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  • 1.
    Bogren Jungmarker, Emily
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Lindgren, Helena
    Hildingsson, Ingegerd
    Playing Second Fiddle Is Okay-Swedish Fathers' Experiences of Prenatal Care2010In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 55, no 5, p. 421-429Article in journal (Refereed)
    Abstract [en]

    Introduction: In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners' involvement in prenatal care as very important. The aim of this study was to describe expectant fathers' experiences of and involvement in prenatal care in Sweden. Methods: Data were drawn from a 1-year cohort study of 827 Swedish-speaking fathers recruited during their partners' midpregnancy and followed up 2 months after childbirth. Results: The participants reported that the most important issues in prenatal care were the woman's physical and emotional well-being and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers' involvement. "Excessive'' care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional well-being. Discussion: Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers' needs and incorporate a family-oriented approach to prenatal care.

  • 2.
    Bogren Jungmarker, Emily
    et al.
    Högskolan Dalarna.
    Lindgren, Helena
    Högskolan Dalarna.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Playing second fiddle is Okay-Swedish Fathers' experiences of prenatal care2010In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 55, no 5, p. 421-429Article in journal (Refereed)
    Abstract [en]

    Introduction: In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners' involvement in prenatal care as very important. The aim of this study was to describe expectant fathers' experiences of and involvement in prenatal care in Sweden. Methods: Data were drawn from a 1-year cohort study of 827 Swedish-speaking fathers recruited during their partners' midpregnancy and followed up 2 months after childbirth. Results: The participants reported that the most important issues in prenatal care were the woman's physical and emotional well-being and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers' involvement. "Excessive" care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional well-being. Discussion: Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers' needs and incorporate a family-oriented approach to prenatal care.

  • 3. Bogren Jungmarker, Emily
    et al.
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hildingsson, Ingegerd
    Playing the second fiddle is okay: Swedish fathers' experiences of prenatal care2010In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 55, no 5, p. 421-429Article in journal (Refereed)
    Abstract [en]

    In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners’ involvement in prenatal care as very important. The aim of this study was to describe expectant fathers’ experiences of and involvement in prenatal care in Sweden. Data were drawn from a 1-year cohort study of 827 Swedish-speaking fathers recruited during their partners’ mid-pregnancy and followed up two months after childbirth. The participants reported that the most important issues in prenatal care were the woman’s physical and emotional wellbeing and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers’ involvement. “Excessive” care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional wellbeing. Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers’ needs and incorporate a family-oriented approach to prenatal care.

  • 4. Christianson, Monica
    et al.
    Eriksson, Carola
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    A Girl Thing: Perceptions Concerning the Word "Hymen" Among Young Swedish Women and Men2011In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 56, no 2, p. 167-172Article in journal (Refereed)
    Abstract [en]

    Methods: Students answered an open-ended question: What do you think about when you hear the word hymen? The answers were analyzed by using content analysis. Results: In total, 198 students, aged 17 to 18 years, answered the question. The theme "a fragile biological structure in the female body" described how the vast majority of the girls and 57% of the boys associated the hymen with a thin membrane that breaks during first vaginal intercourse. The theme "a symbol and manifestation of feminine virginity" described the symbolic meanings of having or not having a hymen. The theme "questioning the existence of the hymen" revealed the doubts that some had about its existence. Discussion: Most of the students associated the hymen with a breakable membrane. This is problematic. It may lead to misunderstandings about virginity or about bleeding during sexual intercourse. Changing these views about the hymen is important to correct such misunderstanding but may be a significant challenge. In modern medical discourse, in health care, and in popular speech, there are few discussions about the hymen as a social construct, indicating that more gender research concerning hymen-related issues is needed.

  • 5.
    Christianson, Monica
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Eriksson, Carola
    A Girl Thing: Perceptions Concerning the Word "Hymen" Among Young Swedish Women and Men2011In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 56, no 2, p. 167-172Article in journal (Refereed)
    Abstract [en]

    Methods: Students answered an open-ended question: What do you think about when you hear the word hymen? The answers were analyzed by using content analysis.

    Results: In total, 198 students, aged 17 to 18 years, answered the question. The theme "a fragile biological structure in the female body" described how the vast majority of the girls and 57% of the boys associated the hymen with a thin membrane that breaks during first vaginal intercourse. The theme "a symbol and manifestation of feminine virginity" described the symbolic meanings of having or not having a hymen. The theme "questioning the existence of the hymen" revealed the doubts that some had about its existence.

    Discussion: Most of the students associated the hymen with a breakable membrane. This is problematic. It may lead to misunderstandings about virginity or about bleeding during sexual intercourse. Changing these views about the hymen is important to correct such misunderstanding but may be a significant challenge. In modern medical discourse, in health care, and in popular speech, there are few discussions about the hymen as a social construct, indicating that more gender research concerning hymen-related issues is needed.

  • 6.
    Eriksson, Carola
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Westman, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Content of childbirth-related fear in Swedish women and men: analysis of an open-ended question2006In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 51, no 2, p. 112-118Article in journal (Refereed)
    Abstract [en]

    The content of childbirth-related fear as described by 308 women and 194 men was analyzed and compared in relation to intensity of fear. The content of fear was similarly described by women and men and concerned the following main categories: the labor and delivery process, the health and life of the baby, the health and life of the woman, own capabilities and reactions, the partner's capabilities and reactions, and the professionals' competence and behavior. Among women, the labor and delivery process was the most frequently reported among the 6 categories of fears, whereas the health and life of the baby was the most frequent among the men. Fears related to own capabilities and reactions were described significantly more often by women with intense fear than by women with mild to moderate fear. The greatest difference between men with intense versus mild to moderate fear was a more frequent expression of concern for the health and life of the woman. Both women and men had fears related to not being treated with respect and not receiving sufficient medical care. This finding suggests that part of the problem with childbirth-related fear is located within the health care system itself.

  • 7.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Thomas, Jan
    Kenyon College, Department of Sociology.
    Maternity services from women's perspecitve in Sweden: processes, problems, and solutions.2007In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 52, no 2, p. 126-133Article in journal (Refereed)
    Abstract [en]

    Most measures of health care quality focus on medical outcomes rather than patients' assessments of quality. Drawing on data from a national survey of Swedish women, this study describes women's opinions about what is important to them during pregnancy and birth. This qualitative study is based on responses of 827 pregnant women to an open question completed in the second trimester. In total, 2061 separate statements were analyzed. Using content analysis, these statements were clustered into 4 themes: desirable characteristics of midwife, prenatal care during pregnancy, care during labor and birth, and care after birth. Within those themes, 13 categories were found. Findings suggest areas for improvement in maternity services including: the timing and length of prenatal visits, making parent education classes available to all women, prelabor visits to the maternity ward, continuous information about the progress of labor, flexibility in time of discharge, and postpartum support for families. Women also stated that characteristics of the midwife, such as being supportive, friendly, attentive, respectful, and nonjudgemental, were important. A patient-centered and individualized approach, with women and their partners as the subjects rather than the objects of care, would increase satisfaction and the overall quality of maternity services in Sweden.

  • 8.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Sundsvall, Sweden.
    Thomas, Jan
    Perinatal outcomes and satisfaction with care in women with high body mass index.2012In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 57, no 4Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The majority of studies on pregnant women with high body mass index (BMI) have focused on medical complications and birth outcome, rather than these women's encounters with health care providers. The aims were to identify the proportion of pregnant women with high BMIs (≥30); compare maternal characteristics and pregnancy and birth outcomes; and assess the experiences of prenatal, intrapartum, and postnatal care in women with high (≥30) and lower (<30) BMIs.

    METHODS: Data were collected through questionnaires and antenatal records from 919 women recruited in mid-pregnancy at 3 hospitals in the north of Sweden, with a follow-up questionnaire 2 months after birth.

    RESULTS: The prevalence of obesity was 15.2%. Women with high BMIs were more often aged 35 years or older and less likely to have a university education. They had more negative attitudes regarding being pregnant and reported more childbirth fear compared to women with lower BMIs, but they did not differ in regard to their feelings about the approaching birth or the first weeks with the newborn. They reported more pregnancy complications and had less continuity of caregiver. High BMI was associated with labor induction and emergency cesarean birth. No differences were found in birth complications; birth experience; or satisfaction with prenatal, intrapartum, or postnatal care.

    DISCUSSION: The findings reveal that women who are obese have more complicated pregnancies and births but are generally satisfied with the care they receive. There are some differences in the way they experience care. Health care providers have a delicate task to provide sufficient information about health risks while still offering respect, encouragement, and support.

  • 9.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Thomas, Jan
    Kenyon College, Gambier, Ohio, USA.
    Perinatal Outcomes and Satisfaction with Care in Women with High Body Mass Index2012In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 57, no 4, p. 336-344Article in journal (Refereed)
    Abstract [en]

    Introduction: The majority of studies on pregnant women with high body mass index (BMI) have focused on medical complications and birth outcome, rather than these women's encounters with health care providers. The aims were to identify the proportion of pregnant women with high BMIs (≥30); compare maternal characteristics and pregnancy and birth outcomes; and assess the experiences of prenatal, intrapartum, and postnatal care in women with high (≥30) and lower (<30) BMIs. Methods: Data were collected through questionnaires and antenatal records from 919 women recruited in mid-pregnancy at 3 hospitals in the north of Sweden, with a follow-up questionnaire 2 months after birth. Results: The prevalence of obesity was 15.2%. Women with high BMIs were more often aged 35 years or older and less likely to have a university education. They had more negative attitudes regarding being pregnant and reported more childbirth fear compared to women with lower BMIs, but they did not differ in regard to their feelings about the approaching birth or the first weeks with the newborn. They reported more pregnancy complications and had less continuity of caregiver. High BMI was associated with labor induction and emergency cesarean birth. No differences were found in birth complications; birth experience; or satisfaction with prenatal, intrapartum, or postnatal care. Discussion: The findings reveal that women who are obese have more complicated pregnancies and births but are generally satisfied with the care they receive. There are some differences in the way they experience care. Health care providers have a delicate task to provide sufficient information about health risks while still offering respect, encouragement, and support. © 2012 by the American College of Nurse-Midwives.

  • 10.
    Lundgren, I
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Berg, Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Lindmark, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Is childbirth experience improved by a birth plan?2003In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 48, no 5, p. 322-328Article in journal (Refereed)
    Abstract [en]

    From antenatal clinics in Sweden, 271 women were recruited after week 33 of pregnancy and given a questionnaire designed to assess their attitudes and feelings about the coming childbirth. Thereafter, they formulated a birth plan. The midwife in attendance at the birth was able to refer to this plan. Women who followed this program were compared with women from the same clinics who were asked to complete a questionnaire during the first postpartum week to assess their birth experience. A questionnaire at the end of pregnancy, followed by a birth plan, was not effective in improving women's experiences of childbirth. In the birth plan group, women gave significantly lower scores for the relationship to the first midwife they met during delivery, with respect to listening and paying attention to needs and desires, support, guiding, and respect. Although a birth plan did not improve the experience of childbirth in the overall group, there may be beneficial effects with regard to fear, pain, and concerns about the newborn for certain subgroups of women.

  • 11.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    McSwiggin, Maureen
    Alivio Med Ctr, Chicago, IL USA.
    Mercer, Judith S.
    Univ Rhode Isl, Providence, RI 02908 USA / Brown Univ, Providence, RI 02912 USA.
    US Midwives' Knowledge and Use of Sterile Water Injections for Labor Pain2008In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 53, no 2, p. 115-122Article in journal (Refereed)
    Abstract [en]

    The purpose of this research study was to identify and describe US midwives' knowledge and use of sterile water injections to relieve pain during labor. Research studies have shown that injections of sterile water to relieve low back pain during labor are effective with good maternal satisfaction. However, no knowledge is available about their use by midwives in the United States. Questionnaires were mailed to a random sample (N = 450) of midwives who were members of the American College of Nurse-Midwives (ACNM). One hundred thirty-two respondents (29%) returned the questionnaire. One-fourth (26%) of the midwives use sterile water injections, although infrequently. More than half of the midwives use the intracutaneous injection technique, and most use a total of four injections. Most midwives give the injections between contractions, with the assistance of another person, and report very good pain relief. Of those not using sterile water injections, most had no experience or training in use of the method and were interested in learning more about their use. While sterile water injections are a good treatment for back pain during labor, there is a lack of knowledge among midwives about this method of pain relief during labor and an interest in knowing more.

  • 12.
    Rilby, Linda
    et al.
    Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Ostra, Sweden.
    Jansson, Solveig
    Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Ostra, Sweden.
    Lindblom, Britta
    Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Ostra, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    A Qualitative Study of Women's Feelings About Future Childbirth: Dread and Delight2012In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 57, no 2, p. 120-125Article in journal (Refereed)
    Abstract [en]

    Introduction: There is extensive knowledge about expectations of and thoughts about childbirth among women who have not given birth. When it comes to women who have given birth to at least 1 child, on the other hand, knowledge about their expectations for a future birth is limited. The purpose of this study is thus to describe the emotions of this group concerning future childbirth. Methods: Participants were 908 women in Sweden who had given birth to at least 1 child. This study is based on responses to the following request in the questionnaire sent out to women 4 to 7 years after they had given birth vaginally: "Please describe your feelings when you think about giving birth in the future." Results: One-third of the women responded that they were mostly frightened of future childbirth, while the remaining two-thirds had mostly positive feelings. The qualitative analysis resulted in 3 categories and 8 subcategories and an overall theme: a mixture of dread and delight. Even with negative feelings/fears about future childbirth, many women want to give birth to more children. Discussion: Despite experiences of severe pain or complications during a previous birth, many women nonetheless looked forward to future childbirth, primarily since they were motivated by having another child and encouraged by having been given good support by the midwife.

  • 13.
    Ängeby, Karin
    et al.
    Cty Council Varmland, Womens Dept, Karlstad, Sweden.;Cty Council Varmland, Clin Res Ctr, Karlstad, Sweden.;Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, Karlstad, Sweden..
    Wilde-Larsson, Bodil
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, Karlstad, Sweden.;Inland Norway Univ Appl Sci, Fac Publ Hlth, Dept Nursing, Elverum, Norway..
    Hildingsson, Ingegerd
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Mid Sweden Univ, Dept Nursing Sci, Sundsvall, Sweden..
    Sandin-Bojo, Ann-Kristin
    Karlstad Univ, Dept Hlth Sci, Fac Hlth Sci & Technol, Karlstad, Sweden..
    Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population2018In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 63, no 1, p. 33-44Article, review/survey (Refereed)
    Abstract [en]

    IntroductionThe prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase. MethodsA descriptive and comparative study was performed in a mid-sized hospital in western Sweden. The sample consisted of 1343 birth records of women who intended vaginal births and who had spontaneous onset of labor at 37 or more weeks' gestation during a one-year period (2013-2014). Background characteristics, obstetric interventions, and labor and neonatal outcomes were compared between women with latent phases lasting less than 18 hours and 18 hours or more, based on women's self-report. Odds ratios with 95% confidence intervals were calculated for the different exposure variables. ResultsA prolonged latent phase lasting 18 hours or more occurred in 23% of all births analyzed (n = 1343). A prolonged latent phase was more common among nulliparous women (29.2%) but also common for multiparous women (17%). Nulliparous and multiparous women who experienced a prolonged latent phase were more often exposed to amniotomy during latent phase. For nulliparous women, the adjusted odds ratio (aOR) was 11.57 (95% confidence interval [CI], 5.25-25.51) and for multiparous women the aOR was 18.73 (95% CI, 9.06-38.69). Similarly, amniotomy during active phase was more common for both nulliparous and multiparous women who experienced a prolonged latent phase (aOR, 4.05; 95% CI, 2.53-6.47 and aOR, 3.93; 95% CI, 2.43-6.37, respectively). Women with latent phases of 18 hours or more, more often experienced augmentation of labor during all phases, especially during latent phase. For nulliparous women, the aOR was 10.13 (95% CI, 2.82-36.39) and for multiparous women, aOR was11.9 (95% CI, 3.69-38.71). A prolonged latent phase was associated with more instrumental vaginal births for multiparas (aOR, 2.58; 95% CI, 1.27-5.26) and emergency cesarean regardless of parity (nulliparous women: aOR, 3.21; 95% CI, 1.08-9.50 and multiparous women: aOR, 3.93; 95% CI, 1.67-9.26). DiscussionBased on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.

  • 14.
    Ängeby, Karin
    et al.
    Women’s Department, Central Hospital, Karlstad, Sweden.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Inland Norway Univ Appl Sci, Fac Publ Hlth, Dept Nursing, Elverum, Norway.
    Hildingsson, Ingegerd
    Department of Health Sciences, Mid Sweden University, Sundsvall, .
    Sandin-Bojö, Ann-Kristin
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Prevalence of Prolonged Latent Phase and Labor Outcome: Review of Birth Records in a Swedish Population2018In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 63, no 1, p. 33-44, article id JMWH12704Article in journal (Refereed)
    Abstract [en]

    The prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase.

    METHODS:

    A descriptive and comparative study was performed in a mid-sized hospital in western Sweden. The sample consisted of 1343 birth records of women who intended vaginal births and who had spontaneous onset of labor at 37 or more weeks' gestation during a one-year period (2013-2014). Background characteristics, obstetric interventions, and labor and neonatal outcomes were compared between women with latent phases lasting less than 18 hours and 18 hours or more, based on women's self-report. Odds ratios with 95% confidence intervals were calculated for the different exposure variables.

    A prolonged latent phase lasting 18 hours or more occurred in 23% of all births analyzed (n = 1343). A prolonged latent phase was more common among nulliparous women (29.2%) but also common for multiparous women (17%). Nulliparous and multiparous women who experienced a prolonged latent phase were more often exposed to amniotomy during latent phase. For nulliparous women, the adjusted odds ratio (aOR) was 11.57 (95% confidence interval [CI], 5.25-25.51) and for multiparous women the aOR was 18.73 (95% CI, 9.06-38.69). Similarly, amniotomy during active phase was more common for both nulliparous and multiparous women who experienced a prolonged latent phase (aOR, 4.05; 95% CI, 2.53-6.47 and aOR, 3.93; 95% CI, 2.43-6.37, respectively). Women with latent phases of 18 hours or more, more often experienced augmentation of labor during all phases, especially during latent phase. For nulliparous women, the aOR was 10.13 (95% CI, 2.82-36.39) and for multiparous women, aOR was11.9 (95% CI, 3.69-38.71). A prolonged latent phase was associated with more instrumental vaginal births for multiparas (aOR, 2.58; 95% CI, 1.27-5.26) and emergency cesarean regardless of parity (nulliparous women: aOR, 3.21; 95% CI, 1.08-9.50 and multiparous women: aOR, 3.93; 95% CI, 1.67-9.26).

    Based on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.

  • 15.
    Ängeby, Karin
    et al.
    City Council Värmland, Karlstad; Karlstad University, Karlstad.
    Wilde-Larsson, Bodil
    Karlstad University, Karlstad; Inland Norway University Appl Sci, Elverum, Norway.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University, Uppsala.
    Sandin-Bojö, Ann-Kristin
    Karlstad University, Karlstad.
    Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population2018In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 63, no 1, p. 33-44Article, review/survey (Refereed)
    Abstract [en]

    IntroductionThe prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase. MethodsA descriptive and comparative study was performed in a mid-sized hospital in western Sweden. The sample consisted of 1343 birth records of women who intended vaginal births and who had spontaneous onset of labor at 37 or more weeks' gestation during a one-year period (2013-2014). Background characteristics, obstetric interventions, and labor and neonatal outcomes were compared between women with latent phases lasting less than 18 hours and 18 hours or more, based on women's self-report. Odds ratios with 95% confidence intervals were calculated for the different exposure variables. ResultsA prolonged latent phase lasting 18 hours or more occurred in 23% of all births analyzed (n = 1343). A prolonged latent phase was more common among nulliparous women (29.2%) but also common for multiparous women (17%). Nulliparous and multiparous women who experienced a prolonged latent phase were more often exposed to amniotomy during latent phase. For nulliparous women, the adjusted odds ratio (aOR) was 11.57 (95% confidence interval [CI], 5.25-25.51) and for multiparous women the aOR was 18.73 (95% CI, 9.06-38.69). Similarly, amniotomy during active phase was more common for both nulliparous and multiparous women who experienced a prolonged latent phase (aOR, 4.05; 95% CI, 2.53-6.47 and aOR, 3.93; 95% CI, 2.43-6.37, respectively). Women with latent phases of 18 hours or more, more often experienced augmentation of labor during all phases, especially during latent phase. For nulliparous women, the aOR was 10.13 (95% CI, 2.82-36.39) and for multiparous women, aOR was11.9 (95% CI, 3.69-38.71). A prolonged latent phase was associated with more instrumental vaginal births for multiparas (aOR, 2.58; 95% CI, 1.27-5.26) and emergency cesarean regardless of parity (nulliparous women: aOR, 3.21; 95% CI, 1.08-9.50 and multiparous women: aOR, 3.93; 95% CI, 1.67-9.26). DiscussionBased on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.

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