Middle Eastern mothers in Sweden, their experiences of the maternal health service and their partner's involvement

<p>Abstract</p> <p>Background</p> <p>Traditional patterns relating to how to handle pregnancy and birth are often challenged due to migration. The purpose of this study was to describe Middle Eastern mothers' experiences of the maternal health care services in Sweden and the involvement of their male partner.</p> <p>Methods</p> <p>Thirteen immigrant mothers from the Middle East who had used the maternal health services in Sweden were interviewed using focus group discussions and individual interviews. These were taped, transcribed and analysed according to Content analysis.</p> <p>Results</p> <p>The four main categories that developed were:</p> <p>• Access to the professional midwife</p> <p>• Useful counselling</p> <p>• Stable motherhood in transition</p> <p>• Being a family living in a different culture</p> <p>Conclusion</p> <p>According to the respondents in this study, understanding the woman's native language or her culture was not vital to develop a good relationship with the midwife. Instead the immigrant woman developed trust in the midwife based on the knowledge and the empathy the midwife imparted.</p> <p>Increasing the amount of first trimester antenatal visits could avoid spontaneous visits to the emergency clinic. There was a greater need for involvement and support by the father during the perinatal period, such as caring for older children and carrying out household chores since the mothers' earlier female network was often lost.</p> <p>Clinical implications</p> <p>There is a need to involve immigrant parents in the available parental education in order to prepare them for parenthood in their new country as well as to explore their altered family situation. Collecting immigrant women and their partner's, experiences of maternal health care services offers a possibility to improve the existing care, both in content, access and availability where the timing of visits and content require further evaluation.</p

Swedish Maternal Health Care in a Multiethnic Society - Including the Fathers

Preventive work in maternal and child health care has a long history in Sweden. Today, Sweden has achieved the lowest maternal and child mortality rates globally based on a maternal health care system regulated by national recommendations; offered to every woman, free of chare, on a continuity basis, by registered midwives at municipal clinics within the community with the purpose of being assessable for all women. Despite the availability of antenatal care, immigrant women living in Sweden often have a different pattern of utilising care and in some cases immigrant women have been shown to be at risk for a negative delivery outcome. The overall aim of this thesis was to investigate differences due to country of birth and utilisation of antenatal care and the experiences of antenatal care, from the perspectives of the both the parents to be. Epidemiological design and explorative qualitative research has been used for the purpose of finding patterns of the utilisation of maternal health care as well as experiences from foreign born men and women concerning maternal health care in general, and maternal health care in the city of Malmö Sweden in particular. Qualitative research has been used to add depth and thereby attain a greater understanding in a social context. In the study population, according to the definitions set in Studies I, IV, the main finding was that 28.3-48.7% of the women had unplanned visits to a midwife and/or to a physician at the delivery ward. Women born in Sweden and in Eastern and Southern Europe had a linear relationship with few planned visits to the midwife at the municipal clinic and more unplanned visits to a midwife at the delivery ward. The women in Study II were positive to the individualised and professional care given at the MHC by empathic and professional midwives. They were positive to the increased involvement of their partner in the area of reproduction and family life since migrating to Sweden. According to the women, this may lead to an increased understanding by the fathers of the woman’s situation during pregnancy, birth and caring for the children as well as it could increase the fathers own emotional as well as practical involvement in their children. The foreign born men, in Study III, were positive towards antenatal care and to be able to take part as support to women at MHC, and during the delivery process. They experienced problems with their situation of being fathers, partners and, as men living in Sweden, due often to their being un-employed and the changed situation that their migration had brought about. The health care system manager need to be aware of the fact that there are groups of women, in a low risk population, who tend to make contact with the maternal care system in a more of less unplanned fashion. By not utilising the planned care offered these women miss an opportunity to meet a midwife who is specialised in preventive care during pregnancy with the focus of treating pregnancy a normal health life event, while at the same time, ensuring the detection of eventual risk factors. A conversation with a midwife in a calm environment is beneficial to the pregnant woman. The immigrant groups need our special attention aimed at making the maternal health care system easily accessible for them, as well as making the maternity staff aware of their own attitudes towards preventive work involving pregnancy in a multiethnic setting. The organisation of care must also, in itself; offer such possibilities for both the staff and the women

Positive Health Outcomes of Fathers’ Involvment in Pregnancy and Childbirth Paternal Support : A Scope Study Literature Review

This study reviewed the literature concerning the involvement by European men in pregnancy and childbirth and examined how this is related to health outcomes; for the men themselves, their partners, and their children. The study also reflects on the literature in relation to other existing research on men, masculinities, and fatherhood. The literature review support the idea that the father’s involvement during pregnancy and delivery can positively influence health outcomes for the man, his partner, and their children. However, little help is offered to the majority of men regarding parenting. It is therefore crucial for the maternal and child healthcare services to develop new ways of reaching out to men. In order to develop new knowledge earlier research needs to be complemented with a multidisciplinary approach where the existing research material, on social science regarding men, masculinities, and fatherhood is also taken into consideration

Routine ultrasound investigations in the second trimester of pregnancy: the experiences of immigrant parents in Sweden

Objective: to describe the experiences of immigrant parents of an ultrasound examination in the second trimester of pregnancy, highlighting information, communication, thoughts, feelings and well-being. Methods: An exploratory, qualitative study using in-depth interviews with parents separately. Content analysis was used. A total of nine Farsi-speaking couples, in all 18 persons, who now live in Sweden, were interviewed. Results: Four main categories emerged from the parents' descriptions: experiencing professionals who were informative and communicative, experiencing the first encounter with their unborn child, experiencing a well-planned routine and experiencing a humanistic encounter within the health-care organisation. Conclusion: Parents saw the ultrasound examination as a means of: getting visual confirmation of their pregnancy, reassurance about the health and well-being of their foetus and making connection with their baby; and receiving confirmation of their baby's gender. The parents were impressed by the quality of their communication with the care-givers, which influenced their judgement of the whole procedure, including the technical quality of the care

Does model of care affect women s health and wellbeing in the perinatal period in Sweden?

Background/Aims Self-rated health before, during and after pregnancy is important for women s quality of life and promotes bonding between mother and child. However, diverse aspects of care models influence women s experiences during pregnancy. This study aimed to investigate low?risk women s self-rated health during the perinatal period in relation to different models of care in Sweden. Methods A retrospective study was conducted of computerised obstetric data from 167 523 women with low-risk pregnancies during 2010 2015. Descriptive analysis was used, as well as group comparisons and ordinal regression analysis, to establish links between self-rated health before, during and after pregnancy and sociodemographic characteristics. Results The majority of women, regardless of model of care, rated their health as very good or good before, during and after pregnancy. During pregnancy, primiparous women, those who attended 7 midwife visits and those followed up by a private centre were more likely to rate their health as good. Women who had more than four midwives, were under the age of 30 years or foreign-born had increased risk of rating their health as bad. Postnatally, women who used private care, primiparous women and those aged 25 29 years were at lower risk of rating their health as bad. Conclusions Women attending private healthcare services tended to rate their health as better. Vulnerable groups of women need special attention from healthcare authorities

Health education to prevent anemia among women of reproductive age in southern India

In this study, we used a narrow, but easily measured, indicator of how communication proceeded among health workers and women in Southern India. Anemia prevention during pregnancy was studied using a semistructured questionnaire. Participants included 5 nurses, 10 health aides, and 10 (traditional birth attendants) TBAs working with maternal health care and education, as well as 32 women seeking maternal health care. Those women who received health education where they lived, from health workers they knew, and together with participants familiar to them learned more about anemia prevention than others

The experience of Middle Eastern men living in Sweden of maternal and child health care and fatherhood: focus-group discussions and content analysis.

Objective To describe how men from the Middle East experience Swedish maternity and child health care. An integral part of the aim of this study has also been to describe the experiences of men from the Middle East when becoming and being a father in Sweden. Design, setting and participants an exploratory, qualitative study using focus-group discussions and individual interviews, with a semi-structured interview guide and content analysis. A total of 16 men participated. Ten Arabic-speaking men from the Middle East living in Sweden participated in three focus-group discussions. Six men from the Middle East living in Sweden, and speaking Swedish, participated in individual interviews. Findings three main categories were developed: meeting empathic professionals; finding new positions within the family; and experiencing social demands. Key conclusions and implications for practice seeing their partners being met individually and with empathy by midwives and child health-care nurses encouraged men to become involved in areas not previously open to them (i.e. pregnancy, childbirth and the care of babies and young children). As the women often lacked knowledge of Swedish, they depended on the help of their partners when meeting maternity and child health-care professionals. The men found the experience of living in an alien country difficult. They were often unemployed, felt they were a burden to their wives after emigrating to Sweden, and that they were no longer a suitable role model for their children

Middle Eastern mothers in Sweden, their experiences of the maternal health

Background: Traditional patterns relating to how to handle pregnancy and birth are often challenged due to migration. The purpose of this study was to describe Middle Eastern mothers’ experiences of the maternal health care services in Sweden and the involvement of their male partner. Methods: Thirteen immigrant mothers from the Middle East who had used the maternal health services in Sweden were interviewed using focus group discussions and individual interviews. These were taped, transcribed and analysed according to Content analysis. Results: The four main categories that developed were: • Access to the professional midwife • Useful counselling • Stable motherhood in transition • Being a family living in a different culture Conclusion: According to the respondents in this study, understanding the woman’s native language or her culture was not vital to develop a good relationship with the midwife. Instead the immigrant woman developed trust in the midwife based on the knowledge and the empathy the midwife imparted. Increasing the amount of first trimester antenatal visits could avoid spontaneous visits to the emergency clinic. There was a greater need for involvement and support by the father during the perinatal period, such as caring for older children and carrying out household chores since the mothers’ earlier female network was often lost. Clinical implicationsThere is a need to involve immigrant parents in the available parental education in order to prepare them for parenthood in their new country as well as to explore their altered family situation. Collecting immigrant women and their partner’s, experiences of maternal health care services offers a possibility to improve the existing care, both in content, access and availability where the timing of visits and content require further evaluation

Self-rated health in Swedish pregnant women : a comprehensive population register study

Background/Aims Sociodemographic factors are associated with perceived overall health status or ‘self-rated health’. However, research using data from the comprehensive population register in Sweden to examine self-rated health in pregnant women is limited. This study aimed to examine sociodemographic factors associated with self-rated health before, during and after pregnancy in low-risk pregnant women, based on comprehensive population register data in Sweden. Methods This was a retrospective analysis of the Swedish pregnancy register (Graviditets registret). Data from 167523 women were tested with group comparisons and ordinal regression analyses. Results Women between the ages of 25 and 29 years and primiparas were less likely to self-rate their health lower.Women born outside Scandinavia, those whose education did not reach university level, jobseekers, those on parental leave and students were more likely to report lower self-rated health.Women with risky behaviours, such as alcohol consumption and those who smoked and/or snuffed were more likely to report lower self-rated health. Conclusions The findings indicate that preventive and health promoting actions in the midwifery profession should build on awareness of possible associated sociodemographic factors