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Background: The pedagogical framework used consists of four types of engagement: Interactive, Constructive, Active, and Passive (ICAP). ICAP may boost students’ learning and participation in constructing knowledge.

Innovations: To illustrate the application of the ICAP framework in teaching students about sexual violence, we selected a relevant case study on sexual violence and demonstrated how a teaching session was guided by ICAP.

Implications: We present a workshop about rape, "The Grey Zone." The workshop consisted of students attending a lecture, reading an article, underlining significant sentences, and writing a summary of the article. The teacher scaffolded students’ understanding of gender theories based on patriarchy and concepts of agency. In a group session, students compared their summaries and created one descriptor of these summaries, which were further discussed in the classroom.

Conclusion: The ICAP taxonomy is innovative and focuses on interaction with students. The highest level of engagement—the interactive mode—can be reached when the students in a dynamic co-interaction group session expand on each other’s knowledge and knowledge production, increasing student motivation, learning, and empowerment.

Background: Swedish labour care is becoming increasingly medicalised, with rising rates of intrapartum interventions such as induction and augmentation of labour, epidural analgesia, and caesarean section. This study aimed to explore the paradox of the increasing medicalisation of childbirth despite the vast evidence of the benefits of low-intervention physiological birth.

Methods: Focused ethnography was used to study woman-midwife interactions during labour and birth and the everyday practices of midwives in two Swedish labour wards. After birth, the women and midwives were interviewed. Thematic analysis was used to analyse the data, and the study design and interpretation of results were informed by a social constructionist view of gender.

Results: The analysis resulted in three themes, mirroring the pillars on which labour and birth care rests– the labour care organisation, the midwives, and the women who give birth. The organisation was hierarchical and based on traditional masculine values such as rationality, efficiency, and productivity. The midwives tried to balance the needs of the birthing women and the organisational demands of throughput. As action and technological skills are more noticeable and linked to masculinity, and thus more valued than the invisible feminine-coded emotional care work of supporting a woman in labour, the midwives became task-oriented and more focused on ‘doing’ than on ‘being’. This led to more birth interventions, less support for the birthing women, and to occupational stress and stress of conscience for the midwives. Normative expressions of femininity were observed in the birthing women, such as placing the needs of others before their own and acts of compliance, which sometimes led to unconsented interventions.

Conclusions: We suggest that societal gender norms and gender-based hierarchies in combination with modern society becoming progressively risk-laden and technology-oriented, have contributed to an increasingly medicalised and interventionist labour and birth care organisation, where physiological birth is rare. Awareness of how gender norms inform labour and birth care practice may be one way to make visible and to recognise all aspects of midwifery care, as well as help flatten hospital hierarchies, improve working conditions for midwives, promote physiological birth, and limit unnecessary and unconsented interventions for the birthing women.

Virginity is a social construct with no medical or scientific value. Although some people believe an intact hymen is proof of virginity, this belief has not been confirmed using forensic evidence. Despite these facts, in many places in the world women's sexuality is controlled via virginity testing and hymen (re)constructions. These practices are on the rise globally, including in Sweden. Voicing the viewpoints of racialised women are rare. Using a gender perspective, this study analysed how young women living in Sweden who experience patriarchal chastity norms construct and understand virginity and what conditions, actions, and consequences follow when virginity is highly valued. A total of 14 young women originating from countries in the Middle East, East Africa, and Sweden were interviewed. This study uses constructive grounded theory to explore concepts such as oppression, inequality, and injustice. The category Unequal sexual conditions for women compared with men describes why virginity is understood as a troublesome condition for women. The category The making and faking of a virgin presents various ways women's sexuality is controlled in cultural and medical contexts. The consequences of the intrusions of medicine and the roles physicians play are included in the category Surgical interventions in gendered bodies. The emergent core category, Intersecting dimensions of honor cultures, (un)medical power, and gender injustice sustain the norms of virginity, explains how the epistemologies of ignorance are connected to virginity and the hymen. Unscientific discourses about virginity testing and the hymen (re)construction must be challenged if we intend to stop these harmful practices.

Background: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system.

Methods: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionalsand managers in the youth mental health system in Sweden. Interviews explored participants’ experience andunderstanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergentstudy design using reflexive thematic analysis.

Results: The analysis produced three themes. The first shows that collaboration is considered as essential andimportant, and that it serves diverse purposes and holds multiple meanings in relation to professionals’ roles andresponsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, andtarget levels, and the third captures the challenges and criticisms in collaborating across the youth mental healthlandscape, but also in growing possibilities for future development.

Conclusion: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system.

Purpose: The aim of this study was to explore how health care providers at youth clinics (YCs) in Sweden engage with, focus on, and navigate across the mental health youth space, while upholding the core bedrock principle of "youth-centeredness".

Methods: Qualitative interviews were conducted with 21 health care professionals working in three YCs located in three different regions of Sweden. Data were analysed using reflexive thematic analysis informed by the work of Braun and Clarke.

Results: The three themes were: 1) "youth mission-at the core of the YCs" work and challenged by a stronger involvement in mental ill health'; 2) "YCs" unique and complementary role in the youth mental health system: a holistic perspective, team work, and a focus on normalization', and 3) "Caught between a rock and a hard place: to treat at a care level that is not optimal for the young users" needs or to refer within an unreliable system'.

Conclusion: This study reflects the individuality and key features of YCs, their widening roles within the mental health sphere, and the challenges faced in maintaining and expanding the characteristic "youth-centred" approach while expanding their work with mental health

Background/objective: Adolescents and young adults are a diverse group with varied health needs. In Sweden, youth clinics are critical for improving their sexual, reproductive, mental, and general health. The aim of this qualitative study was to gain a deeper understanding of key conditions needed for youth friendliness, and to better understand youth-friendly health services from the perspective of adolescents and young adults in northern Sweden.

Methods: Information was collected through focus group discussions and interviews with 23 adolescents and young adults (aged 16 to 25) at youth clinics in each of the four northernmost regions of Sweden. Interviews were analysed inductively using Braun and Clarke's thematic analysis.

Results: Three themes and six sub-themes emerged. A safe, empowering and holistic space, outlines how youth-friendly physical spaces and staff contributed to a sense of safety in contrast to other healthcare facilities. The theme Youth clinics are accessible – but reaching out is challenging, refers to low thresholds for visiting youth clinics and perceived barriers to access. The third theme “You feel a bit vulnerable” – the importance of privacy, highlights privacy dimensions and young people's vulnerability when their privacy is compromised.

Conclusion: Adolescents and young adults perceived youth clinics as being youth-friendly. Key conditions for youth friendliness were safety, respect, a holistic and empowering approach, accessibility, and privacy. Youth-friendly opening hours and outreach to specifically target groups with access barriers are needed. Young people should be involved in the development of equitable youth-friendly health services.

Objectives: Ethical dilemmas at both the individual and structural level are part of the daily work of midwives and gender inequality and injustice can affect women’s sexual and reproductive health. Mainstream bioethical theory has been criticized for neglecting women’s issues. To ensure women’s experiences are addressed, a gender lens on ethics is crucial.

Aim: This study develops a theory model by exploring ethical dilemmas related to gender in the context of maternity care from the perspective of midwifery science and feminist ethics.

Methods: The research strategy followed a coherent stepwise approach: literature search, thematic analysis, elabora- tion of a gender ethics protocol, and the integration of various components into a preliminary gender ethics model for midwifery.

Findings:  A literature search was performed using Scopus and Web of Science to identify ethical dilemmas in mater- nity care linked to gender and power. The search of articles published between 1996 and 2019 returned 61 abstracts. These abstracts were screened and assigned one of the following themes: The Midwifery Profession, The Rights of the Woman, Fetal Rights Dominate, and Medicalization of Pregnancy and Childbirth. A tentative gender ethics frame was developed and tested on two articles on abortion, one from Denmark and one from Japan. The protocol facilitated the gender analysis of ethical dilemmas related to abortion, which were related to the imbalance of power relations  in health care. In the final step, we synthesized the dimensions of gender and power in a gender ethics model for midwifery.

Discussion: The gender ethics protocol developed revealed gendered dimensions of ethical dilemmas in midwifery. This gender analysis adds to the understanding of the “do no harm” principle by revealing assumptions and stereo- types that promote unequal power relations. The gender ethics model is an innovative approach that envisions and exposes powerimbalance at the micro, meso, and macro levels.

Conclusions: The protocol could improve gender competence among researchers, midwives/professionals, and midwifery students throughout the world.

Purpose: In this qualitative study we explored how young women living in Sweden with ethnic and cultural roots in the Middle East and East Africa comply with or resist so-called honour norms and how they perceive that these norms affect their living conditions.

Method: In depth interviews were performed with 14 young women. The majority were between 21 and 32 years of age with a mean age of 24. All interviews were transcribed verbatim and a grounded theory approach was used. To reflect the diversity in women’s experiences, the grounded theory approach was conducted from a feminist perspective to transform women’s personal narratives to a larger social context.

Results: We analysed the core category “Honorable women in becoming” as the central emerging phenomenon related to categories about structural and individual control of women, the women’s adjustment and resistance, and the continuum of severe consequences and violence that they experienced in their struggle for autonomy.

Conclusion: Simone de Beauvoir’s feminist theory about women as “the other” was an inspiration and gave us valuable input to highlight women’s experiences and situations from a perspective of gender, power, and oppression.

Background: In the current study, the approach of ‘utopia as method’ was combined with the concept ‘landscapes of care’ to explore collective imaginaries of caring landscapes in relation to young people living in rural northern Sweden, while focusing specifically on what such landscapes should ideally look like, and how various strategies could help to realise the visions.

Methods: The research was conducted using a modified concept mapping methodology comprising three phases of data collection and analysis. This facilitated the integration of tacit knowledge and utopian visions of young people, professionals and policymakers living and working in various parts of northern Sweden.

Results: The results indicated that caring landscapes should: ‘provide services responsive to young people’s wishes and needs’, ‘be organised around values of safety, equity and youth participation’, and ‘rework metro-centredness’ in order to care for, with and about rural youth.

Conclusions: The findings can be viewed as an imaginary reconstitution of communities in rural northern Sweden, but also as hypothetical building blocks to be used for developing caring landscapes and a ‘good countryside’ where young people have the possibility to live a good life in decent health.

BACKGROUND: Sweden, along with other countries, is facing rising intrapartum intervention rates.

AIM: To explore the medicalisation of childbirth through women's preferences for and use of pain relief, and to investigate whether the presence of a birth plan had any impact on use of pain relief, rate of intervention, and satisfaction with the birth experience.

METHODS: The study was cross-sectional, and included 129 women with birth plans and 110 without, all of whom gave birth in one hospital in Sweden between March and June 2016. Data from birth plans and medical records was analysed through descriptive statistics and logistic regression.

FINDINGS: Parity rather than birth plan was a greater determinant for use of pain relief, frequency of interventions, and level of satisfaction; primiparas used more pain relief, had more interventions, and were less satisfied with their birth experiences than multiparas. Epidural analgesia was associated with a two to threefold increase in interventions, but 79.5% of all women had some form of intervention during birth, regardless of having an epidural or not. Women were generally highly satisfied with their birth experiences, women without epidural analgesia and interventions slightly more so.

CONCLUSION: Contrary to their initial plans, especially primiparas used more pharmacological pain relief than intended, and nearly all (94.6%) had some form of intervention during labour and birth. More interventions were associated with lower levels of satisfaction. The high rate of intervention in a healthy population of birthing women is disquieting and requires further attention.