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  • 1.
    Bang Svendsen, Stine H.
    et al.
    Førsteamanuensis i pedagogikk, Institutt for læreutdanning, NTNU (NOR).
    Areskoug Josefsson, Kristina
    University West, Department of Health Sciences, Section for health promotion and care sciences. Institutt for Atferdsvitenskap, Oslo Metropolitan University, Oslo (NOR).
    Svarstad Solberg, Ada
    Institutt for sykepleie og helsefremmende arbeid, Institutt for atferdsvitenskap, Oslo Metropolitan University (NOR).
    Skaug Sætra, Henrik
    Proba samfunnsanalyse, Oslo (NOR).
    Gunnman Furunes, Mari
    Institutt for tverrfaglige kulturstudier, NTNU (NOR).
    Utdanningene svikter i arbeidet med seksuell og reproduktiv helse og rettig­heter2023In: ForskersonenArticle in journal (Other (popular science, discussion, etc.))
  • 2.
    Bay, Annika
    et al.
    Department of Nursing, Umeå University, Umeå (SWE).
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Burström, Åsa
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (SWE).
    Holstad, Ylva
    Department of Nursing, Umeå University, Umeå (SWE).
    Christersson, Christina
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala (SWE).
    Dellborg, Mikael
    Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Gothenburg (SWE).
    Trzebiatowska-Krzynska, Aleksandra
    Department of Cardiology and Department of Medicine and Health Sciences, Linköping University, Linköping (SWE).
    Sörensson, Peder
    Department of Medicine, Solna, Karolinska Institutet, Stockholm (SWE).
    Thilén, Ulf
    Department of Clinical Sciences, Cardiology, Lund University, Lund (SWE).
    Johansson, Bengt
    Department of Surgical and Perioperative Sciences, Umeå University, Umeå (SWE).
    Symptoms during pregnancy in primiparous women with congenital heart disease.2024In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 58, no 1, article id 2302135Article in journal (Refereed)
    Abstract [en]

    Background: As more women with congenital heart disease (CHD) are reaching childbearing age, it becomes more common for their symptoms to be evaluated during pregnancy. However, pregnancy-related symptoms are similar to those caused by heart disease. This study investigated the prevalence of factors associated with symptoms during pregnancy in women with CHD.

    Methods: The national birth register was searched for primiparous women with CHD who were registered in the national quality register for patients with CHD.

    Results: Symptoms during the third trimester were reported in 104 of 465 evaluated women. The most common symptom was palpitations followed by dyspnea. Factors associated with symptoms were tested in a univariable model; higher NYHA classification (>1) (OR 11.3, 95%CI 5.5-23.2), low physical activity (≤3 h/week) (OR 2.1 95%CI 1.3-3.6) and educational level ≤ 12 years (OR 1.9 95%CI 1.2-3.0) were associated with having symptoms. In multivariable analysis, low physical activity level (OR 2.4 95%CI 1.2-5.0) and higher NYHA class (OR 11.3 95%CI 5.0-25.6) remained associated with symptoms during pregnancy. There were no cases with new onset of impaired systemic ventricular function during pregnancy.

    Conclusion: Symptoms during pregnancy are common in women with CHD but are often already present before pregnancy. Because ordinary symptoms during pregnancy often overlap with symptoms of heart disease, it is important to know if symptoms were present before pregnancy and if they became worse during pregnancy. These results should be included in pre-pregnancy counselling and considered in the monitoring during pregnancy.

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  • 3.
    Berndtsson, Ina
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Sexualitet och fertilitet vid inflammatorisk tarmsjukdom2008Other (Other academic)
  • 4.
    Ekström-Bergström, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Research Group Family Centered Health (FamCeH) University of Skövde Skövde (SWE);School of Health Sciences University of Skövde Skövde (SWE).
    Thorstensson, Stina
    Research Group Family Centered Health (FamCeH) University of Skövde Skövde (SWE);School of Health Sciences University of Skövde Skövde (SWE).
    Bäckström, Caroline
    Research Group Family Centered Health (FamCeH) University of Skövde Skövde (SWE);School of Health Sciences University of Skövde Skövde (SWE).
    The concept, importance and values of support during childbearing and breastfeeding – A discourse paper2021In: Nursing Open, E-ISSN 2054-1058, Vol. 9, no 1, p. 156-167Article in journal (Refereed)
    Abstract [en]

    Background:Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing.

    Aim: The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites.

    Design:Discourse paper.

    Methods:This discourse paper is based on our own experiences and is supported by literature and theory.

    Results: Well-functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered.

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    Nursing Open
  • 5.
    Ewenborg, Stina
    et al.
    University West, Department of Health Sciences.
    Frisk, Sanna
    University West, Department of Health Sciences.
    Kvinnors upplevelse att leva med polycystiskt ovarial syndrom: en litteraturöversikt2022Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of women in fertile age. Many women suffer from symptoms associated with PCOS and the nurse's treatment plays an important role. 

    Aim: The aim of the study was to illuminate women's experience of living with PCOS. 

    Method: A literature review based on qualitative and quantitative studies was applied and analysed with Fribergs five-step model.

    Results: The results show the encounter with care, physical changes, and the experience of not fitting into society's norms, which describes the women's physical and mental state and how it affects them negatively. Ignorance of the diagnosis leads to misleading information that causes women to lose confidence in care and feel distrustful. This leads to a need to seek information on one's own. A feeling of loneliness and decreased self-confidence are some negative consequences.

    Conclusion: PCOS is a diagnosis that affects women. It is an important part for the nurse to have knowledge and a good approach to the woman so she gets good experience of the diagnosis to live a life with good conditions to feel good.

  • 6.
    Granberg, Agnes
    et al.
    Psykologiteamet, Göteborg, Sweden.
    Ekström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bäckström, Caroline
    University of Skövde, School of Health Sciences, Post Box 408, S 541 28, Skövde, Sweden.
    First-Time Mothers' Enjoyment of Breastfeeding Correlates with Duration of Breastfeeding, Sense of Coherence, and Parental Couple and Child Relation: A Longitudinal Swedish Cohort Study2020In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2020, article id 8194389Article in journal (Refereed)
    Abstract [en]

    Objectives: Many women do not reach their own breastfeeding goals regarding duration of breastfeeding. Different factors influence breastfeeding, and to learn more about breastfeeding within a multidimensional and longitudinal perspective, further research is needed. Therefore, the aim of the present study was to investigate diverse factors correlated with first-time mothers' enjoyment of breastfeeding and breastfeeding duration, between childbirth and two years after birth.

    Methods: In a prospective longitudinal cohort study, 324 newly become mothers were followed. The Spearman correlation test was used to investigate factors correlated with the degree to which mothers enjoy breastfeeding and the duration of breastfeeding. The Mann-Whitney test was conducted for comparisons of demographic characteristics between mothers who did or did not breastfeed.

    Results: Among the mothers, 99.2% initiated breastfeeding after birth. Frequencies of breastfeeding were 54.8% at six months, 9.1% at one year, and 1.0% at two years. The degree to which the mother enjoyed breastfeeding was correlated positively with (1) the duration of breastfeeding, (2) more positive feelings for and relation to the child, (3) the partner's perceived relation to the child, (4) a higher sense of coherence, and (5) stronger perceived parental couple's relationship. Longer breastfeeding duration was correlated positively with (1) a higher degree of enjoyment of breastfeeding, (2) more positive relation to the child, and (3) stronger perceived parental couple's relationship. Additionally, breastfeeding during the first two hours after birth, more positive feelings for and relation to the child, and a higher degree of enjoyment of breastfeeding were more frequently reported among breastfeeding mothers, in comparison with not breastfeeding mothers.

    Conclusion: Mothers' subjective experience from breastfeeding, sense of coherence, and couple relationship with partner and relationship with the child are valuable factors in regard to breastfeeding.

  • 7.
    Hoppe, Michael
    et al.
    Department of Gastroenterology and Hepatology , Clinical Nutrition Unit , Sahlgrenska University Hospital , Gothenburg , Sweden.
    Hulthén, Lena
    University of Gothenburg , Department of Internal Medicine and Clinical Nutrition , Sahlgrenska Academy , Gothenburg , Sweden.
    Samuelson, Gösta
    University West, Department of Health Sciences, Section for nursing - graduate level. Uppsala University , Department of Clinical Sciences/Clinical Physiology , Uppsala , Sweden..
    Is cord blood hepcidin influenced by the low-grade acute-phase response occurring during delivery?: A small-scale longitudinal study2019In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 32, no 13, p. 2166-2172Article in journal (Refereed)
    Abstract [en]

    AIM: To measure serum hepcidin in late pregnancy and in cord blood, and to analyze relationship between hepcidin, interleukin-6 and biomarkers of fetal iron status.

    MATERIALS AND METHODS: Data from 15 uncomplicated singleton pregnancies were analyzed longitudinally in trimester 3 (T3) and at birth.

    RESULTS: In T3, S-ferritin (median 14 µg/L) and transferrin (median 4.0 g/L) indicated low iron status, whereas the median soluble transferrin receptor (sTfR) was 4.0 mg/L, ie within the reference interval. Median T3 S-hepcidin was 7.8 ng/mL. Later on in cord blood, ferritin concentration (180 µg/L) were significantly higher, transferrin concentration (1.8 g/L) were significantly lower, and both sTfR (4.7 mg/L) and S-hepcidin concentrations (30.5 ng/mL) were significantly higher than maternal T3 concentrations. At the same time, cord blood interleukin-6 indicated an activated acute-phase reaction. In T3, after logarithmic transformation, there was a significant correlation between S-hepcidin and both S-ferritin (r = 0.691) and sTfR (r = -0.825). There was also a significant correlation between S-ferritin and both sTfR (r = -0.729) and transferrin (r = 0.549) in T3.

    CONCLUSIONS: Although S-ferritin, S-hepcidin, and sTfR were correlated during pregnancy, these relationships were not apparent in umbilical cord blood. Further, cord blood interleukin-6 indicated an activated acute-phase response, and sTfR, which is known to be unaffected by inflammation, indicated a low iron status in cord blood. Thus, instead of representing an enhanced iron status, the data appear to suggest that hepcidin and ferritin in cord blood may be influenced by the low-grade acute-phase response that occurs during delivery.

  • 8.
    Olsson, Evelina
    University West, Department of Health Sciences.
    En kvalitativ litteraturstudie om hur kvinnor med substansbrukssyndrom upplever sin graviditet och sitt moderskap2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pregnant women and mothers with substance abuse is a vulnerable target group in society. The feeling of guilt and shame can cause the woman to avoid seeking care, which reduces the possibility of recovery and can cause harm to the fetus.

    Aim: The aim with this literature study was to increase the understanding of women's experiences of pregnancy and motherhood during substance abuse.

    Method: The study is a literature review based on qualitative articles produced through systematic searches with established inclusion and exclusion criteria. A total of seven articles of high quality have been used to answer the aim.

    Results: The results show that women consider maternity and motherhood a motivating factor to counteract their drug addictions and improve their lifestyles. However, they face numerous obstacles during this journey and evidence shows that support from the family and friends and access to healthcare services are critical in treating substance addiction during parenthood. Furthermore, there appears to be a lack of competence in dealing with this specific target group by healthcare services.

    Conclusion: Substance abuse is generally connected to traumatic experiences from early ages that could cause difficulties in the treatment process. Substance abuse also tend to cause difficulties during parenthood due to lack of structure and routines. Negative experiences with healthcare services can cause lack of trust and will as result limit the recovery of the substance abuse. Support from healthcare services and good relationships from the social circle are vital in the treatment of addiction and the success of parenting

  • 9.
    Olza, Ibone
    et al.
    University of Alcalá, Faculty of Medicine, Henares, Spain (ESP).
    Uvnas-Moberg, Kerstin
    Swedish University of Agricultural Sciences, Skara, Sweden.
    Ekström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Leahy-Warren, Patricia
    University College, School of Nursing and Midwifery, Cork, Ireland (IRL).
    Karlsdottir, Sigfridur Inga
    University of Akureyri, School of Health Sciences, Akureyri, Iceland (ISL).
    Nieuwenhuijze, Marianne
    Zuyd University, Research Centre for Midwifery Science Maastricht, Heerlen, The Netherlands (NLD).
    Villarmea, Stella
    University of Alcalá, Faculty of Philosophy, Henares, Spain (ESP); Faculty of Philosophy, University of Oxford, Oxford, United Kingdom (GBR).
    Hadjigeorgiou, Eleni
    Cyprus University of Technology, Nursing Department, Faculty of Health Sciences, Limassol, Cyprus (CYP).
    Kazmierczak, Maria
    Uniwersytet Gdanski, Institute of Psychology, Gdansk, Poland (POL).
    Spyridou, Andria
    Cyprus University of Technology, Nursing Department, Faculty of Health Sciences, Limassol, Cyprus (CYP).
    Buckley, Sarah
    The University of Queensland, School of Public Health, Herston, Qld, Australia (AUS).
    Birth as a neuro-psycho-social event: An integrative model of maternal experiences and their relation to neurohormonal events during childbirth2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 7, p. 1-15, article id e0230992Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth.

    METHODOLOGY: In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth.

    FINDINGS: The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care.

    CONCLUSION: By listening to women's experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers' wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.

  • 10.
    Scheffel, Evelina
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Örnberg, Emelie
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Kvinnors erfarenheter av att leva med endometrios: En litteraturbaserad studie2022Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Endometriosis is a chronic inflammatory disease that affects 170 million women worldwide. In Sweden there are 250.000 women who suffer from endometriosis. The disease means that the growth of tissue similar to the endometrium ends up on other tissue and organs which leads to inflammation.

    Aim: The aim of this literature study was to shed light on women's experiences of living with endometriosis.

    Method: The study was conducted as a qualitative literature study, based on an analysis of eleven scientific articles.

    Results: The results were shown in two themes; Impact in daily life and The contact with healthcare which both provided results of women’s stories and experiences of being limited through all aspects of their lives. Handling a disease with painful symptoms and not being listened to or trusted by the healthcare system, were the main focus.

    Conclusion: Women who suffer from endometriosis experience reduced quality of life and are often incapable of physical activity related to chronic pain and the feeling of inadequacy and limitations in their social life. Living with endometriosis also affects a woman's self-esteem and identity, while most women are often met with mistrust, skepticism, and misunderstandings about their problems in the healthcare system. 

  • 11.
    Uvnäs Moberg, Kerstin
    et al.
    Swedish University of Agricultural Sciences, Department of Animal Environment and Health, Skara, Sweden.
    Ekström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Buckley, Sarah
    The University of Queensland, School of Public Health, Herston, QLD, Australia (AUS).
    Massarotti, Claudia
    University of Genova, Academic Unit of Obstetrics and Gynecology, Genova, Italy (ITA); Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy (ITA).
    Pajalic, Zada
    ID Specialized University, Faculty of Health Studies, Campus Diakonhjemmet, V Oslo, Norway (NOR).
    Luegmair, Karolina
    Berufs Bildung Zentrum Gesundheit Ingolstadt, Ingolstadt, Germany (DEU).
    Kotlowska, Alicia
    Medical University of Gdańsk, Department of Clinical & Experimental Endocrinology, Faculty of Health Sciences with Subfaculty of Nursing and Institute of Maritime and Tropical Medicine, Gdańsk, Poland (POL).
    Lengler, Luise
    Midwifery Education Unit, Freiburg University Medical Center, Freiburg, Germany (DEU).
    Olza, Ibone
    University of Alcalá, Faculty of Medicine, Alcalá de Henares, Spain (ESP).
    Grylka-Baeschlin, Susanne
    Zurich University of Applied Sciences, Research Unit for Midwifery Science, Winterthur, Switzerland (CHE).
    Leahy-Warren, Patricia
    University College Cork, School of Nursing and Midwifery, Cork, Ireland (IRL).
    Hadjigeorgiu, Eleni
    Cyprus University of Technology, Nursing Department, Health Science, Limassol, Cyprus (CYP).
    Villarmea, Stella
    University of Alcalá, Faculty of Philosophy, Alcalá de Henares, Spain (ESP); University of Oxford, Faculty of Philosophy, Oxford, United Kingdom, UK (GBR).
    Dencker, Anna
    University of Gothenburg, Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg, Sweden.
    Maternal plasma levels of oxytocin during breastfeeding: A systematic review2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 8, article id e0235806Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Oxytocin is a key hormone in breastfeeding. No recent review on plasma levels of oxytocin in response to breastfeeding is available.

    MATERIALS AND METHODS: Systematic literature searches on breastfeeding induced oxytocin levels were conducted 2017 and 2019 in PubMed, Scopus, CINAHL, and PsycINFO. Data on oxytocin linked effects and effects of medical interventions were included if available.

    RESULTS: We found 29 articles that met the inclusion criteria. All studies had an exploratory design and included 601 women. Data were extracted from the articles and summarised in tables. Breastfeeding induced an immediate and short lasting (20 minutes) release of oxytocin. The release was pulsatile early postpartum (5 pulses/10 minutes) and coalesced into a more protracted rise as lactation proceeded. Oxytocin levels were higher in multiparous versus primiparous women. The number of oxytocin pulses during early breastfeeding was associated with greater milk yield and longer duration of lactation and was reduced by stress. Breastfeeding-induced oxytocin release was associated with elevated prolactin levels; lowered ACTH and cortisol (stress hormones) and somatostatin (a gastrointestinal hormone) levels; enhanced sociability; and reduced anxiety, suggesting that oxytocin induces physiological and psychological adaptations in the mother. Mechanical breast pumping, but not bottle-feeding was associated with oxytocin and prolactin release and decreased stress levels. Emergency caesarean section reduced oxytocin and prolactin release in response to breastfeeding and also maternal mental adaptations. Epidural analgesia reduced prolactin and mental adaptation, whereas infusions of synthetic oxytocin increased prolactin and mental adaptation. Oxytocin infusion also restored negative effects induced by caesarean section and epidural analgesia.

    CONCLUSIONS: Oxytocin is released in response to breastfeeding to cause milk ejection, and to induce physiological changes to promote milk production and psychological adaptations to facilitate motherhood. Stress and medical interventions during birth may influence these effects and thereby adversely affect the initiation of breastfeeding.

  • 12.
    Uvnäs-Moberg, Kerstin
    et al.
    University of Agriculture (SLU), Uppsala (SWE).
    Ekström-Bergström, Anette
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Skövde, School of Health and Education, Skövde (SWE).
    Berg, Marie
    University of Gothenburg, Institute of Health and Care Sciences, Gothenburg (SWE).
    Buckley, Sarah
    The University of Queensland, School of Public Health, Brisbane (AUS).
    Pajalic, Zada
    Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences Oslo (NOR).
    Hadjigeorgiou, Eleni
    University of Technology, Faculty of Health Sciences, Cyprus, Limassol (CYP).
    Kotłowska, Alicja
    Medical University of Gdańsk, Faculty of Health Sciences with Subfaculty of Nursing and Institute of Maritime and Tropical Medicine, Gdańsk (POL).
    Lengler, Luise
    Midwifery Research and Education Unit, Hannover Medical School, Hannover (DEU).
    Kielbratowska, Bogumila
    Medical University of Gdańsk, Faculty of Medical Sciences, Gdańsk (POL).
    Leon-Larios, Fatima
    University of Seville, Faculty of Nursing, Physiotherapy and Podiatry, Seville (ESP).
    Magistretti, Claudia Meier
    Lucerne University of Applied Sciences and Arts, Department of Social Work Center for Health Promotion and Social Participation, Luzern (CHE).
    Downe, Soo
    University of Central Lancashire, Research in Childbirth and Health (ReaCH) group, Preston (GBR).
    Lindström, Bengt
    Norwegian University of Science and Technology, Trondheim (NOR).
    Dencker, Anna
    University of Gothenburg, Institute of Health and Care Sciences, Gothenburg (SWE).
    Maternal plasma levels of oxytocin during physiological childbirth: a systematic review with implications for uterine contractions and central actions of oxytocin2019In: BMC Pregnancy and Childbirth, E-ISSN 1471-2393, Vol. 19, no 1, article id 285Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies.

    METHODS: An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects.

    RESULTS: Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.

    CONCLUSIONS: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.

  • 13.
    Zwedberg, Sofia
    et al.
    Sophiahemmet University, Department for Health Promotion Science, Lindtstedtsvägen 8, Stockholm 114 86, Sweden; Karolinska University hospital, Solna. Children´s & Women´s Health Theme PA Pregnancy Care and Delivery, Karolinska Universitetsjukhuset Solna, Karolinska vägen, Solna 171 76, Sweden.
    Forslund Frykedal, Karin
    University West, Department of Social and Behavioural Studies, Division for Educational Science and Languages. Linköping University, Department of Behavioral Sciences and Learning,Linköping, Sweden.
    Rosander, Michael
    Linköping University, Department of Behavioral Sciences and Learning,Linköping, Sweden.
    Berlin, Anita
    The Division of Nursing Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Barimani, Mia
    The Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Academic Primary Care Centre, Region Stockholm, Solnavägen 1 E, 113 65, Stockholm, Sweden.
    Midwives' experiences as preceptors and the development of good preceptorships in obstetric units2020In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 87, article id 102718Article in journal (Refereed)
    Abstract [en]

    Objective: To study midwives' experience in their role as a preceptor and their perception on how to best support midwifery students in obstetrics units. Obstetric units are an important learning area for student midwives but knowledge on how to become a good midwife preceptor is limited. Design: This qualitative study explores midwife preceptors' experience of supervising midwifery students in three obstetric units in Sweden. Following ethical approval seventeen midwife preceptors were inter- viewed and data were analysed thematically. Findings: Thematic analysis of the interviews resulted in the identification of two themes and five sub- themes: (1) self-efficacy in the preceptor role which involves (a) being confident in the professional posi- tion and (b) having the support of management and colleagues and (2) supporting the student to attain self-confidence and independence which entails (a) helping the student to grow, (b) facilitating reflection in learning situations, and (c) "taking a step back". Key conclusion: Good preceptorship occurs when midwives achieve full self-efficacy, when they master the preceptor role, and when they have enhanced their abilities to help, the student reach confidence and independence. Implications for practice: Health care organisations needs to develop and support midwifery preceptor- ships

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