. Namen: Želeli smo podrobneje predstaviti nosečnost po 35. letu starosti, predvsem najpogostejše možne potencialne negativne izide take nosečnosti. Potencialne negativne izzide smo zaradi boljše razumljivosti ločili na tiste, ki se najpogosteje pojavijo pri ženski ter na tiste, ki se najpogosteje pojavijo pri otroku. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo s sistematičnim pregledom tuje in slovenske strokovne literature. Literaturo smo iskali predvsem v angleškem jeziku s ključnimi besedami advanced maternal age, negative pregnancy AND birth outcomes, adverse pregnancy outcomes, chromosome abnormalities, congenital malformations v podatkovnih bazah CINAHL, Medline (PubMed) ter Google učenjak. Rezultati: Izsledki iz pregledane literature nakazujejo, da trend odločanja o materinstvu po 35. letu starosti res narašča po vsem svetu, še posebej v razvitih državah. Potencialnih negativnih izidov je veliko, vendar o njihovi pojavnosti in tveganjih vsa literatura ni skladna. Ne glede na to pa je vsej skupno, da nosečnost po 35. letu starosti poveča možnost negativnega izida nosečnosti in poroda za žensko in prav tako za otroka. Razprava in zaključek: Rezultati kažejo, da je povprečna starost ženske, pri kateri se odloči za materinstvo, vse višja, kar pa ne pomeni tudi manjšega tveganja za določene zaplete nosečnosti in poroda. Potencialnih negativnih izidov, povezanih z nosečnostjo in porodom, je veliko, zato sta priprava in poznavanje teh zelo pomembna tako za žensko kot za zdravstvene delavce. Introduction: All over the world, there has been a growing trend in recent decades, suggesting that more and more women are opting for motherhood after the age of 35. There are many reasons for this, but to a large extent they are very similar to each other and strive for the same views. Pregnancy after the age of 35 is considered a riskier pregnancy, as it brings with it a higher chance of many potential negative outcomes that can endanger a woman and child. Purpose: The purpose of this thesis is to present pregnancy after the age of 35 more specifically, especially the most common possible potential negative outcomes that it brings. Above all the potential negative outcomes for the woman and child. Methods: In the diploma thesis we used a descriptive method, with a systematic review of foreign and Slovenian professional literature. The literature was searched mainly in English with the keywords advanced maternal age, negative pregnancy AND birth outcomes, adverse pregnancy outcomes, chromosome abnormalities, congenital malformations, in the databases CINAHL, Medline (PubMed) and Google Scholar. Results: Findings from the reviewed literature suggest that the trend of deciding on motherhood after the age of 35 is indeed growing worldwide, especially in developed countries. There are many potential negative outcomes, but not all literature is consistent on their occurrence and risks. Despite this, what they all have in common is that pregnancy after the age of 35 increases the possibility of negative pregnancy and childbirth outcomes for a woman and also for a child. Discussion and conclusion: The results are showing that the average age when a woman decides to become a mother is increasing, which does not mean a lower risk of certain complications of pregnancy and childbirth. There are many potential negative outcomes related to pregnancy and childbirth after the age of 35, so the preparation and knowledge of these is very important for both women and health professionals.

Uvod: Obporodno obdobje je obdobje številnih sprememb žensk, kar poveča možnost za razvoj duševnih motenj ali njihovega relapsa. Stres mater v času nosečnosti in jemanje psihofarmakov lahko negativno vplivata na izid nosečnosti, tako za mater kot za otroka. Vloga medicinskih sester v povezavi z drugimi člani multidisciplinarnega tima zagotavlja dobro informiranost žensk in njihovih družin pri odločitvi za zdravo nosečnost žensk in še nerojenega otroka. Namen: Namen diplomskega dela je izpostaviti pomen zdravstveno vzgojnega dela medicinskih sester v povezavi z jemanjem psihofarmakov v obporodnem obdobju žensk s kronično duševno motnjo. Metode dela: Pri pisanju diplomskega dela je bila uporabljena deskriptivna metoda raziskovalnega dela, in sicer pregled slovenske in tuje literature. Pri iskanju smo upoštevali nabor ustrezne literature znanstvenih in strokovnih člankov ter druge oblike ustreznih virov literature, ki obravnavajo temo diplomskega dela. Obdobje iskanja literature je potekalo od decembra 2020 do septembra 2021. Rezultati: Kljub možnostim tveganja v obporodnem obdobju se je zdravljenje s psihofarmaki izkazalo za dokaj varno. Malo je predstavnikov iz skupin psihofarmakov, ki jih v tem času ne priporočajo oziroma imajo teratogene učinke. Kljub rednim pregledom v nosečnosti je pomembno natančno spremljanje bolezni s strani psihiatra, merjenje vsebnosti zdravila v krvi in prilagajanje odmerka glede na potrebe. Medicinske sestre informirajo ženske in družine o njihovi bolezni ter znakih relapsa. Brez obsojanja nudijo podporo in pomagajo ženskam skozi mirno nosečnost in porod. Razprava in zaključek: Osebna prepričanja žensk in njihove izkušnje vplivajo na odločitev o jemanju zdravil med nosečnostjo. Naloga medicinskih sester je, da ženske informirajo in jih podpirajo pri njihovi odločitvi. Empatija in sproščena komunikacija omogočata dober terapevtski odnos. Medicinske sestre predstavljajo pomemben del v celoti zdravljenja duševnih motenj pri ženskah in s tem vplivajo na dober izid nosečnosti ter poroda. Introduction: The perinatal period is a period of many changes in a woman, which increase the chances of developing a mental illness or relapse of a disease. Maternal stress during pregnancy and taking psychopharmaceuticals can negatively affect the outcome of pregnancy for both mother and child. The role of a nurse in conjunction with other members of the multidisciplinary team ensures that a woman and her family are well informed when deciding on a healthy pregnancy for her and the unborn child. Purpose: The purpose of the diploma work is to highlight the importance of health education work of a nurse in connection with the use of psychopharmaceuticals in the perinatal period of a woman with a chronic mental disorder. Methods: A descriptive method of research work was used in writing the diploma thesis, namely a review of Slovenian and foreign literature. In the search, we took into account a set of relevant scientific and professional articles and other forms of relevant sources of literature that address the topic of the thesis. The literature search period ran from December 2020 to September 2021. Results: Despite potential risks during the perinatal period, treatment with psychopharmaceuticals has been shown to be fairly safe. There are few representatives from the group of psychopharmaceuticals that are not recommended or have teratogenic effects at this time. Despite regular check-ups during pregnancy, it is important to closely monitor the illness by a psychiatrist, measure the content of the medicine in the blood and adjust the dose according to the needs. Nurse informs a woman and her family about her illness and signs of relapse. Nurse offers support without condemnation and helps a woman through a peaceful pregnancy and childbirth. Discussion and conclusion: Women’s personal beliefs and their experience influence the decision to take medication during pregnancy. It is a nurse’s job to inform women and support them in their decision. In particular, empathy and relaxed communication enable a good therapeutic relationship. Thus, nurse represents an important part in the overall treatment of mental illness in women and thus affects the good outcome of pregnancy and childbirth.

V pričujočem magistrskem delu avtorica raziskuje doživljanje nosečnosti, poroda, babiške obravnave ter poporodnega obdobja pri ženskah z izkušnjo spolne zlorabe v otroštvu. V teoretičnem delu se osredotoči na vseobsegajoče vplive spolne zlorabe na omenjena obdobja. Osredotoči se na čustveni, psihološki in tudi fizični vidik posledic zlorabe ter na priporočene načine babiške in porodniške obravnave žensk z izkušnjo spolne zlorabe v otroštvu. Predstavi pomen razumevanja razsežnosti posledic spolnega nasilja ter pomen sočutne, celostne, na žensko osrediščene babiške obravnave. Prikaže pogoste stiske, duševne motnje in druge izzive, s katerimi se ženske soočajo ter se osredotoči na pomen podpore. V zadnjem delu teoretičnega dela predstavi tudi izzive v času dojenja, materinstva, vzgoje in partnerstva, ki se pri ženski z izkušnjo zlorabe lahko pojavijo. Empirični del predstavlja in raziskuje omenjene fenomene s pomočjo kvalitativne fenomenološke metodologije. V raziskavo je bilo vključenih 5 žensk z izkušnjo spolne zlorabe v otroštvu ter z izkušnjo nosečnosti, poroda in materinstva. Ženske so bile stare med 20 in 60 let, v večini z visokošolsko izobrazbo. Na podlagi poslušanja in analize transkriptov poglobljenih intervjujev, ki jih je avtorica opravila z udeleženkami, ugotavlja, kako so ženske doživljale fenomen nosečnosti, poroda, babiške obravnave in materinstva. Rezultati so pokazali, da so v večini med nosečnostjo doživljale različne strahove, četudi so se večinoma nosečnosti veselile. Poleg tega so rezultati pokazali pomen sočutne obravnave in podpore med porodom. Ena od udeleženk je kot deklica doživela spolno nasilje s strani zdravstvenih delavcev. Vse so opisovale tudi občutke neslišanosti, pomanjkanja podpore med porodom, nekatere tudi verbalno nasilje, ki so ga doživele s strani zdravstvenih delavcev. Večina udeleženk je imela negativno porodno izkušnjo, ki pa je vplivala tudi na poporodno obdobje. Raziskava je pokazala tudi pogostost drugih oblik nasilja s strani več storilcev. V našo fenomenološko raziskavo smo vključili 5 žensk z izkušnjo zlorabe v otroštvu in nosečnosti, poroda ter materinstva. Raziskovali smo individualno in splošno doživljanje vseh udeleženk. Rezultate raziskav ne moremo posplošiti na splošno populacijo, so pa izsledki lahko vodilo za nadaljnje raziskave na tem področju in predvsem za poglobljeno razumevanje doživljanja nosečnosti, poroda, babiške obravnave in materinstva pri ženskah z izkušnjo spolne zlorabe v otroštvu. In the master's thesis, the author explores the experience of pregnancy, childbirth, midwifery treatment, and the postpartum period in women with experience of sexual abuse in childhood. The theoretical part focuses on the pervasive effects of sexual abuse on these periods. The author focuses on the emotional, psychological as well as physical aspects of the consequences of abuse, and on the recommended ways of midwifery and obstetric care of women who experienced childhood sexual abuse. The first part presents the importance of understanding the extent of the consequences of sexual violence and the importance of sensitive, holistic, woman-centered midwifery care. It shows the frequent hardships, mental disorders, and other challenges that women face and focuses on the importance of support. In the last part of the theoretical part of the presentation, there are also challenges during breastfeeding, motherhood, upbringing, and partnership that can occur in a woman with experience of abuse. The empirical part presents and researches the mentioned phenomena with the help of a qualitative phenomenological methodology. The study included 5 women with experience of childhood sexual abuse and with experience of pregnancy, childbirth and motherhood. Women were between 20 and 60 years old, mostly with a university degree. Based on listening to and analyzing transcripts of in-depth interviews conducted by the author with the participants, she finds out how women experienced the phenomenon of pregnancy, childbirth, midwifery treatment and motherhood. The results showed that most experienced different fears during pregnancy, although they were mostly looking forward to the pregnancy. In addition, the results showed the importance of compassionate treatment and support during childbirth. One of the participants experienced sexual violence by health professionals as a child. All also described feelings of inaudibility, lack of support during childbirth, some also verbal violence experienced by health professionals. Most of the participants had a negative birth experience, which also affected the postpartum period. The research has also shown the frequency of other forms of violence by multiple perpetrators. We included five women who experienced childhood sexual abuse and pregnancy, childbirth and motherhood in our phenomenological research. We researched the individual and general experiences of all participants. The results of the research cannot be generalized to the general population, but the results can be a guide for further research in this area and especially for an in-depth understanding of pregnancy, childbirth, midwifery and motherhood in women with childhood sexual abuse.

Diplomsko delo je antropološki vpogled v izkušnjo poroda v Sloveniji in po svetu v času pandemije covid-19. V diplomskem delu so izpostavljeni ukrepi, ki so bili zaradi zmanjševanja možnosti prenosa okužbe sprejeti v porodnišnicah. Poglobljeno se ukvarja z začasno ukinitvijo pravice do porodnega spremljevalca. V navezavi na sprejete ukrepe se besedilo posveča pojavu medikalizacije poroda in vprašanju, kako se ta kaže v času pandemije. Prav tako se ukvarja z vprašanjem vloge posameznih zdravstvenih delavcev pri porodu v času pandemije in kdo od njih je tisti, ki je sposoben ugotavljati psihofizično stanje porodnice ter v skladu s tem sprejemati odločitve za njeno obravnavo. This bachelor’s thesis concerns the experience of childbirth in Slovenia as well as abroad during the COVID-19 pandemic. Considering the topic from an anthropological perspective, its focus is on the preventative measures implemented in an attempt to halt the rate of infection in maternity wards, notably the restrictions placed on birth attendants. Regarding these measures, the text also deliberates on the phenomenon of medicalization in maternity wards as well as the means by which these are exhibited during times of pandemic. The question of various medical professionals and their role during pregnancy, specifically which are able to provide adequate care in relation to the woman’s psychophysical condition and work in her best interest, is also considered.

Uvod: Poznamo različne modele obravnave žensk v času nosečnosti, poroda in poporodnega obdobja. Model kontinuirane babiške obravnave zajema celostno in integrirano obravnavo, ki jo z vodenjem in izvajanjem obravnave zagotavlja ena babica, skupina babic ali je ta skrb deljena z različnimi strokovnjaki. Ženskam je ob babiški obravnavi zagotovljena ustrezna podpora in razumevanje, obenem pa babica nudi osebni stik in bližino. Z vzpostavitvijo zaupanja se ženska počuti mnogo bolj udobno in bolj samozavestno sprejema informacije. Babice so prav tako bolj zadovoljne v tem modelu, saj jim nudi večji občutek avtonomije in osebnostne ter strokovne rasti. Namen: Namen diplomskega dela je bil predstaviti različne modele babiške obravnave in opisati kontinuirano babiško obravnavo ter predstaviti prednosti in omejitve modela kontinuirane babiške obravnave v primerjavi z ostalimi modeli, vključno z učinkom kontinuirane obravnave na ženske in babice. Metode dela: Opravljen je bil vsebinski pregled literature, objavljene med 2011-2021, v različnih bazah podatkov, kot so PubMed, MEDLINE, PEDro, ScienceDirect, DiKUL, COBISS. Izbrane vire smo ocenili z lestvico PEDro in tako pridobili primerno literaturo. Uporabili smo ključne besede v slovenskem jeziku: babica, nosečnost, poporodno obdobje, porod, spremljanje nosečnosti. Rezultati: V dokončen pregled smo vključili 16 virov. Potrdili so mnoge prednosti tega modela za nosečnice, predvsem manj zapletov med nosečnostjo, boljše splošno udobje med nosečnostjo in večjo samozavest pri materinstvu v času po porodu. Kontinuirana obravnava prav tako zmanjšuje zaplete med in po porodu pri otroku. Babice menijo, da se občasno počutijo obremenjene z delom zaradi konstantne pripravljenosti, vendar je v primerjavi z drugimi modeli obravnave je obremenjenost, ter izgorelost na nižji stopnji. Razprava in zaključek: Kontinuirana babiška obravnava v primerjavi s tradicionalnimi modeli, v katerih za nosečnico skrbi več babic ali obravnavo vodi drug strokovnjak, v povprečju zagotavlja boljše obporodne izide: manj zapletov pri porodih, manj intervencij ter boljše zadovoljstvo, počutje in zdravje ženske in otrok. Introduction: There are different models of midwifery for women and children during pregnancy, birth and postpartum period. The model of continuous midwifery care involves management and implementation of comprehensive and integrated treatment provided by one midwife, a group of midwives, or is shared with different professionals through the management and implementation of the treatment. Women are provided with appropriate support and understanding during midwifery treatment, while the midwife offers her personal contact and closeness. By establishing trust, a woman feels much more comfortable and is more confident in her midwife's competencies. Midwives are also more satisfied with this model, as it offers them a greater sense of autonomy and personal and professional growth. Purpose: The purpose of the final work was to present an introduction to the different models of midwifery care, and to describe continuous midwifery care. In this paper we investigated the advantages and limitations of the model of continuous midwifery treatment compared to other models of care, the effect of continuous care on women and children, and the effect of the model on employed midwives. Methods of work: The final work is based on a systematic review of the literature, which were published between 2011 and 2021 in various databases such as PubMed, MEDLINE, PEDro, ScienceDirect, DiKUL, COBISS. Selected sources were evaluated with the PEDro scale and thus we obtained appropriate literature for review. We used keywords in english language: midwife, pregnancy control, pregnancy, puerperium, birth. Results: We included 16 sources in the final review. Studies confirmed many benefits for pregnant women, most notably fewer complications during pregnancy, better overall comfort during pregnancy, and greater confidence in motherhood in the postpartum period. Continuous care also reduces the chances of complications during and after childbirth for the baby. Midwives feel that they occasionally feel overwhelmed with work due to constantly being on-call, but compared to other models, the workload and burnout is at a lower level. Discussion and conclusion: Continuous midwifery care, compared to traditional models in which a pregnant woman is cared for by various midwives or by a specialist, on average provides better outcomes in the birth process namely fewer complications, less interventions, better satisfaction and well-being of the mother and child throughout the maternity process.

V pričujočem magistrskem delu avtorica raziskuje čustveno doživljanje prve nosečnosti, poroda in poporodnega obdobja pri materah. V teoretičnem delu magistrskega dela predstavi ključne dogodke in fiziološki proces nosečnosti. Osredotoči se na doživljanje ženske v prvi nosečnosti, opiše spremembe na njenih možganih, na telesu, hormonske spremembe in z njimi povezane čustvene spremembe ter nihanje razpoloženja. Predstavi sprejemanje sebe in lastnega spreminjajočega se telesa ter pomembnost partnerjeve podpore v času nosečnosti. Predstavi pomen vzpostavljanja odnosa z otrokom že tekom nosečnosti. Dotakne se tudi odnosa med nosečnico in njeno materjo med nosečnostjo. Predstavi čustvene in duševne stiske, ki se lahko pojavijo med nosečnostjo. V nadaljevanju predstavi pomembnost priprave na porod in opiše fiziološki potek poroda ter zdravstvene ukrepe ob nepravilnostih pri porodu. Opiše pomembnost prisotnosti partnerja pri porodu. V zadnjem delu teoretičnega dela predstavi poporodno obdobje ter z njim povezane spremembe na fizičnem in psihičnem področju pri ženski. Predstavi dojenje kot ključni in osnovni stik z otrokom, odnos s partnerjem po porodu in na koncu sam odnos z otrokom. V empiričnem delu s pomočjo kvalitativne fenomenološke metodologije avtorica raziskuje povezanost fenomena doživljanja nosečnosti, poroda in poporodnega obdobja. V raziskavo je bilo vključenih šest žensk, ki so prvič rodile pred več kot šestimi meseci in manj kot štirimi leti. Pet žensk je rodilo vaginalno, ena je imela urgentni carski rez. Na podlagi intervjujev, ki jih je avtorica opravila z udeleženkami, ugotavlja, kako so ženske doživljale fenomen prve nosečnosti, poroda in poporodnega obdobja in kako bi si lahko to izkušnjo še izboljšale in olajšale. Rezultati so pokazali, da so ženske večinoma dobro sprejemale svoje spreminjajoče se telo in v času nosečnosti dobile s partnerjeve strani veliko podpore. Partnerjeva podpora se je kot ključna izkazala tudi med porodom. Raziskava je pokazala, da je bil prvi stik z otrokom pri večini udeleženk začudenje in niso doživele navala pozitivnih čustev ob prvem srečanju z otrokom. Rezultati kažejo tudi, da so se ženske premalo pripravile na poporodno obdobje, ki jih je zelo presenetilo predvsem iz čustvenega in doživljajskega vidika. V tem obdobju se je za večino udeleženk kot ključna pri premagovanju izzivov spet izkazala partnerjeva podpora. In the present master's thesis, the emotional experiences of first pregnancy, childbirth, and the postpartum period of mothers who give birth are explored. The theoretical part of the master's thesis presents the key events and the physiological process of pregnancy. The focus is on the experience of the pregnancy by a first-time mother, changes in her brain, body, hormonal changes and related emotional changes, and mood swings. Moreover, the author focuses on the acceptance of the physical and emotional changes, and the importance of the partner’s support during pregnancy. The importance of establishing a relationship with the child during pregnancy as well as the relationship between a pregnant woman and her mother during pregnancy are described in detail. The author also touches upon the emotional and mental distress that can occur during pregnancy. In addition, the importance of preparation for childbirth and the physiological course of childbirth are presented, as well as health measures in the event of congenital anomalies. The author also mentions the importance of a partner's presence at birth. The last part of the theoretical part describes the postpartum period and related physical and emotional changes. The author presents breastfeeding as a crucial and basic contact with the child. Lastly, the relationships between the mother and her partner and child are described. Using a qualitative phenomenological methodology, the connection between pregnancy, childbirth, and the postpartum period of first-time mothers was investigated. The study included six women who gave birth for the first time more than six months ago and less than four years ago. Five women gave vaginal birth, and one had an emergency caesarean birth. Based on the findings of the interviews carried out by the author, it is determined how women experienced their first pregnancy, childbirth, and the postpartum period, and how this experience could be further improved and facilitated. The results show that women mostly accepted their changing bodies and received a lot of support from their partners during pregnancy. Partner support has shown to be crucial during childbirth. The research showed that the first contact with the child was a surprise for most of the participants and they did not experience a surge of positive emotions when they first met the child. The results also show that women were not sufficiently prepared for the postpartum period and were surprised by it especially due to strong emotions and their own experiences. During this period, for most of the participants, the partner's support proved to be central to overcoming the challenges.

Namen naše naloge je bil ugotoviti, kakšna je seznanjenost porodnic s stanjem razmika preme trebušne mišice, seznanjenost o ukrepih za zmanjšanje tega ter kakšen je vpliv vrste vadbe na razmik preme trebušne mišice in ostale poporodne težave. Podatke smo zbrali s pomočjo anketnega vprašalnika 1ka, ki je zajemal 21 vprašanj. Pridobljene podatke smo zbrali in uredili v programu Microsoft Excel 2013 ter jih analizirali v statističnem programu IBM SPSS 21 IBM. Za analizo anketnega vprašalnika smo uporabili opisno statistiko. Prikazali smo frekvence in pripadajoče odstotke odgovorov, povprečne vrednosti, standardne odklone, minimum in maksimum odgovorov. Rezultate smo podali v obliki tabel. Za preverjanje statistično značilnih razlik v porazdelitvah odgovorov smo uporabili Hi-kvadrat test. Za iskanje statistično značilnih razlik v povprečjih dveh neodvisnih skupin smo uporabili t-test za dva neodvisna vzorca. Homogenost varianc smo preverjali s pomočjo Levenovega testa. Za iskanje moči povezanosti med dvema številskima spremenljivkama smo uporabili neparametrični Spearmanov korelacijski test. Vsa testiranja smo opravili pri stopnji tveganja 5 %. Naše ugotovitve kažejo, da je več kot tretjina (42,3 %) porodnic seznanjena s stanjem razmika preme trebušne mišice po porodu s strani strokovno usposobljenega delavca. Približno tretjini (30,9 %) porodnic je razmik izmeril fizioterapevt po porodu v porodnišnici, najpogosteje v porodnišnici Šempeter pri Novi Gorici (84,6 %), na Jesenicah (68,4 %) in v Ljubljani (66,4 %). V porodnišnici Ptuj, Slovenj Gradec in Celje razmika preme trebušne mišice niso izmerili niti eni porodnici. Znanje o pravilnosti vadbe med nosečnostjo in po porodu je bilo v povprečju dobro (10,5 od 15 točk). Nekaj manj kot četrtina (21,5 %) vseh anketirank, ki so bile telesno aktivne po porodu, se je udeleževala vodenih vadb za nosečnice, v živo pa le 3,5 % anketirank. Deleži udeležbe so bili precej višji med nosečnostjo, ko še ni bilo prisotnih posledic pandemije Covid-19 (približno tretjina vseh anketirank je bila aktivna med nosečnostjo). Več kot tri četrtine anketirank, ki imajo prisoten čezmeren razmik preme trebušne mišice, ima tudi katero od posledic čezmernega razmika. Najpogosteje porodnice s prisotnim čezmernim razmikom preme trebušne mišice navajajo bolečine v križu (67,0 %), slabšo telesno držo (54,0 %) ter urinsko inkontinenco (36,0 %). Pri anketirankah, ki izvajajo vodeno vadbo po porodu, vadba bolje vpliva na bolečine v križu, kot pri anketirankah, ki vodene vadbe ne izvajajo (a izvajajo kakšno drugo telesno aktivnost, npr. hojo, tek, kolesarjenje itd.). The purpose of our study was to evaluate the awareness of women with the state of diastasis recti abdominis (DRA), awareness of measures to reduce DRA, and the impact of the type of exercise on DRA and other postpartum problems. Data were collected using the 1ka questionnaire, which included 21 questions. The obtained data were collected and edited in Microsoft Excel 2013 and then analyzed in the IBM SPSS 21 statistical program IBM. Descriptive statistics were used to analyze the survey questionnaire. Frequencies and corresponding response percentages, mean values, standard deviations, minimum and maximum responses were shown. The results were given in the form of tables. The Hi-square test was used to check statistically significant differences in the distributions of responses. To find statistically significant differences in the averages of the two independent groups, we used the t-test for two independent samples. The homogeneity of the variances was checked using the Leven test. A nonparametric Spearman correlation test was used to find the strength of the relationship between two numerical variables. All tests were performed at a risk level of 5%. Our findings show that more than a third (42.3%) of mothers are aware of the state of DRA after childbirth by a professionally trained worker. Approximately one third (30.9%) of women were measured by a physiotherapist after giving birth in a maternity hospital, most common in the Šempeter maternity hospital near Nova Gorica (84.6%), in Jesenice (68.4%) and in Ljubljana (66.4%). In the maternity hospitals in Ptuj, Slovenj Gradec and Celje, not a single woman was measured. Knowledge of the correctness of exercise during pregnancy and after childbirth was on average good (10.5 out of 15 points). Slightly less than a quarter (21.5%) of all respondents who were physically active after childbirth participated in guided exercises for pregnant women, while only 3.5% of respondents took part in live exercises. Participation rates were significantly higher during pregnancy, when the consequences of the Covid-19 pandemic were not yet present (approximately one third of all respondents were active during pregnancy). More than three-quarters of respondents who have DRA also have any of the consequences of DRA. Most often, women with DRA report low back pain (67.0%), poor posture (54.0%) and urinary incontinence (36.0%). In respondents who perform guided exercise after childbirth, exercise has a better effect on low back pain than in respondents who do not perform guided exercise (but perform some other physical activity such as walking, running, cycling, etc.).

Uvod: Motnja v duševnem razvoju se kaže kot bistven primanjkljaj v intelektualnih funkcijah, kot tudi v zmanjšani možnosti prilagajanja, ki na dnevni ravni vključuje socialne in praktične sposobnosti. Spolnost oseb z motnjo v duševnem razvoju je od nekdaj predstavljala tabu. Njihove pravice v zvezi s seksualnostjo so bile kršene. Tuje raziskave so pokazale zaskrbljenost babic zaradi pomanjkljivega znanja na področju poučevanja in obsežnega prilagajanja informacij, ki jih podajajo tem ljudem glede varnih spolnih odnosov in drugih podatkov povezanih z nosečnostjo, porodom in poporodnim obdobjem. Namen: Namen diplomskega dela je raziskati in preučiti, kako poteka nosečnost, kakšni so perinatalni izidi ter preživljanje poporodnega obdobja pri ženskah z motnjo v duševnem razvoju. Želimo pridobiti mnenja babic o lastni usposobljenosti za delo z ženskami z motnjo v duševnem razvoju ter pridobiti podatke, s katerimi izzivi se srečujejo tekom izvajanje babiške obravnave. Metode dela: V prvem delu diplomskega dela je uporabljena deskriptivna metoda dela. Uporabljeno literaturo smo pridobili preko podatkovnih baz COBISS, Medline, PubMed, ScienceDirect in Wiley Online Library. V drugem delu diplomskega dela je bila uporabljena kvalitativna metodologija polstrukturiranih intervjujev s petimi slovenskimi babicami, ki so zaposlene v Univerzitetnem kliničnem centru Maribor. Dovoljenje za izvajanje študije smo pridobili s strani Strokovne službe zdravstvene nege Univerzitetnega kliničnega centra Maribor. Izbrali smo pet babic, ki imajo vsaj tri leta delovnih izkušenj v porodnišnici. Posnetkom intervjujev je sledila transkripcija, ki je bila osnova za pridobitev kategorij in kod. Rezultati: Babice svojo vlogo vidijo kot podporo ženski med porodom, sebe vidijo kot pristojne za vodstvo in usmerjanje ženske z motnjo v duševnem razvoju skozi proces poroda. V obravnavo take ženske vključujejo patronažno službo, Center za socialno delo, psihologa, psihiatra in svojce. Največji izziv pri obravnavi take ženske jim predstavlja komunikacija. Način komunikacije babice prilagodijo glede na stopnjo motnje v duševnem razvoju. Babice si želijo pridobiti več znanja na tem področju. Večina se jih ne počuti dovolj kompetentno za izvajanje ustrezne oskrbe ženske z motnjo v duševnem razvoju. Glede ustvarjanja družine med temi osebami so mnenja, da je ta odločitev odvisna od stopnje motnje v duševnem razvoju matere in podpore partnerja. Razprava in zaključek: V Sloveniji praktično ni raziskav, ki bi opisovale to problematiko. Raziskovanje tega področja bo doprineslo h kvalitetnejši oskrbi žensk z motnjo v duševnem razvoju. Introduction: Intellectual disability is chategorized by a significant deficit in intellectual functions and adaptive ability, which affects also many everyday social and practical skills. The sexsuality of the intellectualy disabled has always been a taboo and intelectually disabled persons’ sexsual rights have often been violated in the past. Recent research has brought to attention the concerns of many midwives about the lack of their pedagogical knowledge in working with intelectually disabled mothers and the need for an extensive adaptation of information they have at their disposal, to pass on to intellectually disabled women about safe sex, pregnancy, childbirth and pospartum period. Purpose: The purpose of this thesis is to research and study the course of pregnancy, prenatal outcomes and postpartum period of women with intellectual disability. We then also wish to collect the opinions of midwives about their own ability to work with intellectually disabled women and about the challenges they face during the implementation of midwifery care in the same case. Methods: The first part of the research was theoretical where we reviewed the literature on the topic of the pregnacy, labour and postpartum period of intelectually disabled women. The literature used for the purpose of this research was obtaind through the databases COBISS, Medline, PubMed, ScienceDirect and Wiley Online Library. The second part was conducted in a form of a qualitative study, where semi-structured interviews were used as a method of research. Participants were five Slovenian midwives employed in University Clinical Centre Maribor. Results: Results of our study have shown that midwives in Slovenia view their role as supporting intelectually disabled women in childbirth, being responsible for leading and guiding them through the whole birthing process. They aslo feel that the whole treatment process of intelectually disabled mothers should include the patronage service, social workers (Social work centres), a psychologist, a psychiatrist and relatives of the mother. The biggest challenge midwives perceive having in dealing with intelectually disabled women is communication. They try to adjust their communication according to the degree of intellectual disability of the mother. Slovenian midwives also report the wish to gain more education and training in the aria of woriking with intellectually disabled women, since most of them feel they lack experience and specific knowledge. Lastly, midwives then also feel that family planing of persons with intelectuall disability should be done according to the degree of their intellectual impairment. Discussion and Conclusion: Research on the topic of midwives’ support of intellectually disabled mothers in Slovenia is sparse, so further study in this area should help to develop better methods and procedures of how to efficiently teach intelectually disabled mothers about pregancy and family care. This would also support Slovenian midwives in their efforts of offering t quality midwifery care for women with intellectual disabilities.

V magistrski nalogi smo raziskovali vpliv telesne dejavnosti na potek nosečnosti in poroda. Vzorec je vključeval 77 nosečnic v obdobju 1 meseca po porodu. Kriterij za delitev v dve skupini je bila pogostost, intenzivnost, količina in tip telesne dejavnosti. Prva, eksperimentalna skupina obsega 44 telesno dejavnih nosečnic, ki so bile med nosečnostjo vsaj štirikrat tedensko telesno dejavne več kot 30 minut na vadbeno enoto. Intenzivnost na vadbeni enoti je bila vsaj srednja poleg hoje so izbrale še eno vrsto telesne dejavnosti. Druga, kontrolna skupina je obsegala 33 žensk, ki so bile med nosečnostjo telesno dejavne trikrat tedensko ali manj ter 30 minut ali manj na vadbeno enoto intenzivnost je bila lahka izbrale niso nobene ali samo eno vrsto telesne dejavnosti. Podatki so bili obdelani z računalniškim paketom IBM SPSS 25. Vse hipoteze smo preverjali na ravni 5 odstotkov statističnega tveganja (p ≤ 0,05). Na podlagi pridobljenih rezultatov in statistične analize smo lahko potrdili le prvo hipotezo: telesna dejavnost med nosečnostjo ne vpliva na trajanje nosečnosti. Ostalih pet hipotez, ki navajajo, da telesna dejavnost med nosečnostjo zmanjšuje skupno pridobljeno telesno maso ženske v nosečnosti, poveča telesno maso novorojenčka, skrajšuje čas trajanja poroda in zmanjšuje možnost zapletov, zmanjšuje stopnjo bolečine po VAS lestvici ter vpliva na manjšo uporabo sredstev za lajšanje porodnih bolečin, nismo mogli potrditi, saj med preiskovanima skupinama ni statistično značilnih razlik. Telesna dejavnosti torej nima glavnega vpliva na potek nosečnosti in poroda. Pomemben je tudi zdrav način življenja, kjer so vsakodnevno na jedilniku zdrava prehrana, dobro psihično počutje brez uživanja škodljivih substanc v kombinaciji z redno telesno dejavnostjo. This master's thesis focuses on the influence of physical activity in the course of pregnancy and childbirth. The sample included 77 pregnant women in the one-month period after childbirth. The criteria for division into two groups were frequency, intensity, time and type of physical activity. The first, experimental group comprised of 44 pregnant women who were physically active for more than 30 minutes per exercise unit at least four times a week during pregnancy. The intensity on the exercise unit was at least medium. In addition to walking, they chose another type of physical activity. The second, control group consisted of 33 women who were physically active three times a week or less during pregnancy and 30 minutes or less per exercise unit. The intensity was light but they chose none or only one type of physical activity. Data were processed with the IBM SPSS 25 computer package. All hypotheses were tested on the level of 5-percent statistical risk (p ≤ 0.05). Based on the obtained results and statistical analysis, we could only confirm the first hypothesis: physical activity during pregnancy does not affect the duration of pregnancy. The other five hypotheses that state that physical activity during pregnancy reduces a woman's total body weight during pregnancy increases the weight of the newborn, shortens the duration of labor and reduces the possibility of complications, reduces the level of pain on the VAS scale, and reduces the use of painkillers could not be confirmed as there are no statistically significant differences between the study groups. Physical activity, therefore, has no major impact on the course of pregnancy and childbirth. It is important to have a healthy lifestyle where a healthy diet and mental well-being without the use of harmful substances in combination with regular physical activity is a part of every day.

Uvod: Nosečnost in porod povzročita fiziološke spremembe vseh organskih sistemov, tudi spremembe medeničnega dna. Med nosečnostjo vezivne strukture zaradi vpliva hormonov postanejo ohlapnejše, rast in teža ploda potiskata organe navzdol, zaradi česar so mišice medeničnega dna izpostavljene večjemu bremenu in oslabijo. Z vadbo mišic medeničnega dna med nosečnostjo izboljšamo nadzor in povečamo jakost mišic, ki so pomembne in potrebne za porajanje ploda. Namen: Namen diplomskega dela je na podlagi pregleda strokovne in znanstvene literature ugotoviti vpliv vadbe mišic medeničnega dna na izid poroda. Želimo ugotoviti, kako vadba z namenom povečanja jakosti in vzdržljivosti mišic medeničnega dna vpliva na faze poroda, ter njene učinke na nosečniške, med-porodne ali poporodne zaplete. Metode dela: Pregled literature je potekal po splošni medicinski in zdravstveni podatkovni zbirki PubMed ter v za fizioterapijo specifičnih podatkovnih zbirkah Cochrane library in PEDro. Uporabljeni so bili naslednji vključitveni kriteriji: angleški jezik, raziskave in članki objavljeni med letoma 2010 in 2020, odrasle ženske starosti od 18 do 44 let. Izključitveni kriteriji so bili: pridružene bolezni nosečnice ali ploda, več plodna ali rizična nosečnost oz. nevarnost prezgodnjega poroda. Pregled je potekal tudi preko podatkovne baze Semantic Scholar (vključitven dejavnik so raziskave, objavljene med letoma 2015 in 2020). Rezultati: Med iskanjem literature so bile najdene 303 strokovne raziskave. Glede na izključitvene kriterije je bilo v pregled literature vključenih 8 raziskav objavljenih med letoma 2011 in 2018. Rezultati raziskav kažejo, da vadba mišic medeničnega dna med nosečnostjo pozitivno vpliva na potek poroda, ki se kaže v skrajšani drugi porodni dobi. Prav tako vadba mišic medeničnega dna vpliva na nižjo pojavnost in jakost bolečine in s tem povezano manjšo uporabo analgetikov v med in poporodnem obdobju. Razprava in zaključek: Iz opisanih rezultatov pregleda literature lahko predpostavimo, da z izvajanjem vadbe mišic medeničnega dna pripomoremo k boljši izkušnji nosečnosti in poroda ženske. Izvajanje vaj lahko zmanjša tveganje za mnoge zdravstvene zaplete matere in bodočega novorojenčka. Večina raziskav navaja pozitivne učinke vadbe mišic medeničnega dna, vendarle bi bilo treba na tem področju opraviti še več raziskav. V literaturi ne navajajo, da ima vadba mišic medeničnega dna kakršen koli negativen vpliv na zdravstveno stanje nosečnice in ploda. Introduction: Pregnancy and labour cause physiological changes of all organ systems, including changes of the pelvic floor. During pregnancy, the connective tissue gets loosen up due to the hormon influence. The growth and weight of fetus push the organs down, which causes higher load and weakens of the pelvic floor muscle. With pelvic floor exercise during pregnancy, we can improve the strength and control of these muscles, which are important and necessary in the process of labouring. Purpose: The purpose of diploma work is to determine the impact of pelvic floor muscle exercise on the childbirth outcomes, based on the review of professional and scientific literature. We want to find out how pelvic floor muscle strengthening affects pregnancy, inter and postpartum complications. Methods: The literature review was conducted according to the general medical and health database PubMed and physiotherapy specific databases Cochrane library and PEDro. The following inclusion criteria were used: english language, research and articles published between 2010 and 2020 and adult women aged 18 to 44 years. The exclusion criteria were the following: associated diseases of pregnant women or fetus, multiple fertile or high-risk pregnancy and risk of premature birth. The review was also conducted through the Semantic Scholar database (the inclusion factor were articles published between 2015 and 2020). Results: During the literature search, 303 professional articles were found. According to the exclusion criteria, 8 articles published between 2011 and 2018 were included in the literature review. The results of the research showed that pelvic floor muscle exercise during pregnancy affects the course of labour, which is reflected in shortened second stage of labour. Pelvic floor muscle exercise also affects the incidence and intensity of pain and associated use of analgetics during and after the labour. Discussion and conclusion: Based on the described results from the literature review, we can assume that performing pelvic floor muscle exercises contributes to a better pregnancy experience and childbirth of future mothers. Performing exercises can reduce the risk of many health complications for future mothers and newborn babies. Even though most researches claim the positive effects of pelvic floor muscle exercise, more research is still needed. Scientific literature does not state that pelvic floor muscle exercise has any negative impact on the health of pregnant women and fetus.

Uvod: Porod je biološki dogodek, ki, predstavlja enega izmed najpomembnejših dogodkov v življenju ženske. V zadnjih letih so na področju babištva in porodništva občutja žensk glede doživete porodne izkušnje in zadovoljstva s porodom prepoznana kot pomembno izhodišče za ocenjevanje in raziskovanje. Namen: Namen diplomskega dela je predstaviti dejavnike, ki vplivajo na zadovoljstvo žensk s porodno izkušnjo in na podlagi rezultatov raziskave ugotoviti, kakšno je zadovoljstvo žensk s porodno izkušnjo v Sloveniji. Metode dela: Uporabljeni sta bili deskriptivna in kvantitativna metoda raziskovanja. Prvi del diplomskega dela zajemajo teoretična izhodišča, ki so predstavljena na podlagi pregleda znanstvene in strokovne literature. V drugem, empiričnem delu diplomskega dela smo ugotavljali zadovoljstvo žensk s porodno izkušnjo v Sloveniji z uporabo anketnega vprašalnika Birth Satisfaction Scale (BSS) z dodanimi vprašanji. Rezultati: Uporabili smo vzorec 359 žensk. V tem vzorcu je tudi 137 porodnic, ki so rodile v času epidemije covida-19. 99,2 % porodnic je za kraj poroda izbralo porodnišnico. 177 porodnic (49,3 %) je prejelo farmakološko metodo lajšanja porodne bolečine. Največ porodnic je rodilo vaginalno (n = 299 83,3 %), medtem ko je carski rez imelo 13,4 % porodnic (n = 48). Pri porodnih poškodbah je raztrganino presredka imelo 32,3 % porodnic (n = 116) in epiziotomijo 22 % porodnic (n = 79). Glede na rezultate smo prišli do sledečih ugotovitev. Drugorodnice in mnogorodnice izražajo višjo stopnjo zadovoljstva s porodno izkušnjo v primerjavi z ženskami, za katere je bil to prvi porod. Glede načina poroda izražajo najnižjo stopnjo zadovoljstva ženske z urgentnim carskim rezom. Ugotovili smo negativno statistično povezanost med zadovoljstvom žensk s porodno izkušnjo in epiziotomijo. Rezultati kažejo, da ni statistično značilnih razlik v zadovoljstvu s porodno izkušnjo žensk v času epidemije covida-19 in ostalih, kljub temu pa porodnice, ki so rodile s prisotnostjo partnerja, izražajo višje zadovoljstvo v primerjavi s tistimi, ki so rodile brez prisotnosti partnerja. Razprava in zaključek: Ugotovili smo, da je zadovoljstvo žensk s porodno izkušnjo zelo pomembno, tako za žensko kot za njenega novorojenčka in celotno družino. Glede na mnogo naštetih dejavnikov, ki so v povezani z zadovoljstvom žensk s porodno izkušnjo, se zavedamo, da gre za zelo kompleksen pojem. Med poglavitne dejavnike v povezavi z zadovoljstvom s porodno izkušnjo uvrščamo način poroda, kraj poroda, prisotnost partnerja pri porodu in komunikacijo ter odnos zdravstvenega osebja. V prihodnje so v Sloveniji potrebne še dodatne raziskave na temo zadovoljstva žensk s porodno izkušnjo. Introduction: Labour is a natural process which is one of the most important events in a woman's life. Women's feelings about their birth experiences and birth satisfaction have in the last few years been recognized as important starting points for evaluation and research in the field of midwifery and obstetrics. Purpose: The aim of my thesis is to list and present factors related to birth satisfaction and based on the obtained results determine the birth satisfaction in Slovenia. Methods: A descriptive and quantitative method of work is used. The first part includes theoretical starting points presented on the basis of scientific literature. The second (empirical) part determines the birth satisfaction in Slovenia using the Birth Satisfaction Scale (BSS) with added questions. Results: A sample of 359 women is used. It also includes 137 mothers who gave birth during the covid-19 epidemic. The average result of the BSS questionnaire is 107,36 (SD = 11,03). For 71 % of childbearing women, this was their first birth. 99,2 % of childbearing women chose a maternity hospital as their place of birth. 177 childbearing women (49,3 %) received a pharmacological pain relief in labour. Most childbearing women gave birth vaginally (n = 299 83,3 %), while 13,4 % of childbearing women gave birth by a caesarean section (n = 48). In the case of birth injuries, 32,3 % of childbearing women had a ruptured perineum (n = 116) and 22 % had an episiotomy (n = 79). Based on the results we have come to the following conclusions. Multigravidas express a higher level of birth satisfaction compared to women for whom this was their first birth (primigravidas). Women with an emergency caesarean section express the lowest level of birth satisfaction. There is a negative statistical correlation between women's birth satisfaction and episiotomy. The results show that there were no statistically significant differences in birth satisfaction of women during the covid-19 epidemic and others, however, women who gave birth in the presence of their partners express higher satisfaction compared to those who did not have their partners present. Discussion and conclusion: We found that women's birth satisfaction is very important, for the women and her newborn and the whole family. Considering the many listed factors related to women’s birth satisfaction, we are aware that this is a very complex concept. The main factors in connection to birth satisfaction include the method of birth, the place of birth, the presence of a partner at birth, communication and the attitude of the medical staff. In the future, additional research on the topic of women's birth satisfaction should be done in Slovenia.

Uvod: Perinatalna asfiksija je stanje, ko je placentarna ali pljučna izmenjava plinov v plod ali iz njega ogrožena ali celo preneha delovati ter pride do delnega ali popolnega pomanjkanja kisika v vitalnih organih. Posledice perinatalne asfiksije se lahko kažejo na možganskem, kardio-vaskularnem, kardio-respiratornem in mišično-skeletnem organskem sistemu. Obsežne študije o posledicah invalidnosti otrok na družine so bile narejene v sedemdesetih letih prejšnjega stoletja, ko je bilo »končno« priznano, da je družina, ki ima otroka s posebnimi potrebami, dejansko »družina s posebnimi potrebami«. Namen: Namen diplomskega dela je, da s pomočjo že obstoječe literature raziščemo perinatalno asfiksijo ter vpliv dolgoročnih posledic pri otroku na družino. S kvalitativno raziskavo, ki sledi, želimo ugotoviti, kako se družine soočajo z dolgoročnimi posledicami, kakšne prilagoditve so potrebne in kako to vpliva nanje. Metode dela: Za sistematični pregled že znane literature iz tega področja je uporabljena deskriptivna metoda dela. V nadaljevanju je uporabljena kvalitativna metoda zbiranja podatkov, in sicer intervju, pri katerem so bila vprašanja vnaprej razdeljena v sklope. Podatki so obdelani z metodo vsebinske analize. Raziskovalni vzorec predstavljajo tri prostovoljno javljene mame otrok, ki so doživeli perinatalno asfiksijo. Rezultati: Vse mame so se strinjale, da je bilo prvo soočenje z diagnozo in otrokovo prognozo šok. Vse tri intervjuvanke so se strinjale, da v družini otroka s posebnimi potrebami najbolje sprejme mama, ki tudi prevzame glavno skrb za otroka. Vse tri intervjuvanke so se strinjale, da otrok s posebnimi potrebami največkrat poslabša odnos med partnerjema. Vse so se strinjale, da otrok s težavami vpliva na število sorojencev. Vse intervjuvanke so povedale, da je največ negativnih komentarjev slišati s strani ljudi, ki otroka ne poznajo. Razprava in zaključek: Otroštvo veliko ljudi povezuje z obdobjem rasti in pridobivanja novih veščin, zato je invalidnost pri otroku še toliko težje sprejemljiva. Največ sprememb v življenju družine naj bi bilo po besedah intervjuvank na področju organizacije časa in socialnih stikov mame. Zavedati se moramo, da določeni strokovnjaki spremljamo te otroke in njihove družine en majhen del njihovega življenja. Za nas je bistveno, da staršem po najboljših močeh pomagamo sprejeti njihovega otroka takega, kot je. Introduction: Perinatal asphyxia is a condition in which the placental or pulmonary gas exchange to or from the fetus is compromised or even ceases altogether, resulting in partial or complete lack of oxygen in vital organs. The consequences of perinatal asphyxia can occur in the cerebral, cardiovascular, cardio-respiratory, and musculoskeletal organ systems. Extensive studies on the impact that a child with disability has on the family were made in the 1970s, when it was "finally" recognized that a family with a child with special needs, was in fact a "family with special needs". Purpose: The purpose of the diploma work is to use the existing literature to study the perinatal asphyxia and the impact that it has on a child and ultimately on the child’s family. With the qualitative research that follows, we want to find out how families face long-term consequences, what adjustments are needed and how this affects them. Work methods: A descriptive work method is used for a systematic review of already known literature in this field. This was followed by a qualitative method of data collection, an interview, where the questions were divided into sections in advance. Data was processed with content analysis. The research sample is a group of three volunteering mothers, whose children experienced perinatal asphyxia. Results: It was a great shock for all three mothers when they first found out the diagnosis and prognosis of their children. Everyone agreed that in a family, a mother is the one who accepts a child with special needs the best, and she is also the one that mainly takes care of him. All three mothers agreed that partnership can change for the worse because of the child with disabilities. Everyone agreed that having a child with disability affects on a decision to have more children. All interviewees said that negative comments are usually heard from people who don´t know the child. Discussion and conclusion: Many people have difficulty accepting a child with disabilities because of the idea that a childhood is a period when we grow and learn new skills. According to the interviewees, what changes the most in the family, is mothers time management and her social life. We need to keep in mind that certain professionals only spend short period of time with these children and their families, so it’s hard to get a full picture of their daily life. It is important to do our best to help parents accept their child for who he or she is.

V pričujočem magistrskem delu avtorica raziskuje povezanost pričakovanj o porodu in živete izkušnje poroda, povezanost odnosa med pričakovanji in doživljanjem živete izkušnje poroda ter prvega stika z novorojenim otrokom. V teoretičnem delu magistrskega dela predstavi ključne predpostavke odnosa med pričakovanji, tvorjenjem le-teh in doživljanjem poroda ter prvega stika z otrokom. Osredotoči se na občutja avtonomije, podpore, zaupanja vase, odnosa z zdravstvenim osebjem in doživljanje porodne izkušnje. Izpostavi tudi vlogo izbire porodnega okolja in obporodne nege. Opiše pomen mehanizma navezanosti pri odnosu matere in otroka, pomen stika odrasle navezanosti matere in povezanosti poporodne depresije in navezanosti. V empiričnem delu s pomočjo kvalitativne metodologije raziskuje povezanost fenomena izkušnje poroda in ustvarjenih pričakovanj o porodu ter odnos te povezanosti do doživljanja porodne izkušnje. V raziskavo je bilo vključenih deset žensk, ki so prvič izkusile fenomen poroda, od katerega je minilo najmanj pol leta in največ dve leti. Povprečna starost udeleženk je bila 29,8 let, vse so prihajale iz osrednjeslovenske regije. Osem intervjuvank je imelo vaginalen porod, dve pa porod s carskim rezom. Na podlagi desetih intervjujev z materami, ki so prvič doživele porodno izkušnjo, avtorica ugotavlja povezanost med občutji avtonomije in živeto izkušnjo poroda ter pozitivnim doživljanjem porodne izkušnje. Rezultati so izpostavili povezanost doživljanja porodne izkušnje in občutja podpore prisotnih pri porodu. Občutje podpore se je izpostavilo predvsem kot osebni odnos zdravstvenega osebja, v sklopu katerega so bile porodnice prepoznane kot individualne osebe, njihove želje pa so bile spoštovane. Rezultati so pokazali, da je občutje avtonomije med porodom povezano z odnosom z zdravstvenim osebjem, kar je tesno prepleteno z možnostjo soodločanja o medicinskih intervencijah in drugih okoliščinah poroda. Rezultati so pokazali tudi na povezanost pričakovanj o porodu in doživljanja živete porodne izkušnje, kjer se razhajanje med pričakovanji in izkušnjo kaže v bolj negativnem vrednotenju poroda, skladje med pričakovanji in izkušnjo pa se kaže v bolj pozitivnem vrednotenju te izkušnje. Ključnega pomena sta, glede na rezultate raziskave, občutje avtonomije in možnost nadzora lastne porodne izkušnje. Nenazadnje rezultati kot dejavnik, ki je povezan s prvim stikom med materjo in otrokom ter vzpostavljanjem začetne navezanosti, prikazujejo tudi povezanost med skladjem oziroma neskladjem med pričakovanji in živeto izkušnjo. In her master's thesis, the author explores the connection of birth expectations and lived birth experience, the relationship between the two and connection to mother and newborn first contact. In theoretical section of this thesis the author presents main presumptions of relationship between expectations, formation of expectations and experience of childbirth. The focus is on feelings of agency, support, trust and confidence in self and relationship with health workers. It continues to set out important factors of birth environment and care during birth. The author describes importance of mother adult attachment style and its relationship to postpartum depression. In the empirical section of this thesis, qualitative method with phenomenological approach was implied. The specific phenomenon of childbirth experience and created expectations was focal point of this research. For the research of this phenomenon, the author conducted ten phenomenological interviews with prim parous women, from their birth experience passed at least six months and not more than two years. The average age of participants was 29,8 years and they all lived in central Slovenia. Eight women had vaginal birth and two had a caesarian section. Based on conducted interviews of first time mothers the author found correlation between feelings of agency during childbirth and positive evaluation of childbirth experience and correlation between birth experience and feeling of support from others humans present at birth. Feeling of support was especially emphasized in relationship with healthcare workers in which the support was shown as the woman was recognized as an individual person and their wishes were respected. The feeling of agency during childbirth was correlated with relationship and interactions with healthcare workers, which is then correlated to ability to make decisions about medical interventions and other factors of birth environment. Furthermore there was shown correlation between birth expectations and birth experience, where discrepancy between the two is connected to more negative assessment of birth experience, whereas concordance of expectations and experience is connected to more positive birth assessment. The main aspects of this research were the feeling of agency and possibility of control over childbirth and decisions regarding the process. Last but not least the factor connected to first contact between mother and newborn and the beginning of forming an attachment was in part also the discrepancy or concordance of birth expectations and birth experience.

Uvod: Čeprav je porod za večino žensk najlepša izkušnja, ki jo doživijo v svojem življenju, ga kot posledico anatomsko-fizioloških sprememb večinoma spremlja močna bolečina. Nanjo še pred dejanskim občutenjem te vplivajo različni kulturni, okoljski in socialni dejavniki. Z namenom lajšanja porodne bolečine in s tem preprečevanja mogočih zapletov uporabljamo različne farmakološke in nefarmakološke tehnike. Ena redkeje uporabljenih tehnik je uporaba transkutane električne živčne stimulacije (TENS), ki temelji na teoriji kontrole vrat in se v porodništvu uporablja od leta 1970. Namen: Namen diplomskega dela je s pregledom znanstvene literature ugotoviti učinkovitost transkutane električne živčne stimulacije na zmanjševanje bolečine pri porodu. Metode dela: Članke in literaturo smo iskali v podatkovnih bazah PubMed, CINAHL, PEDro in COBISS+. Izbrana je bila literatura v slovenskem in angleškem jeziku, objavljena po letu 2005 in najdena s pomočjo naslednjih ključnih besed: TENS, porod, porodna bolečina, fizioterapija . Rezultati: Na podlagi vključitvenih in izključitvenih kriterijev smo izbrali osem raziskav. V vseh raziskavah je bil uporabljen TENS z namenom zmanjševanja bolečine pri porodu. V eni od raziskav so preučevali njegovo uporabo za zmanjševanje bolečine pri postopku epiziotomije. Avtorji so ugotovili, da je uporaba TENS-a statistično in klinično pomembno pripomogla k zmanjševanju porodne bolečine v primerjavi s klasično oskrbo, ni pa pomembno zmanjšala bolečine pri epiziotomiji. Njegova uporaba med drugimi ni vplivala na trajanje poroda in na oceno Apgar novorojenčka, merjenega v prvi in peti minuti po rojstvu. Razprava in zaključek: Rezultati, pridobljeni s pregledom literature, so kazalnik, da je TENS učinkovita metoda za lajšanje porodne bolečine. Potrebno bi bilo narediti dodatne raziskave, s katerimi bi lahko natančneje opredelili njegove učinke. Introduction: Although for most women childbirth is one of the most beautiful experiences in their lifetime, it is mostly accompanied by severe pain as a result of anatomical-physiological changes. It is affected by various cultural, environmental and social factors before it is actually even felt. We use a variety of pharmacological and non-pharmacological techniques to relieve labour pain and thus prevent from possible complications. One of the less commonly used techniques is the use of Transcutaneous Electrical Nerve Stimulation (TENS), which is based on the theory of gate control, and has been used in obstetrics since 1970. Purpose: The purpose of this diploma work was to review scientific studies of the effects of TENS on pain relief during labour. Methods: Articles and literature were searched in PubMed, CINAHL, PEDro and COBISS+ databases. Selected literature in Slovene and English language, published after year 2005, was found with the help of key words: TENS, labour, labour pain, physiotherapy. Results: Based on inclusion and exclusion criteria, eight studies were selected. In all studies, TENS was used to relieve labour pain. Its use to reduce pain during the episiotomy procedure was examined in one study. Authors found that the use of TENS statistically and clinically made significant contribution to the relief of labour pain compared to conventional care, but did not significantly reduce pain during episiotomy cutting. Among other things, its use did not affect the duration of labour and the Apgar score of the newborn, measured in the 1st and 5th minute after birth. Discussion and conclusion: The results obtained with the literature review are indicating that TENS is an effective method for pain relief during labour. To define its effects better, further research should be done.

Uvod: Dotik ima v babištvu pomembno vlogo in porod je pomembna izkušnja v življenju ženske. Pri porodu se pogosto uporablja dotik, saj babica lahko s pomočjo psihološko in fiziološko podpornega dotika pomaga ženskam omiliti bolečino ter spodbuditi relaksacijo. Z diagnostičnim dotikom pa spremlja napredovanje poroda. Za oceno napredovanja poroda porodničarji in babice najpogosteje uporabijo vaginalni pregled. Namen: Namen diplomske naloge je s pomočjo obstoječe literature predstaviti pomen dotika v babištvu. Osredotočili smo se na pomen dotika za žensko med porodom ter identificirali izzive soočanja žensk z vaginalnimi pregledi. Poskušali smo izvedeti, ali so zdravstveni delavci spoštovali načela diagnostičnega dotika in informiranega soglasja. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda, s katero je bila pregledana strokovna in znanstvena literatura na temo pomen dotika med porodom. Literaturo smo pridobili s pomočjo mednarodnih iskalnih baz PubMed, Cochrane Libary in Science Direct ter z uporabo digitalne knjižnice Univerze v Ljubljani DiKUL. V analizo smo vključili osem člankov. Rezultati: Zdravstveni delavci z nepremišljenim dotikom intimnih predelov pri ženski izzovejo nelagodje, povzročijo dodatno bolečino in negativno zaznamujejo porodno izkušnjo. Mnoge ženske so deležne bolečih in neprijetnih vaginalnih pregledov. Želijo si, da jih porodničar in babica obravnavata spoštljivo in dostojno. Pričakujejo, da jim zdravstveni delavci, ki izvajajo vaginalni pregled, podajo potrebne informacije, razlago, z njimi vzpostavijo podporno komunikacijo ter da po končanem pregledu prejmejo tudi povratno informacijo. Razprava in zaključek: Med porodom je ključno sočutje babice, zlasti pri obvladovanju bolečine, ki jo povzročijo vaginalni pregledi. Ob spoštljivi obporodni obravnavi bodo ženske lahko razvile dober odnos z babico, kar bo omogočilo razpravo o porodnih pričakovanjih in oskrbi. Introduction: Touch plays an important role in midwifery and childbirth is an important experience in a woman’s life. Touch is often used in childbirth, as the midwife can help women alleviate pain and encourage relaxation with the use of psychologically and physiologically supportive touch. She can also monitor the progress of childbirth with a diagnostic touch. Vaginal examinations are most commonly used by obstetricians and midwives to assess the progress of labour. Purpose: The purpose of this diploma thesis is to present the importance of touch in midwifery, with the help of existing literature. We focused on the importance of touch during childbirth and identified the challenges of women facing vaginal examinations. We tried to find out if health professionals followed the principles of diagnostic touch and informed consent. Methods: In this diploma thesis we used a descriptive method to review the professional and scientific literature on the importance of touch during childbirth. The literature was accessed through the international databases PubMed, Cochrane Libary, Medline, Science Direct and through the digital library of the University of Ljubljana DiKUL. Eight articles were included in the analysis. Results: Healthcare workers can cause discomfort, additional pain and negatively mark the birth experience by recklessly touching the intimate areas. Many women experience painful and uncomfortable vaginal examinations. They want the obstetrician and midwives to treat them with dignity and respect. They expect that the healthcare professionals, who perform vaginal examinations, give the necessary information, explanation and establish supportive communication. Women also expect a feedback after the examination is completed. Discussion and conclusion: During childbirth women need a midwife's compassion especially in the management of pain caused by vaginal examinations. With respectful support during childbirth, women will be able to develop a good relationship with the midwife, which will allow for a discussion of childbirth expectations and care.

Izhodišča (namen): Magistrsko delo je usmerjeno v proučevanje pojavnosti nespoštljivega ravnanja pri skrbi za porodnico. Ocenili smo odstotek žensk v Sloveniji, ki so ob porodu doživele nespoštljivo ravnanje in opisali obliko nespoštljivega ravnanja ter podatke primerjali z rezultati obstoječih raziskav. Raziskovalna metodologija in metode: V teoretičnem delu je bil narejen pregled znanstvene literature na temo kakovosti in spoštovanja v obporodni oskrbi, v empiričnem delu je bila narejena opazovalna presečna raziskava. Uporabili smo metodo anketiranja. Za vrednotenje zastavljene hipoteze smo uporabili hi-kvadrat test. Za preverjanje hipoteze in ugotavljanje statistično pomembnih razlik smo uporabili p-vrednost (p

Magistrsko delo govori o problematiki in situaciji mladih najstniških mam, ki so med nosečnostjo živele v vzgojno-izobraževalnem zavodu in so po rojstvu otroka še vedno v omenjenem sistemu izobraževanja. Teoretični uvod predstavi zavodsko obravnavo, formalne in neformalne oblike pomoči, na katere se mame lahko obrnejo, in pravicah, ki jim pripadajo. V vzgojno-izobraževalnem zavodu, kjer so nastanjeni mladostniki, sem dobila informacijo o treh mamah, ki so rodile v zadnjem letu. Socialna pedagoginja, ki je z mamami ves čas v stiku, mi je pomagala organizirati pogovore. Tako sem z vsemi tremi mamami opravila intervju. Na koncu sem intervju opravila tudi s specialno pedagoginjo, ki je podala svojo strokovno perspektivo in opisala oblike pomoči, ki jih zavod ponudi mamam. Vse tri mlade mame so v intervjuju povedale, da so dobile pomoč zavoda. Vse so z zaposlenimi zelo zadovoljne in pravijo, da so jim nudili tudi neformalne oblike pomoči. Tudi od specialne pedagoginje sem dobila zelo pozitiven odziv. Povedala je, da se v takih situacijah združijo vsi zaposleni in mamam priskočijo na pomoč. Vse tri mame si želijo samostojnosti in vse kažejo svojo odraslost in odgovornost do otrok. Po koncu raziskave sem napisala nekaj predlogov, ki bi mamam lahko še dodatno olajšali in pomagali pri tej zahtevni življenjski nalogi – starševstvu. The master's thesis describes the problems and situations faced by young mothers living in youth residential care centers during pregnancy, and who are still included in their teaching program after giving birth. In the theoretical part it discusses the residential treatment program, formal and informal help programs to which mothers can turn, and the rights of young mothers. A youth residential care center informed me that three young mothers had given birth during the past year. The social pedagogue who is constantly in touch with the mothers helped me organize interviews with these three mothers. In the end, I also interviewed the social pedagogue who described how they handle these kinds of situations and what sort of help they can offer to young mothers. All three young mothers whom I interviewed told me that they had had a lot of help from the employees of the youth residential care center, who also provided them with informal help. The social pedagogue also described how they usually help in situations like these and she demonstrated a very positive attitude. All three mothers want to be independent and have shown their responsible behavior towards their children. At the end, I have written a few suggestions that could help mothers with carrying out the difficult task of parenthood.

V diplomskem delu raziskujem temo poporodne depresije in kako je ta povezana ter kako vpliva na življenja žensk. V teoretičnem delu se posvetim razlagi tega, kaj ženske doživljajo med nosečnostjo in po porodu. Razložim splošne značilnosti nosečnosti, opišem nosečnost po obdobjih (vsako trimesečje) in kaj lahko ženska v vsakem od teh obdobij prestaja. Pri temi poroda prav tako opišem potek poroda, njegove faze, da si posameznik lažje predstavlja izkušnjo ženske, hkrati pa poudarjam, da so opisi splošni in se razlikujejo od ženske do ženske. Tematiko, ki je v zvezi z materinstvom, razdelim na dve podtemi, ki govorita o družbenem konstruktu materinstva in o materah v medijih in na družbenih omrežjih. Za konec pa pojasnim razlike med različnimi poporodnimi stiskami in podrobneje opišem poporodno depresijo (kako se kaže, s kakšnimi simptomi, kako jo zdravimo ...). V raziskovalnem delu me je zanimalo, kako ženske doživljajo obdobje nosečnosti in materinstva (prehod v materinstvo) s kakšnimi težavami se srečujejo ob teh prelomnih trenutkih kako bližnji sprejemajo nosečnosti in materinstvo ženske ter kakšno oporo jim dajejo. Ugotavljala sem tudi, ali se težave v obdobju nosečnosti povezujejo s pojavnostjo poporodne depresije. Raziskava je pokazala, da so ženske z izkušnjo poporodne depresije imele težave v nosečnosti, vendar tega ne moremo zagotovo povezati, saj so obdobje nosečnosti sicer označile kot lepo in lahko. Pokazalo se je tudi, da jim je prehod v materinstvo predstavljal težavo, saj so se bale neznanega in novega. Pomembna je tudi ugotovitev, da ženske pripisujejo velik pomen družbenemu konstruktu idealne mame in da jih ta močno obremenjuje. Intervjuvane ženske so imele v času po porodu dovolj opore bližnjih, vendar jim kljub vsemu največjo stisko povzroča osamljenost, ki je posledica izolacije od preostale družbe. In my graduation thesis I examine the topic of postpartum depression and how it relates to the lives of women and how it affects their lives. In the theoretical part, I focus on explaining what women experience during pregnancy and after childbirth. I explain the general characteristics of pregnancy I describe pregnancy by stages (each trimester) and what a woman can experience during each of these stages. In the subject of childbirth, I also describe the course of childbirth and its phases for an individual to better understand what a woman experiences, while emphasizing that the descriptions are general and depend on every woman individually. I divide the topic concerning motherhood into two sub-topics that discuss the social construct of motherhood and mothers in the media and on social networks. Finally, I explain the differences between different types of postpartum distress and describe postpartum depression in more detail (how it manifests itself, what the symptoms are, how to treat it, etc). In the empirical part, I was interested in how women experience the time of pregnancy and maternity (transition to motherhood) what difficulties they encounter at these turning points how their loved ones accept a woman's pregnancy and motherhood and what support they offer her. I also studied whether problems during pregnancy resulted in postpartum depression. The study showed that women with postpartum depression experienced pregnancy problems, but we cannot substantiate this for certainly as they characterized their pregnancy term as a beautiful and easy time. The study also showed that the transition to motherhood represented a problem for them as they feared the new and the unknown. It is also important to note that women attach great importance to the social construct of the ideal mother and that she is greatly burdened by it. The women interviewed told they had sufficient support from their loved ones after childbirth, but despite everything their greatest distress was loneliness resulting from isolation from the rest of society.