Objective: Women who experience obstetric interventions and complications during childbirth have an increased risk of developing postnatal post-traumatic stress and mental illness. This study aimed to test the effect of a trauma-informed support programme based on psychological first aid (PFA) to reduce the mothers ' symptoms of stress, fear of childbirth (FOC), anxiety and depression after a complicated childbirth. Methods: The study population consisted of women >= 18 years old who had undergone a complicated childbirth (i.e. acute or emergency caesarean section, vacuum extraction, child in need of neonatal care, manual placenta removal, obstetric anal sphincter injury, shoulder dystocia or major haemorrhage ( >1000 ml)). A total of 101 women participated in the study, of whom 43 received the intervention. Demographic questions and three self-assessment instruments measuring stress symptoms, FOC, anxiety and depression were answered one to three months after birth. Results: The women in the intervention group scored significantly lower on the stress symptom scale, with a halved median score compared to the control group. There was no significant difference between the groups regarding FOC, depression and anxiety. Conclusion: Our results indicate that this PFA-based support programme might reduce post-traumatic stress symptoms in women who have gone through a complicated childbirth. With further studies in a larger population, this support programme has the potential to contribute to improved maternal care optimizing postnatal mental health.
Objectives: Sexual risk-taking and its consequences for young women with ADHD(attention deficit hyperactivity disorder) including sexually transmitted diseases, teenage pregnancies and underage parenthood constitute substantial challenges for individuals and midwives. The aim was to investigate current knowledge and specific challenges in reproductive health and contraceptive counselling for women with ADHD at Swedish youth clinics.
Method: Inductive qualitative interview study of ten midwives at six youth health clinics in Stockholm and Uppsala County. We used a semi-structured interview guide. The interviews were transcribed verbatim and analyzed with the NVivo 12 qualitative data analysis software.
Results: Three main categories were identified: (1) challenges in provision of care of young women with ADHD, (2) standard of care and active adaptations towards women with ADHD and (3) organizational readiness for change;. Several challenges and frustrations, such as difficulties with attention with or without concomitant impulsivity and overactivity, in provision of reproductive health and contraceptive counselling for young women with ADHD were identified. Midwives reported high organizational readiness for improvement of standard of care.
Conclusions: Inadequate contraceptive counseling or lack of knowledge on specific challenges in the sexual and reproductive health of young women with ADHD may contribute to this group failing to access, inadequately respond to, or act upon counseling at youth clinics. Support for midwives with evidence-based interventions specifically developed for these women are imperative. Development of such tools should be a priority for research.
Objective: The aims of this study was to use visits for contraceptive counselling as opportunities for examining womens actual life style habits with the main focus being placed on alcohol consumption but also to evaluate the womens opinions about discussing their alcohol and tobacco habits and their weight status. Methods: A total of 535/802 (67%) women completed a study-specific anonymous questionnaire after a contraceptive counselling visit with a midwife. Results: A majority of the women thought that a discussion concerning alcohol habits at a contraceptive counselling session was important (85.5%) and not intrusive (86.4%) neither embarrassing (81.7%). Women with high-risk drinking habits were younger, more often tobacco users and more often planning for childbirth in the future, compared with women who did not display high-risk drinking behaviour. A significantly higher percentage of women who practiced high-risk drinking thought that a discussion of alcohol was intrusive (10.9%) and embarrassing (46.7%), compared with women not practicing highrisk alcohol consumption. Most women (72.9%) stated that no other caregiver during the preceding year except the midwife had discussed drinking habits with them. The weight was a good thing that the midwife brought up for discussion according to 82.5% of the women but the discussions about weight was more often found embarrassing (18.4%) than the discussion about alcohol habits. Conclusion: Women who came for contraceptive counselling found the discussion concerning alcohol habits important, not intrusive or embarrassing and a good thing to be brought up by the midwife. (C) 2014 Elsevier B.V. All rights reserved.
Objectives: Successful gestational weight gain (GWG) restriction programs for obese (Body Mass Index (BMI) amp;gt;= 30 kg/m(2)) pregnant women, have not, so far, shown convincing effects on infants weight development. An intervention starting during the pregnancy might be too late and a pre-conceptional life style change may be preferable. Thus, the aim of this study was to follow children born to mothers who had participated in a weight gain restriction program during pregnancy, and make comparisons with their younger siblings. Study design and main outcome measures: An extended analysis of 262 children belonging to an intervention group and a control group. The effects of BMI at five years of age and weight-for-length/height development from two months of age until five years of age were assessed. Results: In the intervention group there was a difference in BMI at five years of age, between index boys and their younger sisters (p = 0.016). Mean BMI was lower among the boys compared with their younger female siblings. Regarding maternal GWG or the Swedish national reference data there was no difference between the index children and their younger siblings within the intervention or control groups or between younger siblings in the two groups. Conclusions: Maternal pre-conceptional lifestyle change may have a positive effect on the childs weight development during the five first years of age. However, the effect of participation in an extensive GWG restriction program when it comes to the impact on the offsprings weight development is still unclear and further research is required.
Objective: The present aim was to contribute to improving the traditional pelvic examination chair with vertical leg support and to evaluate patients and examiners experience of a new gyneacological and urological examination chair with heated upholstery. Study design: A new gynaecological and urological examination chair was constructed with laterally adjustable leg support, a foot-plate and the perineum exposed only during the examination procedure. Patients (n = 131) with or without endometriosis were invited to participate in an anonymous questionnaire survey concerning how they experienced a gynaecological examination. Main outcome measures: The patients and the gynaecologists who performed the examinations answered questionnaires evaluating the examination procedure in the traditional and in the new gynaecological and urological examination chair, respectively. The questionnaires asked about comfort, heating, integrity and the experience of pelvic examination with vertical or lateral leg support. The examination times were measured with a stopwatch. Results: The majority of the answers (n = 131) were significantly (p amp;lt; 0.05-0.001) in favour of the new concept with lateral leg support and with increased comfort and integrity. The average examination time was significantly shortened and the patients more relaxed in the new gynaecological and urological examination chair. Conclusion: The traditional gynaecological chair with vertical leg support has remained basically unchanged for many years. The present study showed that the pelvic examination procedure can be significantly optimized with easy patient-friendly adaptations.
The major symptoms of endometriosis are dysmenorrhea and infertility. Pertubations with lidocaine have been shown to reduce dysmenorrhea and have an enhancing effect on fertility. Different concentrations of lidocaine were evaluated in a randomized, double-blind study of pre-ovulatory pertubations with lidocaine solutions in women with dysmenorrhea. The patients had laparoscopically diagnosed endometriosis and normal fallopian tubes. Ninety pertubations were carried out without complications on 26 patients during up to six cycles. The effect was evaluated by means of questionnaires where a clinically significant reduction of dysmenorrhea was reported. Pertubation with lidocaine can be a non-hormonal treatment option for dysmenorrhea. (C) 2012 Elsevier B.V. All rights reserved.
Objective: Intimate partner violence (IPV) against women occurs in all settings. Exposure to intimate partner violence, especially during pregnancy, is associated with serious adverse health outcomes and is recognized as a global health issue.Aim: To describe the prevalence of physical, psychological, and sexual intimate partner violence among pregnant women in Sweden during current pregnancy, and to investigate potential associations between exposure and sociodemographic characteristics and health. Methods: Between October and December 2020, a cross-sectional survey study was conducted at 35 midwifery clinics in Stockholm, Sweden.Results: The questionnaire was answered by 3399 pregnant women. The results showed that 2.1% of the women reported exposure to intimate partner violence during pregnancy, with exposure to psychological violence being most common (1.8%), followed by exposure to physical violence (0.6%) and sexual violence (0.1%). Exposure to intimate partner violence was significantly associated with living situation and depressive symptoms, as well as education, country of birth, and employment status.Conclusion: Exposure to intimate partner violence occurs even during pregnancy and it is crucial to identify pregnant women exposed to intimate partner violence in order to inform clinical practice and to provide adequate support. More research is needed to develop screening instruments to detect violence against pregnant women.
Background: There is a lack of knowledge in Swedish healthcare regarding correlations of exposure to intimate partner violence (IPV) from before to during pregnancy, and associated factors as well as pregnant women's perceptions related to screening for IPV in healthcare settings. The frequency of women exposed to IPV during pregnancy is difficult to establish as it is reported at different rates across different studies, depending on the definitions and screening strategies used. Aims: 1. Describe prevalence of IPV experienced by pregnant women. 2. Investigate changes in IPV exposure before and during pregnancy. 3. Examine frequency of screening and women's opportunities and willingness to talk about IPV exposure. Methods. A cross-sectional survey in Stockholm, Sweden. Findings: 6.2 % of women (n = 202) reported exposure to IPV before pregnancy and 2.1 % (n = 72) reported exposure during pregnancy, of these, sixteen women reported exposure only during pregnancy. There were significant associations between exposure to IPV and symptoms of depression, age, living situations and employment status. Sixty-four percent of the exposed women were asked about violence in healthcare settings. Discussion: An important finding was that the frequency of IPV decreased from before to during pregnancy. The reasons for this are unknown but may be multi-factorial. Conclusion: Our investigation provides crucial insights into IPV during pregnancy. Results highlight that relying solely on prevalence rates is inadequate to understand the complexity of IPV exposure related to pregnancy. Screening for IPV and understanding how women perceive and disclose their exposure is complex yet vital for midwives in antenatal care.
Objectives: To examine physical activity level prior to pregnancy, during pregnancy and postpartum and investigate the association with depressive symptoms postpartum among women in Sweden. Study design: Retrospective observational study including 532 women on self-assessment of physical activity level before pregnancy, during pregnancy and postpartum, depressive symptoms postpartum as well as stressful life events in the past two years. Main outcome measures: Level and change of physical activity before pregnancy, during pregnancy and postpartum and depressive symptoms postpartum. Results: Almost two-thirds of the women in the study reported that they were inactive or performed light physical activity (62.9%; n = 331) in the year prior to giving birth. Women with a sedentary lifestyle or performing light physical activity level reported depressive symptoms postpartum to a greater extent than active women. Conclusions: A higher level of physical activity during pregnancy was associated with a lower level of depressive symptoms postpartum. Physical activity is a contributing factor to promote a healthier lifestyle and can contribute to improve mental health for pregnant women, newly become mothers and their children.
Background: Menstrual pain is relatively common among young girls. Many girls turn to youth clinics when seeking care for menstrual problems. Objective: The objective of the study was to describe midwives’ experiences of supporting girls with menstrual pain. Methods: This is a qualitative study with an inductive approach. Semi-structured interviews were conducted with 15 midwives working at Swedish youth clinics. Interviews were held in September 2021. The recordings were transcribed and analyzed using thematic analysis. Results: Two main themes, consisting of three subthemes each, emerged: Guiding and educating young women about menstrual pain and Striving toward pain relief. It was important to the midwives to increase young womens knowledge of menstrual pain and coping strategies, and to guide them in finding a method for menstrual pain relief. Hormonal contraceptives were often a natural choice and an effective method for pain relief, although the midwives occasionally faced resistance from young women or their mothers when recommending this. The midwives also referred to a gynecologist if needed. Conclusion: The results highlight that midwives working at youth clinics have an important role in the care of young women with menstrual pain. The midwives found it important to increase young womens knowledge about menstrual pain and coping strategies, since they had noticed knowledge gaps in these areas. The results suggest a need to improve education about menstrual pain and coping strategies for young women, preferably in school and in cooperation with healthcare professionals. © 2022 The Author(s)
Objective
It seems that traditional gender norms influence young women's and men's sexuality differently. However, little attention has been paid to ideal images of sexual situations. This study identifies young heterosexual men's ideal images of sexual situations and their expectations of themselves in sexual situations.
Study design
The present study employs a qualitative design. Twelve Swedish men (aged 16–20) participated in individual in-depth qualitative interviews. The interviews were transcribed verbatim and analysed using the constant comparative method from grounded theory.
Results
Our study revealed that the young men's conceptions of normal sexual situations were divided into two parts: sexual situations in relationships, and sexual situations in one-night stands. Their ideal image, “a balanced state of emotional and physical pleasure”, was influenced by the presence/absence of intimacy, the partner's response, and their own performance. The greatest opportunities to experience intimacy and the partner's response were found during sexual situations in relationships. In one-night stands, the men wanted to make a good impression by performing well, and behaved according to masculine stereotypes.
Conclusion
Stereotyped masculinity norms regulate young heterosexual men's sexuality, particularly in one-night stands. Sexual health promotion should emphasize the presence of these masculinity norms, which probably involve costs in relation to young men's sexual wellbeing.
The aim of the study was to identify and describe the experiences of healthcare professionals when meeting women with symptoms that might indicate endometriosis.
Methods
Semi-structured interviews were conducted with 10 gynecologists, six general practitioners and nine midwives working at one university hospital, one central hospital, one private gynecology clinic and five healthcare centers in south-east Sweden. The interviews were recorded and transcribed verbatim and analyzed using qualitative conventional content analysis.
Three clusters were identified: the corroborating encounter, the normal variation of menstruation cycles, and the suspicion of endometriosis. The healthcare professionals tried to make a corroborating encounter by acknowledging the woman, taking time to listen, and giving an explanation for the problems. Healthcare professionals had different ways to determine what was normal as regards menstrual pain, ovulation pain and dyspareunia. They also needed to have the competence to act and react when the symptoms indicated endometriosis.
Conclusions
Meeting women with symptoms that might indicate endometriosis is challenging and demands a certain level of competence from healthcare professionals. Sometimes the symptoms are camouflaged as “normal” menstruation pain, making it hard to satisfy the needs of this patient group.
Background
Young people are disproportionally burdened by sexual ill health. The SEXual health Identification Tool (SEXIT) was developed for use at youth clinics, to facilitate identification of visitors exposed to or at risk of sexual ill health. The aim of this study was to explore experiences of using SEXIT among youth clinic staff who participated in a pilot implementation, with a focus on usefulness, implementation determinants, and feasibility of implementing SEXIT at Swedish youth clinics.
Four focus group discussions were conducted with youth clinic staff from three clinics. The clinics had used SEXIT systematically in consultations with all visitors for one month. Data were analysed using qualitative analysis designed for focus groups.
Most participants experienced that the SEXIT routines were well functioning and that using SEXIT gave a comprehensive picture of the visitor and resulted in more concrete answers, which facilitated the risk assessment. The medical staff experienced that they identified more youth at risk with SEXIT, while the psychosocial staff were less convinced. Existing challenges related to the routines at the clinics and heavy workload during drop-in hours.
Staff experience SEXIT as useful for identifying young people exposed to or at risk of sexual ill health. Systematic use ensures consistency and quality in assessing the visitors, which may facilitate implementation. The use of SEXIT is challenged by heavy workload, conflicting routines, and the experience that some visitors identified through SEXIT decline further care. Implementation of SEXIT in Swedish youth clinics is considered feasible.
Objective: To identify and understand womens lived experiences of contraceptive counselling given at the same time as abortion counselling. Methods: We interviewed 13 women aged 20-39 who had experienced an abortion and the related counselling. The women were recruited from five hospitals in Sweden. Interviews were analysed using an interpretative phenomenological approach. Results: We identified two themes: need for respectful counselling and needs for guidance and access to contraceptives. The essence "Being in a state of limbo and feeling sceptical" was coalesced from the themes. The women described a state of limbo, as being caught in an unwanted and emotionally charged situation. They reported that respectful counselling and meeting a skilled health professional helped to dispel their scepticism and influenced their plans for contraceptive use post abortion. Furthermore, women who wanted an intrauterine device described difficulties in access post abortion. Conclusion: The women seem to have a limited receptivity to contraceptive counselling when they have an unwanted pregnancy and are sceptical about contraceptives. Women, who experience respect in the counselling, report being helped in contraceptive decision-making. To receive respectful counselling and to have good access to intrauterine devices emerged as central needs among women at the time of an abortion.
Abstract
Planning sex and relationship health education suitable for adolescents is a pedagogical challenge.
To describe how secondary school pupils in Sweden experience health educational sessions at Youth Clinics.
Data were collected from six focus groups within 2 weeks of an educational session. The groups consisted of pupils aged 14–16 years from three cities. The participants were 29 adolescents divided into groups of girls (n=15) and boys (n=14) and the interviews were audio taped. Data were analysed using qualitative content analysis.
Findings
Five categories were identified: Impact of the educational session, The desirable educator, Didactic setup, Gender inequalities and Suitable age for the educational session. The adolescents were satisfied with the content of the education and the session was evaluated as a complement to school education. The educators were seen as competent with an ability to create a comfortable atmosphere which made it easier for participants to discuss the subject and ask questions. The session was experienced as secure which was appropriate for the intimate and personal subject and gender aspects were seen as influencing the conversation.
This study can give an understanding of the needs and demands of adolescents which can be useful when planning and conducting sex and relationship health education.
Objective: The objective of the study was to translate and culturally adapt the Female Genital Self-Image Scale (FGSIS-7) into a valid and reliable Swedish version, and to test the instrument.Methods: The instrument was translated into Swedish in a three-stage process of translation, back-translation and synthesis. The face validity of the pre-final translation was tested in a cognitive debriefing with a test group of eight women, while construct validity was tested in a group of six subject matter experts. Internal consistency, data completeness, score distributions, and floor and ceiling effects were measured using an online survey with a cross-sectional design.Results: The Swedish version of the instrument (SWE-FGSIS-7) was perceived as a comprehensible, under-standable and user-friendly instrument by the test group and the experts. The online survey included 147 re-sponders with 100 % data completeness and no floor or ceiling effects. The internal consistency was good (Cronbachs Alpha coefficient 0.82). The total mean score was 22.44 (SD = 3.98). Conclusion: SWE-FGSIS-7 is a user-friendly, understandable, valid and reliable instrument for estimating genital self-image, which can be used to initiate a dialogue that may contribute to increased knowledge about womens own bodies and strengthen their reproductive and sexual health.
Objectives: Few studies, with contradictory results, evaluate intrauterine contraceptives (IUC) and sexual function specifically. This study compares perception of sexual desire related to IUC use and aspects of sexual function in women who use the Lng-IUS with those using the Cu-IUD. Study design: A secondary analysis regarding IUC use based on a larger cross-sectional survey of contraceptive use in Sweden, conducted in 2013. In total, 153 IUC users (103 Cu-IUD and 50 Lng-IUS users) answered the questionnaire. The only inclusion criterion was intrauterine contraceptive use. Main outcome measures: Were self-reported sexual desire changes related to contraceptive method. We also analysed aspects of sexual functioning; sexual desire level, sexual activity, orgasm frequency, satisfaction with sex life and satisfaction of desire level. Results: A negative effect on sexual desire due to contraceptive method was reported by 28% of the Lng-IUS users and by 10.1% of the Cu-IUD users (p amp;lt; 0.05). Results were more marked after adjusting for age, body mass index, depression, parity, switching behaviour, and partnership (OR 5.0; CI: 1.8-13.8). The adjusted odds of reporting low sexual desire level (never or almost never feeling sexual desire) (OR 3.5; CI: 1.1-11.2) as well as low satisfaction with sex life (OR 2.7; CI: 1.2-6.3) was higher in the Lng-IUS group (adjusted for same confounders as above). Conclusions: The women in this study using the Lng-IUS more often report negative sexual desire effects of their contraception as well as lower sexual desire level compared with women using the Cu-IUD.
Objectives: In Nepal, the change of the abortion law in 2002 extended the staff duties at family planning clinics to include performing induced abortions. This study investigated the experiences, opinions and attitudes of the staff about their work at safe abortion service centres in the Kathmandu Valley and identified areas in which the health care staff stated the need for improvement.
Study design: Fifteen qualitative semi-structured interviews were conducted with doctors and nurses working with induced abortion at one hospital and five clinics in the Kathmandu Valley. The interviews were transcribed verbatim and analysed using the constant comparative method.
Results: The core category ‘Proud, not yet satisfied’ comprised a strong perception of providing an important service that is beneficial for women’s health and a feeling of pride in providing quality service. Four related categories were identified: ‘Beneficial legal framework’, ‘A will to reach out to all women’, ‘Frustration about misuse’ and ‘Dilemma of sex-selective abortion’. The respondents emphasised that improvements are necessary to (1) ensure that all women have access to safe abortion services; (2) prevent abortions from being used instead of contraceptives; (3) stop illegal medical abortions; and (4) deal with the dilemma of sex-selective abortions.
Conclusions: Respondents were proud of and had psitive experiences from their work. They stated they have the opportunity to secure women’s rights and health; however, changes are needed to bring the quality of abortion care to a satisfactory level.
To describe the views of Swedish midwives on severe fear of childbirth (SFOC).
In this cross sectional study, a random sample of 1000 midwives, selected from the database of the Swedish Association of Midwives, received a questionnaire. The response rate was 84% (n = 834), with 726 questionnaires included in the final analysis.
Main outcome measures
The views of midwives on SFOC in different contexts of work: antenatal care clinic (ACC), labour ward (LW) either ACC/LW or Neither-Nor ACC/LW.
The majority of respondents thought that the frequency of SFOC has increased during the last 10 years (67%), and that pregnant women today are more likely to discuss their fears (70%). Midwives at ACCs thought that special education in SFOC is needed (p < 0.001) and that they have more responsibility to identify women with SFOC (p < 0.001) than midwives at LWs. The majority of respondents, both at ACCs (60%) and LWs (65%), intuitively sensed when they were meeting a woman with SFOC. Opinions among midwives who alternate between working in ACCs and LWs reflected the views of the midwives working either in an ACC or an LW.
The views of midwives on SFOC are partly in concordance and partly contradictory in relation to the different workplaces as well as research data. Knowledge of the views of midwives on SFOC is a necessary pre-requisite to improve care for pregnant women.
Objective: This study explored gynecological patient perceptions of previous pelvic examinations (PE), a learning session about PE prior to a scheduled PE consultation, and the impact of the learning session on the PE during the consultation. Study design: Twelve informants were purposefully sampled from women with scheduled gynecologist appointments at a Swedish University Hospital. The learning session preceded the consultation and provided information on female genital anatomy and the PE, and the informant performed a PE on a mannequin. Individual qualitative interviews followed the consultation. The interviews were transcribed verbatim and analyzed using a constant comparative analysis to acquire a deeper understanding of the womens experiences of the learning session and the subsequent PE. Results: Three categories were identified in the analysis: Harmonizing the bad with the good category, which primarily concerned the informants previous experiences of the PE. Gaining self-confidence through knowledge, which depicted the informants experiences of the learning session. Mental preparation enables bodily recapture, which was the summarizing category of informant experiences of the scheduled PE. The core category, active involvement triggers empowerment, was created from the categories, and constitutes the core of the empirical material. Conclusion: The informants active participation during the learning session increased their knowledge, generated self-confidence, triggered an empowering process, and promoted interaction with the examiner during their subsequent PE.
Objective: To gain a deeper understanding of how undergraduate male medical students experience a pelvic examination learning concept and performing the first pelvic examination (PE) on a professional patient. less thanbrgreater than less thanbrgreater thanStudy design: A qualitative study. In-depth interviews with 12 male medical students after their involvement in a learning session about the PE, with professional patients and a supervising gynecologist as instructors. The interviews were analyzed according to the constant comparative method, a variety of content analysis, to acquire a deeper understanding of the students experiences and the ongoing social processes. less thanbrgreater than less thanbrgreater thanResults: The essence of the entire analysis was "Unexpected enlightening of a female world" and was identified from the three categories; "Not just any exam", "Professional supportive interaction" and "Humble awareness". The male students most prominent concern was how to establish a professional rapport with the patient in the PE situation. Beneficial active support from the professional patient and the gynecologist assisted the students to overcome inherent barriers and facilitated the examination procedure. The informants gained "inside information" from the patients perspective of being examined leading to a new awareness about an earlier unknown "female world" that is what women might go through before and during a PE and an humble understanding of how vulnerable it is to be placed in the examination position. less thanbrgreater than less thanbrgreater thanConclusion: The beneficial PE learning concept promoted an unexpected insight in what a woman might experience during a PE, creating a humble awareness of this vulnerable intimate situation and ideas for how to establish professional rapport.
Objectives: Oxytocin is the drug of choice in preventing postpartum hemorrhage (PPH). The aim was to compare the peroperative- and total blood loss within two hours and PPH after planned cesarean section (CS) when receiving 2.5 IU vs 5.0 IU of oxytocin in different risk groups for PPH. Study design: A pilot study including 927 women undergoing planned CS where women receiving 2.5 IU of oxytocin were compared to women receiving 5.0 IU of oxytocin. Main outcome measures: Data comparing peroperative blood loss, total blood loss within two hours and PPH were analyzed. Results: The women receiving 2.5 IU of oxytocin had a slightly higher peroperative blood loss, compared to the 5.0 IU group (476 ml vs 426 ml, p = 0.029). The total blood loss two hours after surgery showed no significant difference between the groups (626 ml vs 595 ml, p = 0.230). In the 2.5 IU group 13% had a blood loss > 1000 ml vs 10% in the 5 IU group (aOR 1.64, 95% CI = 1.05-2.56). When the women considered to be at high risk for postpartum hemorrhage were excluded, we found no difference in the likelihood for postpartum hemorrhage between the groups (aOR 1.13, 95% CI = 0.64-1.99). Conclusions: Women undergoing planned CS and receiving 2.5 IU of oxytocin had a slightly higher risk for postpartum hemorrhage in this study. However, a lower dose of 2.5 IU of oxytocin seems to be a safe option in planned CS for women without known risk factors for postpartum hemorrhage, but further research is needed to confirm these findings.
AIM: The objective was to examine lifetime exposure to violence, physical and sexual, among women seeking termination of pregnancy (TOP) and its association with socio-demographic factors, PTSD, symptoms of anxiety and depression.
DESIGN: The design of the study was a Swedish multi-centre study targeting women requesting TOP.
METHODS: All women requesting TOP with a gestational length less than 12 pregnancy weeks were approached for participation in the study. The questionnaire comprised the following research instruments: Screen Questionnaire-Post traumatic Stress Disorder (SQ-PTSD) and Hospital Anxiety and Depression Scale (HADS). The response rate was 57% and the final sample was 1514 women. Descriptive and analytic statistics were applied.
RESULTS: Lifetime exposure to violence was common among women seeking abortion. Exposure to violence was associated with low education, single marital status, smoking and high alcohol consumption. Exposure to violence was associated with the occurrence of signs of PTSD and symptoms of anxiety and depression. Among those having PTSD, all had been exposed to sexual violence and almost all had been exposed to physical violence, while for those with symptoms of anxiety and depression almost half had been exposed to either physical or sexual violence.
CONCLUSION: Exposure to physical and sexual abuse was common among women requesting TOP, and was strongly associated with the occurrence of PTSD, symptoms of anxiety and depression. This underscores the importance for health professionals to recognize and offer support to those women exposed to violence.
Objective: The aim was to investigate fear of childbirth (FOC) and sense of coherence (SOC), and their components in women expecting their first child. Methods: A cross-sectional study where 414 women answered the Wijma Delivery Expectancy Questionnaire Version A and the Sense of Coherence Scale. Statistical analyses were performed. Results: The main results show that women with severe FOC reported lower SOC, and all three components of SOC were lower in women with severe FOC. Comprehensibility turned out to have a significant correlation with FOC. Psychological problems before pregnancy were more common in women with severe FOC and low SOC. Conclusions: Women with severe FOC reported lower SOC and lower levels of each of the following components: comprehensibility, manageability and meaningfulness.
Sexually transmitted infections (STIs) pose a worldwide health problem. To improve the efforts of prevention of STIs it is important to gain insight into the awareness of STIs among people in the society.
Objective: To describe the cognizance of STIs among low-income men in western Kenya.
Method: Data was collected from eight focus groups consisted of 64 men between15 and 54 years of age. The interviews were audio taped and content analysis was used for the analysis.
Findings: Three categories were derived: Consciousness of STIs, Risk of and prevention of STIs, and Marital relationship and STIs. The results indicate that men had some limited consciousness of STIs but that there were misunderstandings. The treatments the men mentioned were hospital treatment help, from traditional herbalists and self-administration. Condoms were regarded as an effective prevention method, but there were obstacles to using them as well as to talking about STIs within marriage.
Conclusion: The study stresses the need to promote cognizance of STIs, including gender aspects, and to reduce the gap between knowing and practising.