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Objective: Despite strong evidence of the benefits, Sweden has limited access to midwifery continuity of care (MCoC), particularly in rural areas. There is a knowledge gap regarding how MCoC would function in a rural Swedish context. Therefore, this study aimed to explore midwives' personal and professional views on a MCoC model and its implementation within a rural context in northern Sweden.

Methods: A qualitative interview study using reflexive thematic analysis. Semi-structured interviews were conducted with fourteen midwives working in maternity care.

Results: The findings revealed a notable duality to MCoC, consisting of two major themes. In the first theme, 'Internal conditions of midwifery', midwives reported that working in a MCoC model would offer fulfillment but also present significant challenges, which they did not feel prepared to meet. Establishing a relationship of mutual trust with pregnant women emerged as a major positive aspect. The second theme, 'The impact of external forces', highlighted significant challenges, including organisational issues, staffing shortages, and concerns regarding work-life balance. Interprofessional collaboration and rural adaptation were considered key if the implementation of the model is to go ahead.

Conclusions: For MCoC to succeed in rural Sweden, it is essential to have a supportive organisation that recognises the benefits of the model, and provides midwives with working conditions that meet their professional and personal needs. Involving midwives in the model's design, fostering interprofessional collaboration, and tailoring the model to rural settings are equally important. Addressing organisational challenges is crucial for establishing a functional and sustainable model.

Objective: Hyperemesis Gravidarum affects women's health on a physical, psychological, and socioeconomic level, and they express a need for acknowledgement from family and healthcare providers. Historically associated with hysteria, Hyperemesis Gravidarum may still be stigmatised due to lingering perceptions of it as a psychological issue. To enhance understanding of the disease's impact on women's health, this study aimed to explore women's experiences and self-concepts of Hyperemesis Gravidarum.

Methods: Participants were recruited from a social media platform with the following criteria: i) women in Sweden with Hyperemesis Gravidarum who debuted before week 22 of pregnancy, ii) who gave birth within the last four years, and iii) who received intravenous fluid therapy during their illness. Data were gathered through 15 digital, individual, semi-structured, in-depth interviews and were analysed with Reflexive Thematic Analysis.

Results: The mean age of participants was 32. The majority experienced HG within 12–36 months before the interview and were living with a partner. The overarching theme, "Deprived of my Autonomy", depicts the woman's transition from being responsible, reliable and hard-working to becoming a woman who perceived herself as disempowered, unprioritised and dependent.

Conclusion: The women experienced a new perception of themselves as unable to meet their own and others' expectations in managing pregnancy, family, and work and as individuals disbelieved by the healthcare system. Healthcare professionals' neglectful attitudes may contribute to self-stigma with isolation, and low social support as a result. Healthcare professionals must recognise the impact of dismissive behaviour and implement validating and empowering support structures.

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.

Aim: This study aimed to explore midwifery students’ thoughts on midwifery continuity models of care and the benefits for women and midwives.

Background: The World Health Organization recommends continuity of care for pregnant women because it leads to favorable outcomes such as a higher likelihood of having a spontaneous vaginal birth and a positive birth experience. However, midwifery continuity models are rare in Sweden and few midwifery students are exposed to such models during their clinical placements. Therefore, students’ attitudes towards these models are largely unknown.

Design: A qualitative Swedish national study.

Methods: Digital interviews involving 16 midwifery students were carried out in 2023. Data were analyzed using reflexive thematic content analysis according to Braun and Clark.

Results: The study revealed the main theme: “Midwifery continuity models of care are a perfect complement for women, families and midwives in Swedish maternity care”. This main theme was supported by the following themes: Increased knowledge of midwifery continuity of care would strengthen interest; Working in a midwifery continuity model of care should be based on midwives’ preferences; and Convincing evidence of midwifery continuity of care for women.

Conclusions: The study highlighted the importance of offering women and midwives the opportunity to participate in a midwifery continuity care model and providing support for midwifery students to feel prepared for this approach. Continuity of care was seen as the future model of care. Midwifery students expressed a desire for better conditions for women in maternity care and a sustainable way of working for midwives.

Background: Most people with congenital heart disease (CHD) now reach adulthood, and many wish to become parents. However, many in this group struggle with health challenges and are at risk for complications related to their heart disease early in life. What parenthood means for adults with CHD is still an unexplored area. Objectives: Describe experiences of being a parent with CHD.

Methods: Ten semi-structured interviews with six women and four men were conducted using an inductive approach. Inclusion criteria: (i) visiting a CHD clinic at least once after age 18 and (ii) having biological children. Data were analysed with qualitative content analysis, from a manifest level to deeper latent interpretation.

Results: The results comprised three themes. The complex emotional landscape of parenthood covered how heart disease became a tangible concern after becoming a parent, making life feel fragile. Strategies for navigating life as a parent illustrated how participants dealt with parenthood by adapting to their limitations and accepting their present and future. Sharing eases life’s challenges described the participants’ need to be met as whole persons facing both physical and emotional challenges.

Conclusion: The heart disease became visible in the daily lives of parents with CHD, both as a tangible reminder and in a physical sense. Healthcare professionals should address physical and emotional challenges, as parenthood can heighten awareness of personal vulnerability. The study, underlines the need for inquire about support and counselling needs, as parenthood for adults with CHD can add an extra dimension to life’s challenges. 

Introduction: Pregnant women were one of the most exposed and vulnerable groups during the COVID-19 pandemic. While much is known about the general effects of the pandemic on pregnant women’s well-being, little research has focused on the experiences of women who gave birth while infected with SARS-CoV-2. The aim of this study was to gain a deeper understanding of the lived experiences of women who gave birth while being ill with COVID-19.

Materials and methods: This is a qualitative study utilising a phenomenological reflective lifeworld approach to explore the lived experiences of Swedish women (n = 10) who gave birth while ill with COVID-19 between April 2020 and May 2021.

Results: The essence of the women’s experiences was described as ‘Reclaiming motherhood through shame, distance, and gratitude,’ supported by four constituents: “feeling intense shame and guilt for getting infected”,” striving to overcome distance in the birth setting”, “experiencing gratitude for receiving compassionate care” and “trying to comprehend motherhood and fighting to be reunited”.

Conclusion: A nuanced understanding of the experience at the intersection between childbirth, illness and the societal context is imperative for healthcare professionals and society to provide optimal care for one of the most vulnerable groups during pandemics, pregnant women and their newborns.

Background: In Sweden, women often meet with different midwives during antenatal, intrapartum, and postpartum care, due to the structure of maternity care, with few alternatives which provide continuity. This study aims to explore women’s interest in having a midwife they know present during labor and birth and to identify the characteristics of women who prefer this option.

Methods: A comparative study was conducted involving two Swedish nationwide cohorts of Swedish-speaking pregnant women. The first cohort included 3,061 women, and the second 1,812 women. Descriptive statistics and odds ratios were calculated.

Results: In total, 4,873 pregnant women completed the survey. Most participants were aged 25–35 years, living with a partner, and born in Sweden. Interest in having a midwife they know increased from 53% in 1999 to 76% in 2024. Key factors associated with this preference included primiparity (OR 3.80; 95% CI 3.27–4.40), being pregnant in 2024 (OR 3.21; 2.70–3.86), being born outside Sweden (OR 2.73; 2.11–3.54), and fear of birth (OR 2.03; 1.56–2.63).

Conclusions: Interest in having a known midwife during childbirth has grown significantly in Sweden, highlighting the need for policy changes that promote awareness and expand this option for women.

Background: The number of pregnant women with congenital heart disease (CHD) is rising, and the disease poses increased risks of cardiovascular and obstetric complications during pregnancy, potentially impacting breastfeeding success. This study aimed to investigate breastfeeding in primiparous women with CHD compared to primiparous women without CHD, and to examine potential hindering factors for breastfeeding in women with CHD.

Methods: The data were gathered between 2014 and 2019 and obtained by merging the Swedish Congenital Heart Disease Register (SWEDCON) with the Swedish Pregnancy Register. Primiparous women ≥ 18 years of age with CHD (n = 578) were matched by age and municipality to 3049 women without CHD, giving birth after 22 gestational weeks. Multivariable logistic regression analysis was used to identify factors associated with non-breastfeeding in women with CHD.

Results: Fewer women with CHD breastfed than women without CHD two days (94% vs. 97%, p = 0.001) and four weeks after birth (84% vs. 89%, p = 0.006). When all women were analysed, having CHD was associated with non-breastfeeding at both two days and four weeks after birth. For women with CHD, body mass index (BMI) ≥ 30 (OR 3.1; 95% CI 1.4, 7.3), preterm birth (OR 6.4; 95% CI 2.1, 19.0), self-reported history of psychiatric illness (OR 2.4; 95% CI 1.2, 5.1), small for gestational age (OR 4.2; 95% CI 1.4, 12.2), and New York Heart Association Stages of Heart Failure class II − III (OR 6.0; 95% CI 1.4, 26.7) were associated with non-breastfeeding two days after birth. Four weeks after birth, factors associated with non-breastfeeding were BMI ≥ 30 (OR 4.3; 95% CI 2.1, 9.0), self-reported history of psychiatric illness (OR 2.2; 95% CI 1.2, 4.2), and preterm birth (OR 8.9; 95% CI 2.8, 27.9).

Conclusions: The study shows that most women with CHD breastfeed, however, at a slightly lower proportion compared to women without CHD. In addition, factors related to the heart disease were not associated with non-breastfeeding four weeks after birth. Since preterm birth, BMI ≥ 30, and psychiatric illness are associated with non-breastfeeding, healthcare professionals should provide greater support to women with CHD having these conditions.

Objective: A supportive environment for women with Hyperemesis Gravidarum is crucial but not always provided. There is a lack of research regarding Hyperemesis Gravidarum, its impact on the family, and the partner's perception of supporting their spouse. Thus, this study aims to explore partners’ experiences of Hyperemesis Gravidarum during their spousés pregnancy.

Methods: Data were gathered through 13 individual, semi-structured, in-depth, digital interviews with partners of women who had experienced Hyperemesis Gravidarum and analysed with Qualitative Content Analysis. The partners were recruited through advertisement on a social media platform and were exclusively males, representing 8 of 21 Swedish regions. The mean age was 34, and they had, on average, 1 previous child. The mean time from the experience to the interview was 12 months.

Findings: The main theme, “Navigating in a maze without a map”, explains partners’ situation as stressful and demanding when their spouse suffers from Hyperemesis Gravidarum, with insufficient support and guidance from healthcare providers. The analysis resulted in three themes: “Standing alone with a demanding responsibility”, “Being in a lottery when facing healthcare”, and “Climbing the mountain together.” The themes display challenges within everyday life and healthcare, as well as strained relations within the family.

Conclusion: Partners experience a need to support their spouse in every aspect of daily life and advocate for adequate healthcare. Healthcare professionals must support and acknowledge the partners' struggles during the demanding situation with Hyperemesis Gravidarum.

Background: Poor maternal self-rated health in healthy women is associated with adverse neonatal outcomes, but knowledge about self-rated health in pregnant women with congenital heart disease (CHD) is sparse. This study, therefore, investigated self-rated health before, during, and after pregnancy in women with CHD and factors associated with poor self-rated health.

Methods: The Swedish national registers for CHD and pregnancy were merged and searched for primiparous women with data on self-rated health; 600 primiparous women with CHD and 3062 women in matched controls. Analysis was performed using descriptive statistics, chi-square test and logistic regression.

Results: Women with CHD equally often rated their health as poor as the controls before (15.5% vs. 15.8%, p = .88), during (29.8% vs. 26.8% p = .13), and after pregnancy (18.8% vs. 17.6% p = .46). None of the factors related to heart disease were associated with poor self-rated health. Instead, factors associated with poor self-rated health during pregnancy in women with CHD were ≤12 years of education (OR 1.7, 95%CI 1.2–2.4) and self-reported history of psychiatric illness (OR 12.6, 95%CI 1.4–3.4). After pregnancy, solely self-reported history of psychiatric illness (OR 5.2, 95%CI 1.1–3.0) was associated with poor self-rated health.

Conclusion: Women with CHD reported poor self-rated health comparable to controls before, during, and after pregnancy, and factors related to heart disease were not associated with poor self-rated health. Knowledge about self-rated health may guide professionals in reproductive counselling for women with CHD. Further research is required on how pregnancy affects self-rated health for the group in a long-term perspective.