Högskolan i Skövde

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.