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Amning och existens: Moderskap, sårbarhet och ömsesidigt beroende vid inledande amning
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV).
2015 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of the thesis is to create knowledge about what it means for women to initiate breastfeeding and what consequences these meanings have from an existential perspective.

Approach and method: A lifeworld approach based on the epistemology of phenomenology and hermeneutics was used. Lifeworld interviews and meaningoriented analysis in accordance with the chosen lifeworld approach were performed. A synthesis and a philosophical analysis were carried out that facilitates an understanding of the existential meaning of initial breastfeeding and its consequences as a whole.

Main findings: Initiating breastfeeding, when it functions well, entails an existential challenge, a movement from a bodily performance to an embodied relationship with the infant and with oneself as a mother. When breastfeeding is experienced as being severely difficult, it entails an existential lostness as a mother, forcing her into a constant fight with herself, the infant, and others in order to find her way into motherhood. Severe breastfeeding difficulties can evoke existential vulnerability, forcing the mother to continue breastfeeding despite the difficulties, while hoping to be confirmed as a good mother; a fear of breastfeeding may be a consequence. Existential security is a necessary condition for continued breastfeeding whilst insecurity and fear of breastfeeding can lead to ceased attempts to breastfeed when experiencing severe initial difficulties. Initial breastfeeding and motherhood are intertwined in a way that affects the woman’s existence as a mother.

Conclusions: Initial breastfeeding is a complex phenomenon that is more than just a biological adaptation or a cultural issue; it touches on and evokes existential aspects of being a woman and a mother. Though anchored in both biology and culture, breastfeeding cannot be reduced to one or the other: it is both. There is a struggle between biology and culture that has existential consequences for women’s experiences of breastfeeding, the breastfeeding decision, and the women’s existence as a mother. There is a need for health professionals to look beyond the statistics of breastfeeding and consider the existential dimensions of breastfeeding-as-lived when encountering mothers wanting to breastfeed.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press , 2015. , 101 p.
Series
Linnaeus University Dissertations, 220/2015
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:hb:diva-118ISBN: 978-91-87925-59-7 (print)OAI: oai:DiVA.org:hb-118DiVA: diva2:814323
Public defence
2015-05-22, Sal Wicksell, Hus K, Växjö, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2015-05-29 Created: 2015-05-26 Last updated: 2015-12-21Bibliographically approved
List of papers
1. Existential vulnerability can be evoked by severe difficulties with initial breastfeeding: A lifeworld hermenutical single case study for research on complex breastfeeding phenomena
Open this publication in new window or tab >>Existential vulnerability can be evoked by severe difficulties with initial breastfeeding: A lifeworld hermenutical single case study for research on complex breastfeeding phenomena
2014 (English)In: Breastfeeding Review, ISSN 0729-2759, Vol. 22, no 3, 21-32 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Australian Breastfeeding Association, 2014
Keyword
initiating breastfeeding, breastfeeding difficulties, mother-infant relations, psychodynamics, lifeworld research, hermeneutic, Exixtens och lärande
National Category
Nursing
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-1960 (URN)2320/14431 (Local ID)2320/14431 (Archive number)2320/14431 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-12-01Bibliographically approved
2. Existential security is a necessary condition forcontinued breastfeeding despite severe initialdifficulties: a lifeworld hermeneutical study
Open this publication in new window or tab >>Existential security is a necessary condition forcontinued breastfeeding despite severe initialdifficulties: a lifeworld hermeneutical study
2015 (English)In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 10, no 17, 1-11 p.Article in journal (Refereed) Published
Abstract [en]

Background:The majority of new mothers in Sweden initiate breastfeeding and many experience initial difficulties. This experience is an important cause of early breastfeeding cessation. To increase understanding, there is a need to explore the lived experiences of the decision to continue or cease breastfeeding. The aim of this study is therefore to explain and understand how this decision is influenced by the meaning of severe initial difficulties.

Methods: A lifeworld hermeneutical approach was used for the study. The study was conducted in Sweden with eight mothers who experienced severe difficulties with initial breastfeeding. All except one were interviewed on two different occasions resulting in fifteen interviews. The interviews were conducted between 2010 and 2013.

Results: Mothers who experience severe difficulties with initial breastfeeding feel both overtaken and violated not only by their own infants and their own bodies but also by their anger, expectations, loneliness and care from health professionals. These feelings of being overtaken and invaded provoke an existential crisis and place mothers at a turning point in which these feelings are compared and put in relation to one another in the negotiation of the decision to continue or cease breastfeeding. This decision thus depends on the possibility of feeling secure with the breastfeeding relationship. If insecurity dominates, this can, in severe cases, create a feeling of fear of breastfeeding that is so great that there is no alternative but to stop breastfeeding.

Conclusions: Existential security in the breastfeeding relationship seems to be an underlying factor for confidence and therefore a necessary condition for continued breastfeeding when having severe initial breastfeeding difficulties. Unresolved feelings of insecurity may be a serious barrier to further breastfeeding that can result in a fear of breastfeeding. Such fear can force the mother to cease breastfeeding. This study highlights how women are situated in a complex cultural and biological context of breastfeeding that has existential consequences for them. An existential crisis forces mothers into a turning point for the breastfeeding decision. In the existential crisis, mothers’ responsibility for the mother-infant relationship guides continuing or ceasing breastfeeding.

Keyword
Breastfeeding, Caring science, Early breastfeeding cessation, Hermeneutic, Initial breastfeeding
National Category
Other Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-600 (URN)10.1186/s13006-015-0042-9 (DOI)
Available from: 2015-08-10 Created: 2015-08-10 Last updated: 2017-08-23Bibliographically approved
3. Severe breastfeeding difficulties: an existential lostness as a mother
Open this publication in new window or tab >>Severe breastfeeding difficulties: an existential lostness as a mother
2012 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, 1-10 p.Article in journal (Refereed) Published
Abstract [en]

A majority of women in Sweden initiate breastfeeding but almost a quarter stop or wean the infant in the first few weeks after birth because of difficulties. In order to develop care that facilitates initiation of breastfeeding and enables mothers to realize their expectations concerning breastfeeding, it is necessary to understand what having severe breastfeeding difficulties means for women who experience them. The aim of this study is to describe the lived experiences of initiating breastfeeding under severe difficulties. A reflective lifeworld research design was used. Eight women, seven primiparous and one multipara, were interviewed within 2 months of giving birth. The essential meaning of the phenomenon is described as "Existential lostness as a mother forcing oneself into a constant fight". This pattern is further explicated through its constituents; shattered expectations, a lost time for closeness, being of no use to the infant, being forced to expose oneself, and gaining strength through sharing. The results show that mothers with severe breastfeeding difficulties feel alone and exposed because of their suffering and are lost in motherhood. Thus, adequate care for mothers should enhance the forming of a caring relationship through sharing rather than exposing.

Place, publisher, year, edition, pages
Co-Action Publishing, 2012
Keyword
amning, reflekterande livsvärldsansats
National Category
Nursing
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-1302 (URN)10.3402/qhw.v7i0.10846 (DOI)000300454800001 ()22312409 (PubMedID)2320/11272 (Local ID)2320/11272 (Archive number)2320/11272 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-12-01
4. Breastfeeding: An existential challenge—women's lived experiences of initiating breastfeeding within the context of early home discharge in Sweden
Open this publication in new window or tab >>Breastfeeding: An existential challenge—women's lived experiences of initiating breastfeeding within the context of early home discharge in Sweden
2010 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 3Article in journal (Refereed) Published
Abstract [en]

For most Swedish women, breastfeeding is an essential part of the childbearing period. Yet, the meaning of breastfeeding from women's perspective is scantily explored. Therefore, the aim of this study is to describe women's lived experiences of initiating breastfeeding within the context of early home discharge. Eight women, two primiparous, and six multiparous were interviewed within 2 months after birth. A reflective lifeworld research design based on phenomenological philosophy was used during the data gathering and data analysis. The results show that the phenomenon, initiating breastfeeding, in spite of good conditions, i.e., early home discharge, is complex and entails an existential challenge. The essential meaning of the phenomenon is conceptualized as, “A movement from a bodily performance to an embodied relation with the infant and oneself as a mother.” This pattern is further described in its five constituents: “Fascination in the first encounter,” “Balancing the unknown,” “Devoting oneself and enduring the situation,” “Seeking confirmation in the unique,” and “Having the entire responsibility.” Caring for women initiating breastfeeding entails, from a caring science perspective, to help the mother meet insecurity and strengthen confidence to trust her ability to breastfeed the newborn infant. According to these findings, it is suggested in the discussion that it is time for health care professionals to reject the idea of breastfeeding merely as meals or eating for the infant. Instead, they ought to embrace its origin, namely as a way to closeness between mother and infant.

Place, publisher, year, edition, pages
Co-Action Publishing, 2010
Keyword
breastfeeding, lived experiences, caring science, phenomenology, reflective lifeworld research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:hb:diva-2869 (URN)10.3402/qhw.v5i3.5397 (DOI)2320/6995 (Local ID)2320/6995 (Archive number)2320/6995 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-11-02Bibliographically approved

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