Anders Möller

What characterizes women in Norway who wish to have a caesarean section

Aims: The aim of this study was to describe the characteristics of pregnant women who wish to have a caesarean section. Methods: Data were collected as part of the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Pregnant women booked for antenatal care in Norway between 1999 and 2006 were invited to participate in the study. Data on womens interest in mode of delivery and a set of associated variables were gathered from a questionnaire completed by 55,859 women at 30 weeks of pregnancy. Results: A wish for caesarean section was expressed by 10% of the women, and 33% thought that the woman herself should be allowed to decide whether to have a caesarean section or not. A negative experience from a previous labour, a second birth, an age>35, a low level of education, being single, being unemployed, having an assisted conception, expecting more than one foetus, experiencing urinary and bowel incontinence before current pregnancy, experiencing pelvic pain, having a fear of childbirth and reporting negative intra-psychic phenomena were significantly associated with a wish for caesarean section. Conclusions: At 30 weeks of pregnancy, one out of 10 women in a sample of Norwegian women would choose a caesarean section. Negative experiences from previous pregnancies and fear of giving birth are two of the strongest factors associated with a wish for a caesarean section and should be taken into consideration.

Experiences of persons with early-onset dementia in everyday life: A qualitative study

Background: The small number of existing studies confirms that people with early-onset dementia (EOD) need special assistance from the beginning and as the disease progresses. There is a need to develop services to respond to the specific needs of persons with EOD. Aim: To find out how people experience living with early-onset dementia, and to assess the implications for practice and the development of further services. Method: Grounded theory, a qualitative method, with interviews of 20 informants (aged 54–67 years; 12 of them men) during 2010–2011. Findings: One category, the process toward a dementia diagnosis, covered two subcategories; describing changes and being diagnosed. Another category fighting for dignity describes how the informants try to maintain their quality of life, covering two subcategories; intrapsychic challenges and social challenges. Conclusion: Health services should give persons with EOD the ability to maintain contact with society and their voices should not be overlooked.

How Does Preference for Natural Childbirth Relate to the Actual Mode of Delivery? A Population‐based Cohort Study from Norway

BACKGROUNDnIn Norway, intervention in childbirth has increased from 3 percent in 1967 to 37 percent in 2006. The objectives of this study were, first, to estimate to which extent women who expressed a preference for natural birth actually were delivered vaginally without interventions, and second, to estimate the influence that emotions and maternal background factors have on the mode of delivery.nnnMETHODSnWe used data from 39,475 pregnancies of participants in the Norwegian Mother and Child Cohort Study in which the pregnant woman had expressed a preference for natural birth, and linked these data with the pregnancy outcome as registered in the population-based Medical Birth Registry of Norway during 2000 to 2006. The influence of maternal factors on the mode of delivery was estimated with log-binomial regression models, stratified by parity.nnnRESULTSnAmong primiparas, 29.3 percent delivered vaginally without interventions (natural birth), 56.1 percent gave birth vaginally with interventions, and 14.5 percent had a cesarean section. The strongest predictor for actually having a natural birth was age below 25 years, having more than 12 years education, carrying a single fetus, and having a low score for anxiety and depression. Among multiparas, 61.1 percent gave birth vaginally without interventions, 30.6 percent vaginally with interventions, and only 8.3 percent had a cesarean section. The effects of maternal age, education, and anxiety or depression on the outcome were smaller for multiparas than for primiparas.nnnCONCLUSIONSnThe chance of actually having a natural birth for women with a preference for a natural birth is much greater for multiparas than for primiparas. The factors that influence the chance of having a natural birth are different for primiparas and multiparas.

Reasoning about timing of wanting a child: A qualitative study of Nordic couples from fertility clinics

Objective: To explore the reasoning of Nordic couples recruited through fertility clinics in deciding ‘the right time’ to attempt conception and whether nationality impacts on this reasoning. Background: Although previous studies have explored the motivation for childbearing, few investigations have focused on how couples determine the ‘right time’ for parenting. Methods: A qualitative study, including 22 couples recruited from fertility clinics in the 5 Nordic countries. Results: Two main categories were identified: ‘prepared for parenthood’ with four subcategories – stable social conditions, stable relationships, appropriate age, mutual desire for children; and ‘decision-making catalysts’ with three subcategories – social balance, duty to family and fear of infertility. Conclusions: Preparation comes first and clears the way for influences from other factors, although fear of infertility caused couples to accelerate their decision-making processes. Nationality did not affect the categories, although this could be related to the fact that Nordic countries have similar social structures. Reasoning regarding ‘the right time’ depended on situation rather than nationality.

What characterizes women who want to give birth as naturally as possible without painkillers or intervention

OBJECTIVEnTo describe the characteristics of pregnant women who wish to have as natural a birth as possible without analgesics and without intervention.nnnSTUDY DESIGNnNational cohort study.nnnSETTINGnNorwegian Institute of Public Health.nnnPOPULATIONn55,859 pregnant women booked for antenatal care in Norway 1999-2007.nnnMETHODSnData on womens interest in natural birth and a set of possible predictors were retrieved from a questionnaire completed at the 30th week of pregnancy and linked to the Medical Birth Registry of Norway.nnnMAIN OUTCOME MEASUREnNatural birth and the characteristics of pregnant women with such preferences.nnnRESULTSnInterest in natural childbirth was consistently expressed by 72%. Positive experience from previous pregnancies, first birth or third or later birth, no fear of giving birth, and reporting positive intra-psychic phenomena are significantly associated with the wish for natural birth.nnnCONCLUSIONSnPositive experiences from previous childbirths and no fear of giving birth are the strongest factors associated with a wish for as natural birth as possible and should be taken into consideration in public health.

Hiding parts of one's self from others – a grounded theory study on teenagers diagnosed with ADHD

The aim of this study was to gain deeper knowledge of how teenagers with the diagnosis of ADHD experience their disorder, treatment and the consequences of diagnosis and treatment in their daily lives. Ten teenagers were interviewed in depth. The interviews were analyzed according to the grounded theory method. In the analysis of the data the core category hiding parts of ones self from others emerged. Four other categories were also identified: being different from others; wanting to be like everybody else; keeping the medical treatment a secret; and feeling worried about the future. The teenagers strove for normalcy and wanted to be like everyone else. They tried their utmost to conceal their diagnosis and medical treatment from others, such as schoolmates, friends and the reference group.

The experience of women living with Congenital Adrenal Hyperplasia: impact of the condition and the care given.

Congenital adrenal hyperplasia (CAH) is caused most often by mutations in the CYP21A2 gene, resulting in cortisol and aldosterone deficiency and increased production of androgens.

Worrying about one’s children after breast cancer diagnosis: desired timing of psychosocial intervention

BackgroundThe purposes of this observational study were to analyze at what time point mothers desired psychosocial support regarding the worry about their children during the year after breast cancer diagnosis and to identify any psychosocial factors associated with this worry.MethodsIn a population-based study, we analyzed data from 280 mothers diagnosed with breast cancer at Sahlgrenska University Hospital in Gothenburg, Sweden.ResultsOf those who did not receive chemotherapy treatment, 70 out of 112 women (63xa0%) reported a desire to receive support about the worry about their children, and of those who received chemotherapy treatment, 20 out of 49 (41xa0%) reported a need for support immediately following diagnosis and before surgery. We identified having children at home (Pu2009<u20090.0001), worry about sex life (Pu2009=u20090.0009), fear of dying from breast cancer (Pu2009=u20090.0055), and worried about one’s personal financial situation (Pu2009=u20090.0413) as the variables most closely related to worry about the children.ConclusionsOur population-based study shows that mothers with breast cancer had an immediate desire to receive psychosocial support regarding the worry about their own children. If we wish to shorten the pain associated with this worry among women diagnosed with breast cancer, it may be helpful to offer support as early in the disease trajectory as possible as it may reduce the risk of a later, more complicated, unnecessarily prolonged psychosocial rehabilitation process.

Nordic couples’ decision-making processes in anticipation of contacting a fertility clinic

Objective: To explore the decision-making processes of Nordic couples in anticipation of contacting a fertility clinic after experiencing difficulties in conceiving. Method: A retrospective descriptive qualitative study of 22 heterosexual infertile couples recruited from fertility clinics in all five Nordic countries. Results: The process comprises three decisions: (i) accepting that they have a shared problem, (ii) acknowledging the need for more knowledge and (iii) taking action to get help. Subcategories were: (i) infertile or not, maintain the balance in the relationship; (ii) information from social networks and information from the health care system; (iii) having an alternative plan and fear of a wrong decision. The core category was ‘negotiation and re-negotiation’. Differences between the countries were found with regard to the time couples waited before contacting a fertility clinic, and in the utilisation of private vs. public clinics. Conclusion: It requires a process of negotiation and re-negotiation for couples to reach a compromise. Furthermore, the decision-making process is influenced by the structure of health care services in respective countries.

Motivating and discouraging factors with being a support contact in the dementia care sector: a grounded theory study

Abstract Background: People with dementia need different forms of assistance as the disorder progresses. In Norway, support contacts work as ‘paid friends’ and their role can be compared with respite carers or voluntary workers in other Western countries. Support contacts may be helpful within the dementia sector, especially in the early stages of the disorder, though they are rarely used. Aim: The aim of this study was to find out how the support contacts perceive their work. Method: Grounded theory, a qualitative method, with interviews of 19 participants (14 women and five men aged 40–75 years) during 2009–2010, from 12 local authorities. Findings: This study describes the participants motives for becoming a support contact and their encouraging and discouraging experiences while being a support contact, expressed as four sets of opposites; flexibility vs rigidity; being compensated vs feeling used; affiliation vs abandonment; and satisfaction vs lack of satisfaction. Conclusion: Greater flexibility,...