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Objective: To describe migrant women's experiences of bilingual community-based doulas (CBD) contribution to care in relation to labor and birth., Methods: Mixed methods study combining quantitative data from 82 women who received CBD-support within a randomized controlled trial and qualitative data from semi-structured interviews with a sub-sample of 12 women from the same study arm. Descriptive analyses were used for quantitative data and content analysis for the manifest and latent content of the qualitative data. Quantitative findings were categorized according to qualitative findings., Results: The women expressed how CBDs played an essential role in the response to their basic emotional, informational, and physical support needs, when no other female family member was available. Three main categories emerged from the analysis of interviews: The doulas help women feel safe and calm - providing support before, during and after childbirth; The doulas' support role fills the void left by a deeply missed family, mother or sister; and The doulas assist women in achieving autonomy through communication support and advocacy. More than half of women reported feeling involved during labor and birth (56.8%), most valued CBD positively (such as being competent, calm, secure, considerate, respectful, encouraging, supportive) (40.8%-80.3%), that CBD had interpreted (75.6%), facilitated communication with the midwife (60,3%), comforted the woman (57.7%) and reduced anxiety (48,7%). Few reported negative CBD-characteristics (1.3-9.2%). Nevertheless, 61.7% of women felt frightened sometime during labor and birth, which made it even more important to them that the doula was there. Few women (21.8%) reported that the CBD had supported her partner but expressed so in the interviews., Conclusion: Through an essential contribution in responding to migrant women's basic emotional, informational, and physical needs, bilingual community-based doulas have the potential to improve migrant women's experience of care during labour and birth. However, more focus on the quality of CBD-support to partners seem necessary., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: The trend to delay motherhood to the age of 30 and beyond is established in most high-income countries but relatively little is known about potential effects on maternal emotional well-being. This study investigates satisfaction with life during pregnancy and the first three years of motherhood in women expecting their first baby at an advanced and very advanced age., Methods: The study was based on the National Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Data on 18 565 nulliparous women recruited in the second trimester 1999-2008 were used. Four questionnaires were completed: at around gestational weeks 17 and 30, and at six months and three years after the birth. Medical data were retrieved from the national Medical Birth Register. Advanced age was defined as 32-37 years, very advanced age as ≥38 years and the reference group as 25-31 years. The distribution of satisfaction with life from age 25 to ≥40 years was investigated, and the mean satisfaction with life at the four time points was estimated. Logistic regression analyses based on generalised estimation equations were used to investigate associations between advanced and very advanced age and satisfaction with life when controlling for socio-demographic factors., Results: Satisfaction with life decreased from around age 28 to age 40 and beyond, when measured in gestational weeks 17 and 30, and at six months and three years after the birth. When comparing women of advanced and very advanced age with the reference group, satisfaction with life was slightly reduced in the two older age groups and most of all in women of very advanced age. Women of very advanced age had the lowest scores at all time points and this was most pronounced at three years after the birth., Conclusion: First-time mothers of advanced and very advanced age reported a slightly lower degree of satisfaction with life compared with the reference group of younger women, and the age-related effect was greatest when the child was three years of age.

Objective: to investigate first-time fathers' expectations and experiences of childbirth and satisfaction with care in relation to paternal age., Design: data from a randomised controlled trial of antenatal education were used for secondary analysis. Data were collected by questionnaires in mid-pregnancy and at three months after the birth. Comparisons by χ(2)-tests and Student's t-tests were made between men in three age groups: young men aged ≤27 years (n=188), men of average age 28-33 years (n=389) and men of advanced age ≥34 years (n=200)., Setting: the expectant fathers were recruited from 15 antenatal clinics spread over Sweden., Participants: 777 first-time fathers., Findings: antenatal expectations and postnatal memory of the childbirth experience varied by paternal age. In mid-pregnancy, mixed or negative feelings about the upcoming birth were more prevalent in men of advanced age (29%) compared with men of average (26%) and young (18%) age (p<0.01), and they feared the event more than the youngest (mean on the Wijma Delivery Expectancy Questionnaire: advanced age 43.3; average age 42.9; young 38.7; p<0.01). The older men also assessed their partner's labour and birth as more difficult (advanced age 43%; average age 41%; young 32%; p=0.05) and had a less positive overall birth experience (advanced age 30%; average age 36%; young 43%; p<0.05). However, older fathers were more satisfied with care given during the intrapartum period: 52% were overall satisfied compared with 46% of the men of average age and 39% of young age (p=0.03)., Key Conclusions: men of advanced age had more fearful and negative expectations during their partner's pregnancies and postnatally assessed the births as less positive and more difficult than younger men did. Despite this, older men were more satisfied with intrapartum care., Implications for Practice: knowledge about age-related differences in the expectations and experiences of first-time fathers may help midwives and doctors give more individualised information and support, with special attention to older men's expectations and experiences of the birth as such, and to younger men's perception of care., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Delaying the first childbirth to an advanced age has increased significantly during the last decades, but little is known about older first time mothers' experience of childbirth. This study investigates the associations between advanced maternal age in primiparous women and the postnatal assessment of childbirth., Methods: The study was based on the National Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Data on 30 065 nulliparous women recruited in the second trimester 1999-2008 were used. Three questionnaires were completed: around gestational week 17 and 30, and at 6 months postpartum. Medical data were retrieved from the national Medical Birth Register. Advanced age was defined as ≥32 years and the reference group as 25-31 years. Descriptive and multiple logistic regression analyses were conducted., Results: Primiparous women aged 32 years and above expressed more worry about the upcoming birth than the younger women (adjusted OR 1.13; 95% CI 1.06-1.21), and 6 months after the birth they had a slightly higher risk of having experienced childbirth as 'worse than expected' (adjusted OR 1.09; 95% CI 1.02-1.16). The difference in birth experience was explained by mode of delivery. Comparisons within subgroups defined by the same mode of delivery showed that the risk of a more negative birth experience in the older women only applied to those with a spontaneous vaginal birth (adjusted OR 1.12; 95% CI 1.02-1.22). In women delivered by cesarean section, the older more often than younger women rated childbirth as 'better than expected' (elective cesarean delivery: adjusted OR 1.36; 95% CI 1.01-1.85, emergency cesarean delivery: adjusted OR 1.38; 95% CI 1.03-1.84)., Conclusion: Postponing childbirth to ≥32 years of age only marginally affected the experience of childbirth. Older women seemed to manage better than younger with having an operative delivery.

Background: Self-rated health (SRH) is a valid measure that predicts mortality, morbidity, and the use of health services. We wanted to explore SRH over the time period of pregnancy and the first year of parenthood, dividing the measurement into physical and emotional SRH and also to include the fathers., Aim: To investigate the prevalence of poor physical and emotional self-rated health in women and men during pregnancy and after childbirth and to identify associated risk factors., Methods: A longitudinal study of 1212 pregnant women and 1105 partners recruited in gestational week 18 and follow-ups in gestational week 33, 2 months and 1 year after childbirth. Data was collected by questionnaires., Results: In women, the prevalence of poor physical SRH increased from 20% to 37% between mid- and late pregnancy, and from 19% and 34% between 2 months and 1 year after the birth. Men had a more stable level of physical SRH, 17-19% during pregnancy and 2 months postpartum, but reached 31% 1 year after birth. A similar pattern was found for poor emotional SRH, where women's and men's poor emotional health reached 24% and 22%, respectively, at 1 year. Factors associated with poor emotional or physical SRH were: physical and emotional changes, fear of childbirth, parenthood stress, lack of partner support, bodily pain, low level of education, financial worries, tobacco use, and an emergency caesarean section., Conclusions: Women's physical and emotional self-rated health is affected negatively by pregnancy and the first year of motherhood, but positively by childbirth. New fathers' health is stable throughout the pregnancy and the postpartum period, but is negatively affected by the first year of parenthood. Problems in mothers'and fathers' self-rated health may be longer term than many health professionals realize, generally as well as in relation to a cesarean section., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Objective: The aims of the present study were to describe the prevalence of a number of physical symptoms, as described by women themselves, two months and one year after childbirth in a national Swedish sample and to investigate the association between specific symptoms and women's self-rated health., Design: Cohort study., Setting: Swedish antenatal clinics., Population: A total of 2413 women recruited from 593 antenatal clinics in Sweden during three one-week periods evenly spread over one year (1999-2000), representing 54% of women eligible for the study and 76% of those who consented to participate. The representativity of the sample was assessed by comparison with the total Swedish birth cohort of 1999., Methods: Data were collected by means of questionnaires in early pregnancy, two months and one year after the birth and from the Swedish Medical Birth Register., Main Outcome Measures: Self-reported symptoms and self-rated health., Results: Tiredness, headache, neck, shoulder and low back pain were common problems at two months as well as one year after childbirth. At two months, pain from caesarean section, dyspareunia and haemorrhoids were frequent problems, whereas stress incontinence was often reported at one year. Ninety-one percent of the women said self-rated health was 'very good' or 'good' at two months after birth, and 86% at one year. Low self-rated health was associated with symptoms that affected general physical functioning and wellbeing, such as tiredness, headache, musculoskeletal problems, mastitis, perineal pain, dysuria, stomachache and nausea. Complaints related to more specific situations, such as dyspareunia, constipation and stress incontinence were not associated with self-rated health., Conclusion: Despite the fact that physical symptoms were common two months and one year after the birth, the vast majority of women rated their health as 'very good' or 'good'.