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Background Fear of birth is common and complex, caused by a variety of reasons. The aim was to investigate the prevalence of pre-established reasons in relation to fear, and to identify profiles of women based on their reported reasons behind fear of birth. Methods A cross-sectional Swedish study of women with self-reported fear of birth who completed an online survey. Descriptive statistics, chi-square test, crude and adjusted odds ratios with 95% confidence intervals were used in the analysis of pre-established reasons in relation to self-reported severe fear. A Kappa-means cluster analysis was performed in order to group reasons, that were further investigated in relation to women’s background variables. Results A total of 1419 women completed the survey. The strongest reason behind fear of birth was to be forced to give birth vaginally. Four clusters were identified and labeled: minor complexity (reference group), relative minor complexity, relative major complexity, and major complexity. Cesarean section preference, previous mental health problems, being younger, primiparity, and exposure to domestic violence were factors related to cluster grouping. Conclusions Women with fear of birth have various reasons and diverse complexities behind their fear. Health care providers need to investigate these reasons and support pregnant women with childbirth fear, based on their needs.

Background: Previously developed instruments measuring the quality of postnatal care, based on women’s experiences and views, are mainly country-specific which makes it important to have studies for specific populations. The aim of this study was to explore validity and reliability evidence of a previously developed postnatal questionnaire for women living in Sweden. Method: A cross-sectional study based on self-report questionnaire. The questionnaire included the Early Postnatal Questionnaire (EPQ), and was administered to 1061 women who gave birth in two regional hospitals in Swedish during 2017. Validity evidence of the EPQ was undertaken using principal component analysis. Regarding reliability, Cronbach’s alpha was used. Results: The questionnaire was returned by 483 postnatal women. The analysis resulted in three components: Information, Postnatal Environment and Caring Relationship. The Cronbach alpha values of the components ranged from 0.762 to 0.879. Foreign-born women scored higher (more positively) in all three components, compared to women born in Sweden. Conclusions: The results of this study suggest that the instrument EPQ is a psychometrically useful tool, suitable for both research and clinical settings. The three-component structure provides researchers with the opportunity to conduct a more detailed exploration of various aspects of postnatal care to develop postnatal care. Further studies focusing on foreign-born women’s experiences of postnatal care are warranted.

INTRODUCTION Although high-quality postnatal care provides information and recognizes women's personal and cultural contexts, foreign-born women are more exposed to poor health and adverse birth outcomes. The aim of this study was to compare the length and model of postnatal care, along with the content of care, between foreign-born and native-born women living in Sweden. Another aim was to explore factors associated with being very satisfied with various aspects of postnatal care. METHODS This was a descriptive cross-sectional study of 483 postnatal women in two Swedish hospitals in 2017. Women completed a questionnaire comprising background data, pregnancy and birth related variables and the Early Postnatal Questionnaire. Data were analyzed using descriptive statistics, analysis of variance and multivariate logistic regression analyses. RESULTS Foreign-born women were more likely to have a shorter (<24 h) or longer (>48 h) length of postnatal stay than women born in Sweden. No differences in birth outcomes emerged between the two groups. Foreign-born women rated the medical (OR=1.77; 95% CI: 1.04-3.03) and emotional (OR=2.0; 95% CI: 1.17-3.40) aspects of postnatal care as being more important than Swedish-born women did. The most important aspect of overall satisfaction was the content of care, and the subscale Caring Relationship (AOR=8.15; 95% CI: 4.87-14.62) outscored all other aspects. CONCLUSIONS Important factors of satisfactory experiences with postnatal care in a Swedish context were receiving information, professional care, and a hospital environment that facilitates recovery after labor and birth. Culturally sensitive and individualized postnatal care with continuity should therefore be prioritized.

IntroductionApproximately 2 million babies are stillborn annually worldwide, most in low- and middle-income countries. Present review studies of the parental and healthcare providers' experiences of stillbirth often include a variety of settings, which may skew the findings as the available resources can vary considerably. In high-income countries, the prevalence of stillbirth is low, and support programs are often initiated immediately when a baby with no signs of life is detected. There is limited knowledge about what matters to parents, siblings, and healthcare providers when a baby is stillborn in high-income countries. ObjectivesThis systematic review and interpretive meta-synthesis aim to identify important aspects of care and support for parents, siblings, and healthcare professionals in high-income countries from the diagnosis of stillbirth throughout the birth and postpartum period. MethodsA systematic review and qualitative meta-synthesis were conducted to gain a deeper and broader understanding of the available knowledge about treatment and support when stillbirth occurred. Relevant papers were identified by systematically searching international electronic databases and citation tracking. The quality of the included studies was assessed, and the data was interpreted and synthesised using Gadamer's hermeneutics. The review protocol, including qualitative and quantitative study approaches, was registered on PROSPERO (CRD42022306655). ResultsSixteen studies were identified and included in the qualitative meta-synthesis. Experiences of care and support were interpreted and identified as four fusions. First, Personification is of central importance and stresses the need to acknowledge the baby as a unique person. The parents became parents even though their baby was born dead: The staff should also be recognised as the individuals they are with their personal histories. Second, the personification is reinforced by a respectful attitude where the parents are c

BACKGROUND: Midwifery continuity models of care are highly recommended yet rare in Sweden, although approximately 50% of pregnant women request them. Before introducing and scaling up continuity models in Sweden, midwives' attitudes about working in continuity models must be investigated. OBJECTIVE: to investigate Swedish midwives' interests in working in midwifery continuity models of care and factors influencing the midwifery workforce's readiness for such models. METHODS: A cross-sectional online survey was utilised and information collected from a national sample of midwives recruited from two unions regarding background and work-related variables. Crude and adjusted odds ratios and logistic regression analysis were used in the analysis. RESULTS: A total of 2084 midwives responded and 56.1% reported an interest. The logistic regression model showed that respondents' ages 24-35 years (OR 1.73) or 35-45 years (OR 1.46); years of work experience 0-3 years (OR 5.81) and 3-10 years (OR 2.04); rotating between wards or between tasks (OR 2.02) and working temporary (OR 1.99) were related to interest in continuity models. In addition, working daytime only (OR 1.59) or on a two-shift schedule (OR 1.93) was associated with such interest. CONCLUSION: A sufficient number of midwives in Sweden appear to be interested in working in continuity models of midwifery care to align with women's interest in having a known midwife throughout pregnancy, birth and postpartum period. Developing strategies and continuity models that will address the preferences of women in various areas of Sweden is important for offering evidence-based maternity services.