Midwives' experience of encountering women with posttraumatic stress symptoms after childbirth.

OBJECTIVE: To describe midwives' experience of encountering women with posttraumatic stress symptoms after childbirth. STUDY DESIGN: Semi-structured interviews with eight midwives with experiences of encountering women with posttraumatic stress symptoms after childbirth. Data were analyzed using thematic content analysis. RESULT: The midwives encountered women with severe experiences after a childbirth, which had affected their lives. The midwives thought that they had to reflect on their own attitude and use their gentleness as they responded to the women's stories. By listening to and enabling the women to express their feelings and tell their stories, the midwives thought that they could confirm the women's experience. The midwives thought that they could support women who had lost confidence to give birth but also thought that cesarean section did not solve the women's problems. CONCLUSION: Training of midwives is necessary to increase awareness of the cause of women's posttraumatic stress symptoms. It is urgent to optimize the implementation of new research into practical reality to raise the quality of care of women with fear of childbirth. Childbirth is an important experience that can influence a woman's well-being and her connection to the child. Posttraumatic stress symptoms should be identified in an early stage/pregnancy to allow early treatment on the right level of care.

Parents' experiences of using videoconferencing as a support in early discharge after childbirth.

OBJECTIVE: to describe parents' experiences of using videoconferencing (VC) when discharged early from a maternity unit. DESIGN: a combination of quantitative and qualitative methods was used to describe parents' experiences. Data were collected via questionnaires and interviews. SETTING: a pilot study involving a maternity department and new parents in their homes was conducted. Through VC, parents discharged early were able to maintain follow-up contact with the midwife via sound and picture at the department. PARTICIPANTS: nine couples/new parents participated. FINDINGS: the analysis revealed four categories of responses: 'feeling confident with the technology'; 'feeling confident of having control of their privacy'; 'feeling confident being face-to-face on the VC'; and 'feeling confident when worries and concerns were met and answers were received'. KEY CONCLUSIONS: using VC as a support in cases of early discharge after childbirth can facilitate a meeting that makes it possible for new parents to be guided by the midwife in their transition into parenthood. IMPLICATIONS FOR PRACTICE: the findings of this study indicate that VC equipment may be helpful for parents discharged from hospital early after childbirth. The findings can also be used as a foundation for further development of the application of VC within maternal health care and in health care in rural areas.

Midwives' experience of using videoconferencing to support parents who were discharged early after childbirth.

Videoconferencing was used to support parents who were discharged early after childbirth. In a one-year pilot study, 23 videoconferences took place between midwives and parents at home. To ensure good picture quality, a high-speed, 10 Mbit/s broadband connection was used. We used a combination of quantitative and qualitative research methods to describe the participants' experience. Seven midwives with experience of supporting nine couples/new parents completed a questionnaire. The 20 responses (87%) showed that the main reason for contact was routine and the most frequent advice concerned breastfeeding. The quality of sound and picture were judged to be good and very good, respectively. The experience of communicating with the parents via videoconferencing was also investigated through semi-structured interviews. Analysis of the interviews revealed that videoconferencing was: easy to handle and useful for making assessments; a valuable and functional complement to usual practice; almost like a real-life encounter. The results suggest that videoconferencing may be a useful tool in postpartum care.

Midwives' experience of organisational and professional change.

OBJECTIVE: to describe midwives' experiences of changes in their caring role and professional function in postpartum wards in the northern part of Sweden. In this part of the country, three out of eight maternity departments have been closed over the last 5 years. During the same period, hospital stays have reduced in length, and an early discharge model has been introduced. DESIGN: focus-group discussions. SETTING: four focus groups at two hospitals in northern Sweden. PARTICIPANTS: 21 midwives experienced in midwifery practice in maternity wards. FINDINGS: the analysis revealed four categories of comments: 'to have limited time when caring for the mother and the baby'; 'no longer being valued as the expert'; 'a wish to have responsibility for childbirth in its entirety'; 'to see future possibilities in the development of the profession'. The theme identified is 'being ahead in ideas about caring but still partly caught up in the past'. KEY CONCLUSIONS AND IMPLICATIONS: the identified theme of being ahead in ideas about caring but still partly caught up in the past can be understood as representing a transition. The midwives experienced loss and grief over their former midwifery practice, but had ideas and visions for developing and expanding their future professional role. A healthy transition requires support, participation and skilled management.