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Many countries have adopted abstinence guidelines for pregnant women, due to uncertainty around the risk of harm caused by small amounts of alcohol. There is a lack of research exploring frontline midwives' attitudes towards alcohol use during pregnancy and comparisons of practices in different countries. Sixteen semi-structured interviews were conducted with midwives working in Liverpool, England (n = 7) and Örebro County, Sweden (n = 9). Data were analysed inductively, using thematic analysis with thematic networks. The findings show that all midwives believed pregnant women should be advised not to consume any alcohol during pregnancy and there is a need to tailor their approach to the individual. A key concern among midwives in both countries was how to advise about alcohol exposure that occurs before the pregnancy is known to the woman. English midwives discussed the uncertainty around the risk of consuming small amounts of alcohol, whereas Swedish midwives believed any amount of alcohol was associated with risk. Discussing alcohol was viewed as part of the health professional's role, but routine questions for all women were perceived to aid discussions about alcohol. Future research should further explore the impact of wider social and political environment on midwives' attitudes around risks with prenatal alcohol use. [ABSTRACT FROM AUTHOR]

Following a restructuring of Swedish healthcare in the 1990s - moving from a welfare model to one inspired by New Public Management - maternity care in Sweden is increasingly centralised to bigger towns. This has led to several units being relocated or forced to close, and to a bigger distance to maternity care for women living in smaller towns and rural areas. In the present article, I analyse the media reporting on the recent closure of the maternity ward in Sollefteå, a small town in Sweden’s northern region. Using intersectional risk theory, I explore how pregnancy-related risks are articulated in Swedish newspapers, and how such articulations relate to power and ideology. Articles from three Swedish newspapers, published during a 4-month period, have been analysed using critical discourse analysis. I conclude that the newspaper articles were most likely to stress the family as the main ‘risk victim’, while the pregnant woman was rarely the focus of risk articulations. When she was, risks were described as ‘worry’ or ‘unworthiness’, and never in medical terms. When such articulations appeared within an individualist ideological discourse, they were naturalised and as such, disconnected from the political decision to close the maternity ward. My contention is that a feminist perspective is largely missing in the media articles and that a bigger focus on the effect that maternity ward closures have for women living outside urban centres is needed. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have shown an increased risk of obstetric complications in pregnancies after oocyte donation (OD). The present study includes all singletons born after OD over 10 years in Sweden.Material and Methods: This was a retrospective population-based cohort study. Data from all Swedish in vitro fertilization (IVF) clinics between 2003 and 2012 were collected. Data were cross-linked with the Swedish Medical Birth Registry. The study included 388 OD singletons, 26 696 IVF/ICSI singletons and 999 804 spontaneously conceived (SC) singletons. An adjusted odds ratio (aOR) was calculated with adjustment for relevant confounders.Results: Singleton OD pregnancies had a significantly increased risk of preeclampsia compared with IVF (aOR 3.05; 95% CI 2.23-4.16) and SC (aOR 2.84; 95% CI 2.10-3.84), and increased risk of postpartum hemorrhage (>1000 mL) compared with IVF (aOR 2.66; 95% CI 2.04-3.49) and SC (aOR 2.87; 95% CI 2.20-3.71), a higher risk of preterm birth (<37 weeks) compared with IVF (aOR 1.79; 95% CI 1.30-2.46) and SC (aOR 1.58; 95% CI 1.15-2.16) and a higher risk of low birthweight (<2500 g) compared with IVF (aOR 1.67; 95% CI 1.15-2.42) and SC (aOR 1.46; 95% CI 1.01-2.11). The rate of large-for-gestational age was significantly increased in singletons born after OD with frozen cycles than with fresh cycles (odds ratio 5.29, 95% CI 1.30-21.54).Conclusions: Singleton pregnancies conceived after OD are associated with increased maternal and perinatal risks compared with IVF/ICSI pregnancies using the woman's own oocytes and with SC. [ABSTRACT FROM AUTHOR]

Background: Overweight or obesity is detrimental during pregnancy. We studied time trends in the educational gradient of overweight and obesity among pregnant women. Differences in overweight and obesity by area of residence and country of birth were also examined. Methods: The study was based on the Swedish Medical Birth Register between 1992 and 2010 and included 1,569,173 singleton pregnancies. Weight and height were registered during the first visit at the antenatal-care clinic. Data on education, country of birth, and area of residence were derived from registers with national coverage. Results: In 2008-2010, 32% of Swedish nulliparous pregnant women were overweight or obese. The relative risk of obesity among lower educated women compared to women with higher education increased from 1.91 (95% confidence interval: 1.85-1.97) in 1992-1995 to 2.09 (95% confidence interval: 2.05-2.14) in 2008-2010. There was an inverse linear relationship between risks of overweight or obesity, and population density and type of residence municipality. An excessive gestational weight gain according to the American Institute of Medicine was observed among 57-63% of the overweight or obese women, but there were small differences by education. Pregnant women born in Africa, Middle East or Latin America had higher risks of being overweight or obese compared to women born in Sweden. Conclusions: The prevalence of obesity as well as the social inequalities in obesity during pregnancy increased in Sweden between 1992 and 2010. Further understanding of social inequalities and geographical differentials in health behaviours of pregnant women is needed when planning public health interventions. [ABSTRACT FROM AUTHOR]