Midwives' experiences of encountering immigrant women during labour and birth who do not master the host country's language. A lifeworld hermeneutic study

Background - Immigrant women are in a vulnerable position during labour and birth due to language barriers. Communication with women who do not master the host country's language is difficult for midwives, but there are few studies about midwives' experiences. Aim - To explore Norwegian midwives' experiences of encountering immigrant women during labour and birth who do not master the native language. Method - A hermeneutic lifeworld approach. Interviews with eight midwives working at specialist clinics and hospital maternity wards in Norway. Results - The findings were interpreted based on four concepts in the theory “Birth territory: A theory for midwifery practice” by Fahy and Parrat presented in five themes: language barriers can cause disharmony and prevent participation, language barriers can lead to midwifery domination and poorer care, midwives strive for harmony and to be a guardian, medicalisd birth due to language barriers, and disharmony can lead to crossing boundaries. The main interpretation shows that it is midwifery domination and disintegrative power that are prominent. However, the midwives strived to use their integrative power and be guardians, but in doing so they encountered challenges. Conclusion - Midwives need strategies for better communication with immigrant women involving the women and for avoiding a medicalised birth. To be able to meet immigrant women's needs and to establish a good relationship with them, challenges in maternity care need to be addressed. There are needs of care that focus on cultural aspects, leadership teams that support midwives, and both theoretical and organisational care models that support immigrant women

Women's lived experiences of induction of labour in late- and post-term pregnancy within the Swedish post-term induction study - a phenomenological study

Purpose: There is a trend worldwide to induce pregnant women earlier. However, few studies have focused on women’s experiences. The aim was to gain a deeper understanding of women’s lived experiences of induction of labour in late- and post-term pregnancy. Methods: Phenomenology with a reflective lifeworld approach was chosen as the method. Twelve women participating in a larger study in which women were randomized to either induction of labour in week 41 or to expectant management until week 42, were interviewed one to three months after giving birth. Results: The essence is described as follows: labour becomes another journey than the intended one. The women adapted to this new journey by seeing the advantages and handing themselves over to the healthcare system, but at the same time something about giving birth could be lost. The result is further described by its four constituents: planning the unplannable, being a guest at the labour ward, someone else controlling the labour, and overshadowed by how it turned out. Conclusion: Induced labour presents a challenge to maternity personnel to support the birthing woman’s normal progress, not to rush her through labour, and to involve her in the process

Health professionals’ perceptions of a midwifery model of woman-centred care implemented on a hospital labour ward

Publisher Copyright: © 2019 The AuthorsBackground: Theoretical models as a basis for midwives’ care have been developed over recent decades. Although there are similarities between these models, their usefulness in practice needs to be researched in specific cultural contexts. Aim: To explore whether, when adopted by midwives on labour wards, a midwifery model of woman-centred care (MiMo) was useful in practice from the viewpoint of a variety of health professionals. Methods: Data were collected from a variety of health professionals before and after an intervention of implementating MiMo at a hospital-based labour ward in Sweden, using nine focus group interviews with a total of 43 participants: midwives (n = 16), obstetricians (n = 8), assistant nurses (n = 11) and managers (n = 8). The text from interviews was analysed using content analysis. Findings: From expressing no explicit need of a midwifery model of woman-centred care before the intervention, there was a shift in midwives, obstetricians and managers perceptions towards identifying advantages of using the MiMo as it gives words to woman-centred midwifery care. Such shift in perception was not found among the assistant nurses. Discussion: Clarification of the various roles of health professionals is needed to develop the model. Heavy workloads and stress were barriers to implementing the model. Thus, more support is needed from organisational management. Conclusions: The model was useful for all professional groups, except for assistant nurses. Further studies are needed in order to clarify the various professional roles and interdisciplinary collaborations in making the MiMo more useful in daily maternity care.Peer reviewe

Kalkningar i Gislaveds kommun 1998-2003. Måluppfyllelse och effekter. Del 1 och Del 2

Kalkning är nödvändig för att åtgärda de mycket omfattande försurningsskadorna i Gislaveds kommun. I stort sett hela kommunen omfattas av kalkningsåtgärder. Varje år sprids ca 4 200 ton kalk i Gislaveds kommun, vilket finansieras av staten och kommunen. I denna rapport sammanfattas de kalkningar som har skett under perioden 1998-2003.Kalkningen av sjöar i Gislaveds kommun ger relativt bra resultat för vattenkemin i sjöar, men inte lika bra resultat i vattendrag. De vattenkemiska målen har varit uppfyllda i 90 % av sjöytan och i 49 % av vattendragslängden. Måluppfyllelsen för biologi är lägre än för vattenkemi, vilket drar ner den totala måluppfyllelsen till 75 % av sjöytan och 31 % av vattendragslängden. Att målen inte är uppfyllda i 25 % av sjöytan och 69 % av vattendragslängden beror dels på att de vattenkemiska målen inte är uppfyllda överallt och dels på att det tar tid för biologin att återhämta sig. Om man räknar antalet mål har 60 % av åtgärdsområdenas målsättningar varit uppfyllda. Jämfört med den förra utvärderingen, som omfattade treårsperioden 1995-1997, så är den totala måluppfyllelsen något lägre.I åtta åtgärdsområden föreslås sänkta kalkdoser, i fem åtgärdsområden föreslås höjda doser eller förtätningar av omkalkningsintervallen och i 13 åtgärdsområden bedöms nuvarade kalkningsstrategi fungera bra. Utvecklingen i okalkade vattendrag tyder på att kalkning kommer att behövas under en lång tid framöver i kommunen.Regionala inventeringsrapporter import från MDP 2015-05</p

A midwifery model of woman-centred childbirth care--in Swedish and Icelandic settings.

Theoretical models for health care practice are important both as tools for guiding daily practice and for explaining the philosophical basis for care. The aim of this study was to define and develop an evidence-based midwifery model of woman-centred care in Sweden and Iceland. Using a hermeneutic approach we developed a model based on a synthesis of findings from 12 of our own published qualitative studies about women's and/or midwives' experiences of childbirth. For validity testing, the model was assessed in six focus group interviews with 30 practising midwives in Iceland and Sweden. The model includes five main themes. Three central intertwined themes are: a reciprocal relationship; a birthing atmosphere; and grounded knowledge. The remaining two themes, which likewise influence care, are the cultural context (with hindering and promoting norms); and the balancing act involved in facilitating woman-centred care. The model shows that midwifery care in this era of modern medical technology entails a balancing act for enhancing the culture of care based on midwifery philosophies. The next step will be to implement the model in midwifery programmes and in clinical practice, and to evaluate its applicability

Norwegian midwiveś experiences of encounter and support women with fear of childbirth during birth

Objective: To describe midwiveś experiences of encountering and supporting women with fear of childbirth (FOC) during the birth. Method: Qualitative study with a phenomenological approach, using 10 individual semi-structured interviews with midwives who had cared for women with FOC during the birth. All midwives worked in birth clinics or maternity wards. The data was analysed using Malterud́ s systematic text condensation (STC). Results: The findings present in three main themes: taking on a professional role as a midwife to take care of women; time matters for safety and trust; and to encounter and see women without prejudices. Themes to describe a ‘professional midwife’ included self-confidence, control, competence/experience, independence, promoting normal birth, and motivation. Time played a crucial role in enabling a calm approach and a relationship built on trust, as well as in creating a sense of continuity and being present. Individual care and equality among the women was of importance to prevent prejudices, as was having control of the term FOC. Self-awareness was also important for evaluating the quality of the relationship, and the midwives’ wanted clear guidelines for handling women with FOC. Conclusion: Aspects related to professional midwifery skills, organisational factors such as time to establish safety and trust, and use of the concept of FOC, are all important for midwives when encountering and supporting women with FOC at birth. All these aspects need to be improved in the care of women with FOC, and clearly defined guidelines for handling such cases need to be developed