Margareta Johansson

A qualitative investigation into the pregnancy experiences and childbirth expectations of Australian fathers-to-be

AIM To explore and describe mens experiences of pregnancy and childbirth expectations. BACKGROUND There remains limited work exploring expectant fathers perspectives. DESIGN Qualitative descriptive design. Twelve Australian expectant fathers participated in between 1 and 2 interviews during pregnancy and 1 after childbirth (32 in total). Six fathers also chose to submit a number of diary entries via e-mail. Thematic analysis was used to analyse the data set. FINDINGS Five themes emerged from the data. The themes pregnancy news: heralds profound change adjusting to pregnancy, and birth looming described how men processed the news of pregnancy, worked to accept their changed circumstances and negotiated the final week of the pregnancy. A fourth theme, labelled Feeling sidelined, outlined mens experiences of antenatal care and their feeling of isolation as a result of largely feeling ignored by health care professionals. The fifth theme represents mens childbirth expectations. CONCLUSION Adjusting to the news of a pregnancy was a potentially unsettling time for an expectant father that was often associated with increased apprehension and anxiety. Regardless of whether they were a first or once again father most men engaged in a level of emotional work to come to terms with and accept the pregnancy. Understanding mens antenatal experiences and anxieties is an important step in the development of preventative paternal perinatal mental health measures. The significance of this work is situated within the reality that mens wellbeing is associated with maternal psychological well-being, positive peri-natal experiences and child development.

Childbirth fear in expectant fathers: Findings from a regional Swedish cohort study

OBJECTIVE to investigate the prevalence of childbirth related fear in Swedish fathers and associated factors. DESIGN a regional cohort study. Data was collected by a questionnaire. SETTING three hospitals in the middle-north part of Sweden PARTICIPANTS 1047 expectant fathers recruited in mid-pregnancy during one year (2007) who completed the Fear of Birth Scale (FOBS). MEASUREMENTS prevalence of childbirth fear and associated factors. Crude and adjusted odds ratios were calculated between men who scored 50 and above (childbirth fear) and those that did not (no fear). Logistic regression analysis was used to assess which factors contributed most to childbirth fear in fathers. FINDINGS the prevalence of childbirth fear in men was 13.6%. Factors associated with childbirth related fear were as follows: Less positive feelings about the approaching birth (OR 3.4; 2.2-5.2), country of birth other than Sweden (OR 2.8; 1.3-6.1), a preference for a caesarean birth (OR 2.1; 1.7-4.1), childbirth thoughts in mid-pregnancy (OR 1.9; 1.1-2.0) and expecting the first baby (OR 1.8; 1.2-2.6). KEY CONCLUSIONS high levels of fear were associated with first time fathers and being a non-native to Sweden. Men with fear were more likely to experience pregnancy and the coming birth as a negative event. These men were also more likely to identify caesarean section as their preferred mode of birth. IMPLICATIONS FOR PRACTICE engaging expectant fathers in antenatal conversations about their experiences of pregnancy and feelings about birth provides health-care professionals with an opportunity to address childbirth fear, share relevant information and promote birth as a normal but significant life event.

Factors associated with a positive birth experience : An exploration of Swedish women‘s experiences

BACKGROUND: The birth of a baby is a powerful life event that has implications for a woman’s well-being and future health. A positive birth experience promotes a sense of achievement, enhances feeling of self-worth, and facilitates confidence—all of which are important for a healthy adaptation to motherhood and psychological growth. Understanding what constitutes a positive birth experience is critical to providing maternity care that meets childbearing women’s individual needs, preferences, and priorities. OBJECTIVE: To explore the prevalence of Swedish women reporting a very positive birth experience 2 months and 1 year after childbirth and identify factors associated with this experience. In addition, the study aimed to identify whether women’s assessment of their birth experience changed over time. METHOD: A prospective, longitudinal study where the main outcome variable was perceptions of a very positive birth experience. The study was undertaken in a Northern region of Sweden in 2007. Women were recruited at their ultrasound examination in midpregnancy. Data was collected via questionnaires. There were 928 women who responded to questions about their birth experience at 2 months postpartum. Nearly 83% of these women (n = 763) also completed the questionnaire package 1 year after birth. Descriptive statistics were used together with Friedman’s test to detect changes over time. Logistic regression analysis was performed to reveal which factors contributed most to a very positive birth experience. RESULT: More than a third of the women reported a very positive birth experience. Women’s assessment of birth changed over time with 22% of the women becoming more positive and 15% more negative. Important associated factors for a very positive birth experience included positive feelings about the approaching birth as well as feeling in control, using no or only cognitive forms of pain management, and achieving a spontaneous vaginal birth. Furthermore, how women rated their midwifery care was also shown to affect their assessment of their birth experience. CONCLUSION: This study found that women’s birth experiences changed over time and most becoming more positive after 1 year. Factors associated with a very positive birth experience were related to women’s prenatal attitudes, intrapartum procedures, pain relief used, and care received during labor and birth. Respectful individualized midwifery care that remains focused on the woman and keeping birth normal increases positive perceptions of the birth experience.

Few fathers-to-be prefer caesarean section for the birth of their baby.

Please cite this paper as: Johansson M, Rådestad I, Rubertsson C, Karlström A, Hildingsson I. Few fathers‐to‐be prefer caesarean section for the birth of their baby. BJOG 2010; DOI: 10.1111/j.1471‐0528.2010.02508.x.

Swedish women's interest in models of midwifery care - Time to consider the system? : A prospective longitudinal survey

BACKGROUND Sweden has an international reputation for offering high quality maternity care, although models that provide continuity of care are rare. The aim was to explore womens interest in models of care such as continuity with the same midwife, homebirth and birth center care. METHODS A prospective longitudinal survey where 758 womens interest in models such as having the same midwife throughout antenatal, intrapartum and postpartum care, homebirth with a known midwife, and birth center care were investigated. RESULTS Approximately 50% wanted continuity of care with the same midwife throughout pregnancy, birth and the postpartum period. Few participants were interested in birth center care or home birth. Fear of giving birth was associated with a preference for continuity with midwife. CONCLUSIONS Continuity with the same midwife could be of certain importance to women with childbirth fear. Models that offer continuity of care with one or two midwives are safe, cost-effective and enhance the chance of having a normal birth, a positive birth experience and possibly reduce fear of birth. The evidence is now overwhelming that all women should have maternity care delivered in this way.

Fathers want to stay close to their partner and new baby in the early postnatal period: The importance of being able to room in after a surgical birth

The early postnatal period can be challenging for new fathers especially when their partner has experienced a caesarean section. The aim of this study was to describe mens perceptions and feelings of staying with their partner and new baby in the context of having experienced a surgical birth. Thematic analysis was employed to analyse telephone interviews collected from 21 Swedish fathers who had experienced elective or emergency caesarean section. Being involved, receiving support and providing support were main reasons men considered it important they be facilitated to stay with their partners. Postnatal care should be oriented towards the whole family.