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Professional support in childbearing, a challenging act of balance
University of Skövde, School of Life Sciences.ORCID iD: 0000-0001-7510-606X
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim was to contribute to the development of optimal quality care in childbearing through exploring how professionals learn to act and how they act in support of women and their partners and what supportive needs women and their partners have during childbearing, as well as how professional support influences parents' experience during childbearing and their relation to the baby. I) Diaries from student midwives (n=11), about offering continuous support during childbirth, analysed with qualitative analysis. II) An observation and interview study during childbirth with midwives (n=7), women (n=7) and their partner (n=7), analysed with hermeneutic text interpretation. III) First-time mothers (n=10) were interviewed three days after birth, as a step in the validation process of the "Mother to Infant Relation and Feelings" (MIRF) scale, analysed with qualitative content analysis. IV) A random longitudinal intervention study including a process-oriented training program for midwives and postnatal nurses. First time mothers with a caesarean or a normal birth (n=395) answered questionnaires at three days, three and nine months postpartum about professional support and their relation to and feelings for the baby, analysed statistically. Result: I) Offering continuous support made students aware of the importance to establish rapport, but needing reassurance could hamper their efforts to establish rapport. Experiencing a lack of confidence made students focus more strongly on their medical skills. II) Which ideology midwives adopted during childbirth influenced if the individual supportive needs of women and their partners were met. III) The MIRF scale appears valid to use in research and in dialogue with new mothers to support mother-to-infant interactions. IV) Trained professionals strengthened mothers' perception of professional support which may buffer negative effects of caesarean birth in relation to the baby. Conclusion: Professional support in childbearing is a challenging act of balance which can strengthen women's sense of ability in meeting the needs of the baby even in the additional challenge of caesarean birth. Training in support and reflection about one's attitudes and ideology in practice improve supportive skills.

Place, publisher, year, edition, pages
Örebro universitet , 2012. , 180 p.
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 39
Keyword [en]
Professional support, social support, education, attitudes, childbearing, motherhood, mother-infant interaction, caesarean birth, ideology in practice
National Category
Health Sciences
Research subject
Medical sciences
Identifiers
URN: urn:nbn:se:his:diva-6547Libris ID: 12745618ISBN: 978-91-7668-874-8 OAI: oai:DiVA.org:his-6547DiVA: diva2:561271
Public defence
2012-09-26, Hörsal Insikten, Portalen, Högskolan i Skövde, Skövde, 13:00
Opponent
Supervisors
Note

Ett av fyra delarbeten (övriga se rubriken Delarbeten)

Study II) Thorstensson, S., Ekström, A., Lundgren, I., & Hertfelt Wahn, E. (2012). Exploring midwives' professional support during labour; an observation and interview study. Manuscript

Available from: 2012-10-18 Created: 2012-10-18 Last updated: 2014-10-31Bibliographically approved
List of papers
1. Evaluation of the Mother-to-Infant relation and feeling scale: Interviews with first-time mothers' for feelings and relation to their baby three days after birth
Open this publication in new window or tab >>Evaluation of the Mother-to-Infant relation and feeling scale: Interviews with first-time mothers' for feelings and relation to their baby three days after birth
2012 (English)In: International Journal of Nursing and Midwifery, ISSN 2141-2456, Vol. 4, no 1, 8-15 p.Article in journal (Refereed) Published
Abstract [en]

Mothers’ perception of their relationship with their baby might affect sensitive parenting. This study aimed to explore first time mothers’ feelings for and their relation to the baby associated with how they responded to the "mother to infant relation and feelings (MIRF) scale" as a step in the validation process of the scale. Interviews with ten first-time mothers, three days after birth, were performed, using open questions followed by questions directly from the MIRF scale items. An inductive and deductive approach inspired by the "Think aloud" method guided the study. Results describe main category; New mothers bewilderment and anticipation which contained four categories; Natural and great but mixed, Maternal instinct and kinship, Ability and expectations and Not yet for real. When mothers responded to MIRF scale items they describe talking to their baby which they did not in their open answers. Answering the MIRF scale helped mothers in differentiating between their own mixed feelings of becoming mothers and their relation to and feelings for the baby. The MIRF scale appears valid in reflecting important aspects of mothers’ feelings for and relation to their baby. The MIRF scale could be used in research and when evaluating care routines as well as in dialogue with new mothers to support mother-to-infant interactions.

Place, publisher, year, edition, pages
Academic Journals, 2012
Keyword
Maternal feeling assessment, becoming a mother, motherhood, childbirth, professional support, validity
National Category
Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-5892 (URN)10.5897/IJNM11.041 (DOI)
External cooperation:
Available from: 2012-05-24 Created: 2012-05-24 Last updated: 2016-09-05Bibliographically approved
2. An exploration and description of student midwives' experiences in offering continuous labour support to women/couples
Open this publication in new window or tab >>An exploration and description of student midwives' experiences in offering continuous labour support to women/couples
2008 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 24, no 4, 451-459 p.Article in journal (Refereed) Published
Abstract [en]

Aim: to explore and describe the student midwife's experiences in offering continuous labour support.Design: a qualitative research design was chosen. Each student midwife offered continuous labour support to five women/couples and wrote narratives about each of these occasions. Written narratives from 11 student midwives were analysed using qualitative content analysis.Findings: when student midwives offer continuous labour support to women/couples, they tyr to establish rapport. When this works, their presence, their sense of confidence and their ability to offer reassurance increase. If establishing rapport does not work, students experience a sense of powerlessness, a need for reassurance and a lack of confidence. Key conclusions: offering continuous labour support to women and/or their partners made the students aware of the importance of establishing rapport, and it made them realise the impact that their mere presence in the room could have. The students had a need for reassurance which could hamper their efforts to establish rapport. Experiencing a lack of confidence made students focus more strongly on their clinical skills and on their perceived role as a student midwife. Implications for practice: this study can initiate discussions about how student midwives learn to be supportive, as well as about the role models that students encounter during their clinical training in Sweden.

Place, publisher, year, edition, pages
Elsevier, 2008
Keyword
Continuous labour support, Social support, Childbirth, Establishing rapport
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-2845 (URN)10.1016/j.midw.2007.05.003 (DOI)000261540400009 ()17881100 (PubMedID)2-s2.0-55149087728 (Scopus ID)
Available from: 2009-03-12 Created: 2009-03-12 Last updated: 2013-10-22Bibliographically approved
3. Professional Support in Pregnancy Influence Maternal Relation to and Feelings for the Baby after Cesarean Birth: An Intervention Study
Open this publication in new window or tab >>Professional Support in Pregnancy Influence Maternal Relation to and Feelings for the Baby after Cesarean Birth: An Intervention Study
2012 (English)In: Journal of Nursing and Care, ISSN 2167-1168, Vol. 1, no 4, 112- p.Article in journal (Refereed) Published
Abstract [en]

Background: Cesarean birth may negatively affect mother-infant interactions, while professional support may positively affect these interactions. The aim of this study was to evaluate the effects of a process-oriented training program for antenatal midwives and postnatal nurses on first time mothers’ perceptions of professional support and on their relation to and feelings for their baby after a cesarean or a normal birth. Methods: An intervention through process-oriented training for health professionals regarding professional support in childbearing was conducted between 1999 and 2003. Ten municipalities were paired and within each pair, randomly assigned to intervention (five) or control (five) municipality. Mothers having caesarean (n=94) or normal birth (n=301) were included. Mothers received routine care (Control Group=CG) or care from health professionals having received training (Intervention Group=IG). The mothers answered questionnaires three days, three and nine months after birth. Factor analysis identified three factors: “Taking in baby,” “Confidence in relation to baby,” and “Feelings for baby.” Results: Mothers in the IG with cesarean birth reported more positive for the “Taking in baby” factor (p=0.002) three days after birth, more positive for the “Confidence in relation to baby” factor (p=0.004) and for the “Feelings for baby” factor (p=0.004) nine months after birth compared to Mothers in the CG. Mothers in the IG reported stronger professional support from health professionals compared to CG. Conclusion: Our result suggests that improved professional support during pregnancy may buffer negative effects of caesarean birth for first-time mothers in relation to and feelings for the baby.

Place, publisher, year, edition, pages
OMICS Publishing Group, 2012
Keyword
Caesarean birth, Health education, Mother-infant interaction, Parental support, Professional support, Process-oriented training
National Category
Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-7009 (URN)10.4172/2167-1168.1000112 (DOI)
Available from: 2013-01-14 Created: 2013-01-14 Last updated: 2015-11-03Bibliographically approved

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