Midwives' lived experience of caring during childbirth--a phenomenological study.

OBJECTIVE: The aim of this study was to obtain a deeper understanding of midwives' lived experience of caring during childbirth in a Swedish context. METHODS: Ten midwives were recruited from one university hospital with two separate delivery units in western Sweden. Data were collected by both written narratives and interviews. With an inductive approach using a descriptive phenomenological method, the answers to the question: "Can you describe a situation in which you felt that your caring was of importance for the woman and her partner?" were analysed. RESULTS: A general structure of the phenomenon of caring in midwifery during childbirth, including five key constituents: sharing the responsibility, being intentionally and authentically present, creating an atmosphere of calm serenity in a mutual relationship, possessing the embodied knowledge, and balancing on the borders in transition to parenthood. CONCLUSIONS: This study emphasises how the midwives shared the responsibility and their possessed embodied knowledge of childbirth and how new unique knowledge was constructed together with the woman, child and her partner. The study has the potential to increase knowledge and understanding of midwives' lived experience of caring during childbirth and therefore has implications for practice, education, and research.

National survey of how acupuncture education is organised for Swedish midwives.

OBJECTIVE: in Sweden, acupuncture education is required before midwives can use the method in clinical practice. Courses in acupuncture are usually organised by private individuals or companies, and each health facility decides on the adequacy of the educational package. Therefore, there is no overall standard or quality control for free-standing courses of acupuncture education for midwives. The aim of this study was to survey the education given to Swedish midwives in the use of acupuncture treatment in the obstetric area. DESIGN: a postal survey using a structured questionnaire. SETTING: organisers of acupuncture education. PARTICIPANTS: 18 acupuncture instructors. MEASUREMENTS AND FINDINGS: acupuncture courses were usually organised outside universities and colleges. The courses were similar in terms of extent and content, and were mainly based on a Western medical approach. The recommended indications were extensive despite a lack of scientific evidence. The most common instructor profile was a midwife without any academic degree. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: courses differed considerably in the extent to which they were research based. Continuing professional education for midwives should be given at the same academic level, at least, as basic midwifery education.

Empowerment in the midwifery context--a concept analysis.

OBJECTIVE: The concept empowerment is difficult to understand, define and translate into different contexts. Therefore, the purpose of this paper was to analyze the empowerment concept in the midwifery context, focused on the childbearing period, aimed at clarifying its meaning in order to enable comprehension and use in clinical practice, education and research. DESIGN: Semi structured interviews and written text. SETTING: Prenatal clinics, delivery and maternity wards in western Sweden. PARTICIPANTS: Nine midwives and 12 couples. MEASUREMENTS AND FINDINGS: A concept analysis was undertaken according to the hybrid model which consists of the theoretical, fieldwork and analytical phases. After a literature review, the concept was empirically elucidated in the fieldwork phase. The final step was to describe criteria and attributes, illustrative cases, antecedents and consequences of the concept. The following tentative criteria and attributes of empowerment in the midwifery context are described: developing a trustful relationship; starting an awareness process, making it possible to reflect on the changing situation; acting based on the parents' situation on their own terms, getting them involved and able to make informed choices; confirming the personal significance of becoming parents. Finally, empowerment in the midwifery context was redefined. KEY CONCLUSION: Midwives use empowerment in education and research as well as strategies on both the micro and macro levels in practice. IMPLICATIONS FOR PRACTICE: Empirical findings from the concept analysis confirm the concept's relevance in the midwifery context.

A national survey of how acupuncture is currently used in midwifery care at Swedish maternity units.

OBJECTIVE: it is not known how acupuncture is used in midwifery care in Sweden and what kind of requirements health-care providers have for midwives and acupuncture training programmes. The aims of this study were to survey indications for the use of acupuncture in midwifery care in Sweden, and to examine the criteria and requirements used for purchase of acupuncture education programmes. DESIGN: a postal survey using a structured questionnaire. SETTING: 45 maternity units in Sweden. PARTICIPANTS: the midwife-in-charge of the units. MEASUREMENTS AND FINDINGS: the most common indications for the use of acupuncture were relaxation, pain relief, retained placenta, after pains, milk stasis during lactation, hyperemesis and pelvic instability. Specific requirement for acupuncture education were provision of a short course during weekdays including a follow-up course. KEY CONCLUSION: acupuncture is widely used for many indications in Swedish maternity units despite weak or no evidence to support effectiveness in midwifery care. Requirements for acupuncture education did not seem to be in accordance with what might be expected for this type of qualified intervention. IMPLICATIONS FOR PRACTICE: the use of acupuncture in midwifery care should not persist until systematic evaluation of the effect of this method is carried through.