Kvinnors upplevelse av planerad hemförlossning i Skandinavien : Women´s experience of planned home birth in the Scandinavian countries

Background: In Sweden and Norway planned home birth is not included in the health care system. In Denmark women with expected low risk birth have the right to choose home birth. Registrations of home births in the Nordic countries are not completed and women’s experiences of planned home birth in Scandinavian context are not earlier described.Objective: The aim of this study was to describe women’s experiences of planned home birth in the Scandinavian countries.Design: Inductive content analysis. Fifty-three Scandinavian women who have experienced planned home birth have replied an open question in a questionnaire. Findings: In the analysis five categories and twelve subcategories emerged. The categories were, to feel secure, experiences of support, being in control, harmony and insecurity. The women felt secure and calm in their own homes. They felt being in control, secure, support and trust in the midwife, relatives and the own body. What worried the women most in presence of the delivery was that the midwife should not be present. Keywords: Home birth, experiences, women.

We did it together : Fathers´ experiences of planned home birth in the Nordic countries

Sammanfattning: Bakgrund: för många pappor kan det vara en av livets största och bästa stund att närvara vid när deras barn föds. Det finns studier som beskriver pappors upplevelse av sjukhusförlossning, däremot finns det få studier som beskriver pappors upplevelse av planerad hemförlossning. Syftet med den här studien är att beskriva pappans upplevelser och erfarenheter av planerad hemförlossning. Metod: i denna studie medverkar 105 pappor från de nordiska länderna som har deltagit i planerad hemförlossning mellan 2009-2011. Materialet från en öppen enkätfråga analyserades med hjälp av deduktiv ansats. Den öppna frågan löd ”beskriv gärna förlossningen med egna ord”. Resultat: papporna upplevde den planerade hemförlossningen som lugn och säker, mycket tack vare den professionella barnmorskan och den välbekanta miljön. Att få vara hemma med sin partner och om så önskades, sin familj var högt skattat. Födelseprocessen hemma beskrevs av papporna som att ”vi gjorde det tillsammans” och ”det var vår egen förlossning”. Papporna uttryckte delaktighet i förlossningsflödet. De kände också att de fick ett barn och var en del av en vacker förlossning full av kärlek. Konklusion: att välkomna ett barn hemma i en lugn miljö där paret känner sig trygga och ostörda, kan underlätta en positiv och meningsfull förlossningsupplevelse.

Behaviour of Surface Defects in Wire Rod Rolling

Defects are often present in rolled products, such as wire rod. The markets demand for wire rod without any defects has increased. In the final wire rod products, defects originating from the steel making, casting, pre-rolling of billets and during the wire rod rolling can appear. In this work, artificial V-shaped longitudinal surface cracks has been analysed experimentally and by means of FEM. The results indicate that the experiments and FEM calculations show the same tendency except in two cases, where instability due to a fairly “round” false round bars disturbed the experiment. FE studies in combination with practical experiments are necessary in order to understand the behaviour of the material flows in the groove and to explain whether the crack will open up as a V-shape or if it will be closed as an I-shape.

Evolution of artificial defects during shape rolling

Very often defects are present in rolled products. For wire rods, defects are very deleterious since the wire rods are generally used directly in various applications. For this reason, the market nowadays requires wire rods to be completely defect-free. Any wire with defects must be rejected as scrap which is very costly for the production mill. Thus, it is very important to study the formation and evolution of defects during wire rod rolling in order to better understand and minimize the problem, at the same time improving quality of the wire rods and reducing production costs. The present work is focused on the evolution of artificial defects during rolling. Longitudinal surface defects are studied during shape rolling of an AISI M2 high speed steel and a longitudinal central inner defect is studied in an AISI 304L austenitic stainless steel during ultra-high-speed wire rod rolling. Experimental studies are carried out by rolling short rods prepared with arteficial defects. The evolution of the defects is characterised and compared to numerical analyses. The comparison shows that surface defects generally reduce quicker in the experiments than predicted by the simulations whereas a good agreement is generally obtained for the central defect.

Studies of Design and Assembly Defects on Integrated and Modular Architectures

It is known that despite companies’ efforts to improve the quality of their products, design and assembly defects results in large repair costs both in terms of repair and providing feedback to the origin of the defect. The purpose of this paper is to study these types of defects and the defect rates in design and assembly. The paper presents a web based questionnaire answered by 29 companies. The result shows that the defect rate (defects per product) spanned from 0.01 to 10. Also, design and assembly defects covered 46%, 23% respectively, of all occurred defects. A case study is also presented, performed at a company who recently implemented a modular architecture. In this company, defects from 5 700 integrated product architectures are compared with defects from 431 modular architectures. The average defect rate increased by 21.5% – from 0.65 to 0.79 – when a more modular architecture has been implemented. Furthermore, the study showed that the assembly defects have decreased while the design defects increased. The results presented in this paper will also support the development of the MPV (Module Property Verification) method which is briefly described.

Fear causes tears – perineal injuries in home birth settings : a Swedish interview study

Background: Perineal injury is a serious complication of vaginal delivery that has a severe impact on the quality of life of healthy women. The prevalence of perineal injuries among women who give birth in hospital has increased over the last decade, while it is lower among women who give birth at home. The aim of this study was to describe the practice of midwives in home birth settings with the focus on the occurrence of perineal injuries. Methods: Twenty midwives who had assisted home births for between one and 29 years were interviewed using an interview guide. The midwives also had experience of working in a hospital delivery ward. All the interviews were tape-recorded and transcribed. Content analysis was used. Results: The overall theme was "No rushing and tearing about", describing the midwives' focus on the natural process taking its time. The subcategories 1) preparing for the birth; 2) going along with the physiological process; 3) creating a sense of security; 4) the critical moment and 5) midwifery skills illuminate the management of labor as experienced by the midwives when assisting births at home. Conclusions: Midwives who assist women who give birth at home take many things into account in order to minimize the risk of complications during birth. Protection of the woman's perineum is an act of awareness that is not limited to the actual moment of the pushing phase but starts earlier, along with the communication between the midwife and the woman.

Acupuncture with manual and electrical stimulation for labour pain : a two month follow up of recollection of pain and birth experience.

BACKGROUND: In a previous randomised controlled trial we showed that acupuncture with a combination of manual- and electrical stimulation (EA) did not affect the level of pain, as compared with acupuncture with manual stimulation (MA) and standard care (SC), but reduced the need for other forms of pain relief, including epidural analgesia. To dismiss an under-treatment of pain in the trial, we did a long-term follow up on the recollection of labour pain and the birth experience comparing acupuncture with manual stimulation, acupuncture with combined electrical and manual stimulation with standard care. Our hypothesis was that despite the lower frequency of use of other pain relief, women who had received EA would make similar retrospective assessments of labour pain and the birth experience 2 months after birth as women who received standard care (SC) or acupuncture with manual stimulation (MA). METHODS: Secondary analyses of data collected for a randomised controlled trial conducted at two delivery wards in Sweden. A total of 303 nulliparous women with normal pregnancies were randomised to: 40 min of MA or EA, or SC without acupuncture. Questionnaires were administered the day after partus and 2 months later. RESULTS: Two months postpartum, the mean recalled pain on the visual analogue scale (SC: 70.1, MA: 69.3 and EA: 68.7) did not differ between the groups (SC vs MA: adjusted mean difference 0.8, 95 % confidence interval [CI] -6.3 to 7.9 and SC vs EA: mean difference 1.3 CI 95 % -5.5 to 8.1). Positive birth experience (SC: 54.3 %, MA: 64.6 % and EA: 61.0 %) did not differ between the groups (SC vs MA: adjusted Odds Ratio [OR] 1.8, CI 95 % 0.9 to 3.7 and SC vs EA: OR 1.4 CI 95 % 0.7 to 2.6). CONCLUSIONS: Despite the lower use of other pain relief, women who received acupuncture with the combination of manual and electrical stimulation during labour made the same retrospective assessments of labour pain and birth experience 2 months postpartum as those who received acupuncture with manual stimulation or standard care. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01197950.