A description of birth in Finland

A review of the definition and scope of practice of midwives in five representative countries

Objective

To review the definition and scope of the practice of midwives in Sweden, Finland, the United Kingdom, the United States, and Australia to find models and make suggestions for reforms in the midwifery policies of China.

Methods

This article reviewed the midwifery policies published by authorities, organizations, and governments of these countries and relevant literature in the databases of PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), and Wanfang database.

Results

The definition and scope of practice of midwives in five representative countries and China were reviewed. The similarities and differences in midwifery policies among them show that most countries set standards based on the definition and scope of practice of midwives recommended by International Confederation of Midwives.

Conclusions

The definition of midwives should include registration, midwifery education, and acceptance standards. The scope of practice of midwives should specify an autonomous environment, the objective of care, the period of care involved, prescribing rights, emergency treatment, and health counseling.

Utilization of Large Data Sets in Maternal Health in Finland: A Case for Global Health Research

In recent years, the use of large data sets, such as electronic health records, has increased. These large data sets are often referred to as "Big Data," which have various definitions. The purpose of this article was to summarize and review the utilization, strengths, and challenges of register data, which means a written record containing regular entries of items or details, and Big Data, especially in maternal nursing, using 4 examples of studies from the Finnish Medical Birth Register data and relate these to other international databases and data sets. Using large health register data is crucial when studying and understanding outcomes of maternity care. This type of data enables comparisons on a population level and can be utilized in research related to maternal health, with important issues and implications for future research and clinical practice. Although there are challenges connected with register data and Big Data, these large data sets offer the opportunity for timely insight into population-based information on relevant research topics in maternal health. Nurse researchers need to understand the possibilities and limitations of using existing register data in maternity research. Maternal child nurse researchers can be leaders of the movement to utilize Big Data to improve global maternal health.

Cultural Influences on Pain Perceptions and Behaviors

The perception of pain and behaviors associated with pain are influenced by the sociocultural contexts of the individuals experiencing pain. This article provides an overview of the literature on these cultural influences. With the increase in global migration, nurses need to develop increased sensitivity to the influence of culture on pain perceptions and behaviors. In the provision of home health care, it is essential that nurses are sensitive to such influences in the delivery of culturally competent care in the assessment and management of both acute and chronic pain.

Methods of Coping With Labor Pain Used by Jordanian Women

The purpose of this study is to explore labor pain coping methods among Jordanian parturients. Descriptive statistics and content analysis were used to analyze data on demographics and coping methods from 100 low-risk parturients who were recruited from the postpartum unit in a major hospital in Jordan: Four labor pain-coping methods that included physiological, psychological, spiritual, and cognitive coping were reported. This study confirms previous findings regarding coping methods and adds new knowledge on coping with labor pain among Jordanian parturients: The significance of childbirth education as a means to inform Jordanian women about coping with labor pain is emphasized. This study also highlighted the important roles that nurses and midwives can play as educators and supporters during pregnancy and labor.

Pregnant Families' Discussions on the Net-From Virtual Connections Toward Real-Life Community

The aim of this research was to analyze conversations between expectant families (N = 21) in Net Clinic, an Internet-based service designed for patients using public maternity care. The online conversations, shared opinions about experiences of pregnancy, and family life constituted the data for content analysis. The families developed a sense of virtual community, which gradually evolved into a real-life community, by discovering the similarity of their life situations and by giving parent-to-parent support for everyday life events. As a view of daily family life, Net Clinic offers maternity care professionals a deeper understanding of how to enhance safer pregnancy, birth, and growth of the family.

Collaborative International Research

The current age of globalization poses challenges as to how to promote professional interaction to further international scholarly efforts in nursing. Models of global research are defined. Global health priorities are explicated, with recommendations for the conduct of outcomes-focused research leading to the generation of cost-effective interventions that contribute to the health and well-being of individuals, families, communities, and nations throughout the world. The challenges and opportunities in international collaborative nursing research are described based on the experiences of the authors during nearly two decades of collaborative work. International partnerships in globally relevant research, which respect and value equity between nurse researchers practicing in developed and developing countries, are essential.

Experiences of security associated with pregnancy and childbirth: a study of pregnant women

The aim of this study was to describe the sense of security associated with pregnancy and childbirth and to identify factors associated with it. Security was conceptualized in accordance with Kaufmann as a human need and as a human value. The instrument used was a questionnaire with a 4-point scale. The sample consisted of 481 pregnant Finnish women. The response rate was 69%. Rotated factor analysis was carried out and sum variables were produced. The effects of various background variables were calculated using the Kruskal-Wallis test and the Mann-Whitney U-test. The elements creating security were social support, knowledge, prenatal health-care experiences, support from the partner, livelihood, positive stories and, in multiparae, positive previous childbearing experiences. The most salient finding concerning factors related to security was that women who had no pregnancy-related problems in the current pregnancy reported social support, prenatal health-care experiences and support from the partner as security-creating elements more often than women with such problems. This was the only factor related to manifestation of security. The findings suggest that all pregnant women should be assisted by professionals to find security-creating elements in their particular situation to promote and strengthen the sense of security, paying special attention to women with pregnancy-related problems.

Fears and coping strategies associated with pregnancy and childbirth in Finland

The purpose of this study was to describe the causes of fear associated with pregnancy and childbirth and to describe coping strategies of pregnant women who have fears. Data were collected by using semistructured interviews on the maternity units of two university hospitals in Finland. A convenience sample of 20 women served as participants, and data were analyzed by using content analysis techniques. In most cases, the source of fear was either previous experience and knowledge or uncertainty. In some cases, the source of fear was beliefs about childbirth with no clear origin of the belief. Knowledge was described as a means of dealing with fear, as were talking, writing, and reasoning. When seeking help, many participants relied on their social network and on health care professionals, but some sought information independently from books, magazines, etc. Methods for dispelling or alleviating fear included talking about feelings, increasing knowledge, accessing health care services, referring to positive experiences, receiving reassurance from medical screening, and/or feeling the baby move. Knowledge can be a cause of fear, but its ability to decrease fear is of greater consequence. What seemed to matter most was the way in which information is given.

Experiences of fears associated with pregnancy and childbirth: a study of 329 pregnant women

BACKGROUND

Women may experience a variety of fears in association with pregnancy and childbirth. The purpose of this study was to describe their objects, causes, and manifestations, and to identify factors associated with the fears.

METHODS

The study sample comprised 481 pregnant women in western Finland, of whom 329 (response rate 69) completed a questionnaire. It was developed on the basis of semi-structured interviews and previous studies and had a 4-point scale and a dichotomous scale. Data were subjected to rotated factor analysis, and sum variables were produced. The effects of various demographic variables were calculated using the Kruskal-Wallis and Mann-Whitney U tests.

RESULTS

Of the 329 respondents, 78 percent expressed fears relating to pregnancy, to childbirth, or to both. Specific fears concerned childbirth, the child's and mother's well-being, health care staff, family life, and cesarean section. Causes of fears were negative mood, negative stories told by others, alarming information, diseases and child-related problems, and, in multiparas, negative experiences of previous pregnancy, childbirth, and baby's health and care; causes were significantly related to occupation. Fears were manifested as symptoms of stress, effects on everyday life, and a wish to have a cesarean section or to avoid pregnancy and childbirth; employment situation and elective cesarean section were the most important factors related to manifestation of fears. Parity and antenatal training were the most important variables related to objects of fears.

CONCLUSIONS

Women's fears that are associated with pregnancy and childbirth can be explained by different factors. It is important for perinatal health caregivers to ask pregnant women about their feelings related to the current pregnancy, childbirth, and future motherhood, and to give women who express fears an opportunity to discuss them, paying special attention to primiparas and to multiparas with negative experiences of earlier pregnancies.

Security associated with pregnancy and childbirth--experiences of pregnant women

The aim of this study was to describe security associated with pregnancy and childbirth. Security was described as a human need and as human value. Data were collected in semi-structured interviews in two maternity health care clinics. Data interpretation was based on the method of content analysis. A convenience sample of 20 volunteer Finnish women was interviewed during pregnancy. The elements creating security associated with pregnancy and childbirth were maternity health care, social support, sense of control, and attitudes. The feeling of security was manifested in different resources, feelings and behavior. If the feeling of security associated with pregnancy and childbirth was impaired, the participants would resort to their network of social support, contact health care or social welfare services, or try to achieve a sense of security by their own resources. Feeling secure during pregnancy influences the pregnant woman's resources, feelings and behavior. It is important that professionals in maternity health care talk with the client about issues that influence her individually-experienced security associated with pregnancy and childbirth. These include examination of the client's network of social support and informing the client about the health care and social welfare services available.