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Objective: To examine whether a method for raising women's awareness of fetal movements, Mindfetalness, can affect pregnancy outcomes.Design: Cluster-randomised controlled trial.Setting: Sixty-seven maternity clinics in Stockholm, Sweden.Population: Women with singleton pregnancy with birth from 32 weeks' gestation.Methods: Women registered at a clinic randomised to Mindfetalness were assigned to receive a leaflet about Mindfetalness (n = 19 639) in comparison with routine care (n = 20 226). Data were collected from a population-based register.Main Outcome Measures: Apgar score <7 at 5 minutes after birth, visit to healthcare due to decrease in fetal movements. Other outcomes: Apgar score <4 at 5 minutes after birth, small-for-gestational-age and mode of delivery.Results: No difference (1.1 versus 1.1%, relative risk [RR] 1.0; 95% CI 0.8-1.2) was found between the Mindfetalness group and the Routine care group for a 5-minute Apgar score <7. Women in the Mindfetalness group contacted healthcare more often due to decreased fetal movements (6.6 versus 3.8%, RR 1.72; 95% CI 1.57-1.87). Mindfetalness was associated with a reduction of babies born small-for-gestational-age (RR 0.95, 95% CI 0.90-1.00), babies born after gestational week 41+6 (RR 0.91, 95% CI 0.83-0.98) and caesarean sections (19.0 versus 20.0%, RR 0.95; 95% CI 0.91-0.99).Conclusions: Mindfetalness did not reduce the number of babies born with an Apgar score <7. However, Mindfetalness was associated with the health benefits of decreased incidence of caesarean section and fewer children born small-for-gestational-age.Tweetable Abstract: Introducing Mindfetalness in maternity care decreased caesarean sections but had no effect on the occurrence of Apgar scores <7. [ABSTRACT FROM AUTHOR]

Background The transition to parenthood is an overwhelming life event. From a theoretical perspective, transition to parenthood is a developmental transition that contains certain phases and patterns. Aim This study aim was twofold (i) discover, describe and comprehend transitional conditions that parents perceive as facilitating and inhibiting during transition to parenthood and to (ii) use that knowledge to develop recommendations for professional interventions that support and facilitate transition to parenthood. Design Meleis transition theory framed the study's deductive qualitative approach - from planning to analysis. Methods In a secondary analysis, data were analysed (as per Meleis transition theory) from two studies that implemented interviews with 60 parents in Sweden between 2013 and 2014. Interview questions dealt with parents' experiences of the transition to parenthood - in relation to experiences with parent-education groups, professional support and continuity after childbirth. Ethical issues A university research ethics board has approved the research. Results These factors facilitated transition to parenthood: perceiving parenthood as a normal part of life; enjoying the child's growth; being prepared and having knowledge; experiencing social support; receiving professional support, receiving information about resources within the health care; participating in well-functioning parent-education groups; and hearing professionals comment on gender differences as being complementary. These factors inhibited transition to parenthood: having unrealistic expectations; feeling stress and loss of control; experiencing breastfeeding demands and lack of sleep; facing a judgmental attitude about breastfeeding; being unprepared for reality; lacking information about reality; lacking professional support and information; lacking healthcare resources; participating in parent-education groups that did not function optimally; and hearing professionals accentuate gender differences in a problematic way. Conclusion Transition theory is appropriate for helping professionals understand and identify practices that might support parents during transition to parenthood. The study led to certain recommendations that are important for professionals to consider. [ABSTRACT FROM AUTHOR]

Background: Professional support does not always meet the needs of expectant fathers or co-mothers. The way in which professional support is offered during pregnancy varies internationally, depending on the country. In order to attain a greater understanding of partners' experiences of professional support, it is necessary to further illuminate their perceptions of it. The aim of this study was therefore to explore pregnant women's partners' perceptions of professional support during pregnancy.Methods: Qualitative research design. Partners of pregnant women were interviewed during gestational week 36-38. Individual semi-structured interviews were used to explore the partners' perceptions. The data was analysed using a phenomenographic approach. The study was performed in a county in south-western Sweden; the data collection was conducted from November 2014 to February 2015. Fourteen partners (expectant fathers and co-mothers) of women who were expectant first-time mothers with singleton pregnancies, were interviewed.Results: The findings of the study are presented through four descriptive categories: Ability to absorb adequate information; Possibility to meet and share with other expectant parents; Confirmation of the partner's importance; and Influence on the couple relationship. Using a theoretical assumption of the relationship between the categories showed that the fourth category was influenced by the other three categories.Conclusions: The partners perceived that professional support during pregnancy could influence the couple relationship. The partners' ability to communicate and to experience togetherness with the women increased when the expectant couple received professional support together. The support created also possibilities to meet and share experiences with other expectant parents. In contrast, a lack of support was found to contribute to partners' feelings of unimportance. It was essential that the midwives included the partners by confirming that they were individuals who had different needs for various types of professional support. The partners perceived it easier to absorb information when it was adequate and given with a pedagogic that made the partners become interested and emotionally engaged. [ABSTRACT FROM AUTHOR]

Background: The extended use of ultrasound that is seen in maternity care in most Western countries has not only affected obstetric care but also impacted on the conception of the fetus in relation to the pregnant woman. This situation has also raised concerns regarding the pregnant woman's reproductive freedom. The purpose of this study was to explore Swedish obstetricians' experiences and views on the role of obstetric ultrasound particularly in relation to clinical management of complicated pregnancy, and in relation to situations where the interests of maternal and fetal health conflict.Methods: A qualitative study design was applied, and data were collected in 2013 through interviews with 11 obstetricians recruited from five different obstetric clinics in Sweden. Data were analysed using qualitative content analysis.Results: The theme that emerged in the analysis 'Two sides of the same coin' depicts the view of obstetric ultrasound as a very important tool in obstetric care while it also was experienced as having given rise to new and challenging issues in the management of pregnancy. This theme was built on three categories: I. Ultrasound is essential and also demanding; II. A woman's health interest is prioritised in theory, but not always in practice; and III. Ultrasound is rewarding but may also cause unwarranted anxiety.Conclusions: The widespread use of ultrasound in obstetric care has entailed new challenges for clinicians due to enhanced possibilities to diagnose and treat fetal conditions, which in turn might conflict with the health interests of the pregnant woman. There is a need for further ethical discussions regarding the obstetrician's position in management of situations where maternal and fetal health interests conflict. The continuing advances in the potential of ultrasound to impact on pregnancy management will also increase the need for adequate and appropriate information and counselling. Together with other health care professionals, obstetricians therefore need to develop improved ways of enabling pregnant women and their partners to make informed decisions regarding pregnancy management. [ABSTRACT FROM AUTHOR]

Background Established in 1999, the Swedish Maternal Health Care Register (MHCR) collects data on pregnancy, birth, and the postpartum period for most pregnant women in Sweden. Antenatal care (ANC) midwives manually enter data into the Web-application that is designed for MHCR. The aim of this study was to investigate midwives' experiences, opinions and use of the MHCR. Method A national, cross-sectional, questionnaire survey, addressing all Swedish midwives working in ANC, was conducted January to March 2012. The questionnaire included demographic data, preformed statements with six response options ranging from zero to five (0 = totally disagree and 5 = totally agree), and opportunities to add information or further clarification in the form of free text comments. Parametric and non-parametric methods and logistic regression analyses were applied, and content analysis was used for free text comments. Results The estimated response rate was 53.1%. Most participants were positive towards the Webapplication and the included variables in the MHCR. Midwives exclusively engaged in patient-related work tasks perceived the register as burdensome (70.3%) and 44.2% questioned the benefit of the register. The corresponding figures for midwives also engaged in administrative supervision were 37.8% and 18.5%, respectively. Direct electronic transfer of data from the medical records to the MHCR was emphasised as significant future improvement. In addition, the midwives suggested that new variables of interest should be included in the MHCR - e.g., infertility, outcomes of previous pregnancy and birth, and complications of the index pregnancy. Conclusions In general, the MHCR was valued positively, although perceived as burdensome. Direct electronic transfer of data from the medical records to the MHCR is a prioritized issue to facilitate the working situation for midwives. Finally, the data suggest that the MHCR is an underused source for operational planning and quality assessment in local ANC centres. [ABSTRACT FROM AUTHOR]