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Balle CK, Hvidtjørn D, Brintow MLB, Wu C, Prinds C. Existential communication in maternity care - Mixed method evaluation of a postgraduate short course. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 41:100983. [PMID: 38820691 DOI: 10.1016/j.srhc.2024.100983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVE The birth of a child is a significant life event, possibly accompanied by thoughts and feelings of existential turmoil, which some parents need to share. Maternity care professionals may be unprepared for this, as very few educational initiatives exist with a focus on existential communication. We evaluated the curriculum and delivery of a course in existential communication for midwives. The evaluation was based on participants' experiences of self-reported self-efficacy and self-reflection before and after participation. METHODS A parallel mixed methods design with pre- and post-course questionnaires and field observations. Quantitative data were evaluated using Mann-Whitney analyses, and open-ended questions and field observations were thematised for further analysis. RESULTS Seventy-three maternity care professionals participated in the course. Of these, 69 (95%) completed a pre-course questionnaire, and 71 (97%) a post-course questionnaire. The quantitative data found a significant difference in various participant measures such as increase in self-efficacy in existential communication and understanding of existential communication. Qualitative data from the questionnaires and field observations led to six different themes including topics such as the need for reflection with peers and the presence of existential within maternity care. CONCLUSIONS The course evaluation suggested an increase in participants' awareness of existential aspects of maternity care and improved self-reflection and existential awareness.
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Affiliation(s)
- Cæcilie Kongsgaard Balle
- University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Holbæk Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark.
| | - Dorte Hvidtjørn
- University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | | | - Chunsen Wu
- University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Christina Prinds
- University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; University Hospital South Denmark, Kresten Philipsensvej 15, 6200 Aabenraa, Denmark
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Damm MF, Jørgensen ML, Eklund MV, Hvidtjørn D, Prinds C. Carrying Death: A Qualitative Study of Women's Bodily Perceptions After Their Baby Died in Utero. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231190544. [PMID: 37493011 DOI: 10.1177/00302228231190544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
When a child dies in utero death becomes an integrated part of the mothers living body and this complex experience places a heavy existential and bodily burden on a woman experiencing stillbirth. This study uses a phenomenological approach with focus groups and individual interviews and data is discussed within a theoretical existential framework. Interviews of six women who experienced stillbirth within a range of 5 years were performed in Denmark. The participants experienced the dissonance of carrying death in their living body, expressed heightened existential considerations, a sense of transgression and of feeling trapped in an unbearable situation, and an experience of both dislocation from their body and an extreme bodily awareness. The study generates new knowledge and understanding of the how stillbirth is experienced as incomprehensible and as a violent bodily invasion of death with deep existential impact.
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Affiliation(s)
- Maiken F Damm
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Sygehus Sønderjylland, University Hospital South Denmark, Aabenraa, Denmark
| | | | | | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Unit for Perinatal Loss, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Prinds
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Sygehus Sønderjylland, University Hospital South Denmark, Aabenraa, Denmark
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Prinds C, Hvidt NC, Schrøder K, Stokholm L, Rubin KH, Nohr EA, Petersen LK, Jørgensen JS, Bliddal M. Prayer and meditation practices in the early COVID-19 pandemic: A nationwide survey among Danish pregnant women. The COVIDPregDK study. Midwifery 2023; 123:103716. [PMID: 37209582 DOI: 10.1016/j.midw.2023.103716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/17/2023] [Accepted: 05/06/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND The emergence of the COVID-19 pandemic and the derived changes in maternity care have created stress and anxiety among pregnant women in different parts of the world. In times of stress and crisis, spirituality, including spiritual and religious practices, may increase. OBJECTIVE To describe if the COVID-19 pandemic influenced pregnant women's considerations and practises of existential meaning-making and to investigate such considerations and practices during the early pandemic in a large nationwide sample. METHODS We used survey data from a nationwide cross-sectional study sent to all registered pregnant women in Denmark during April and May 2020. We used questions from four core items on prayer and meditation practices. RESULTS A total of 30,995 women were invited, of whom 16,380 participated (53%). Among respondents, we found that 44% considered themselves believers, 29% confirmed a specific form of prayer, and 18% confirmed a specific form of meditation. In addition, most respondents (88%) reported that the COVID-19 pandemic had not influenced their responses. CONCLUSION In a nationwide Danish cohort of pregnant women, existential meaning-making considerations and practices were not changed due to the COVID-19 pandemic. Nearly one in two study participants described themselves as believers, and many practised prayer and/or meditation.
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Affiliation(s)
- Christina Prinds
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Hospital Sønderjylland, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark.
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Katja Schrøder
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; User Perspectives and Community-based Interventions, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Lonny Stokholm
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Katrine Hass Rubin
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Ellen A Nohr
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Lone K Petersen
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Jan Stener Jørgensen
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Mette Bliddal
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
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Stripp TK, Büssing A, Wehberg S, Andersen HS, Kørup AK, Pedersen HF, Søndergaard J, Hvidt NC. Measuring Spiritual Needs in a Secular Society: Validation and Clinimetric Properties of the Danish 20-Item Spiritual Needs Questionnaire. JOURNAL OF RELIGION AND HEALTH 2022; 61:3542-3565. [PMID: 35230599 DOI: 10.1007/s10943-022-01533-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
In secular cultures, such as Denmark, tools to measure spiritual needs are warranted to guide existential and spiritual care. We examined the clinimetric properties of the Danish version of the Spiritual Needs Questionnaire (DA-SpNQ-20) based on a digital survey in a test-retest setup. A convenience sample was reached via social media and student platforms. A total of 325 (148 for retest) respondents were included in the analysis. The sample was randomly split into two groups (A and B) and used for exploratory (EFA) and confirmatory factor analysis (CFA) by structural equation modeling, respectively. SpNQ dimensions had an internal consistency with Cronbach's alpha between 0.73 and 0.93. The four factors of the SpNQ were supported by both EFA and CFA as follows: religious needs, existential needs, inner peace needs, and generativity needs. The instrument showed good internal consistency, good test-retest reliability, and acceptable structural validity in the sample of relatively young and healthy persons.
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Affiliation(s)
- Tobias Kvist Stripp
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J. B. Winsløvsvej 9, 5000, Odense C, Denmark.
| | - Arndt Büssing
- Institute of Integrative Medicine, Faculty of Medicine, Witten/Herdecke University, 58313, Herdecke, Germany
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, 5000, Odense C, Denmark
| | - Sonja Wehberg
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J. B. Winsløvsvej 9, 5000, Odense C, Denmark
| | - Helene Støttrup Andersen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J. B. Winsløvsvej 9, 5000, Odense C, Denmark
| | - Alex Kappel Kørup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J. B. Winsløvsvej 9, 5000, Odense C, Denmark
- Department of Mental Health Service, Vejle, Region of Southern Denmark, Denmark
| | - Heidi Frølund Pedersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8000, Aarhus C, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J. B. Winsløvsvej 9, 5000, Odense C, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J. B. Winsløvsvej 9, 5000, Odense C, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, 5000, Odense C, Denmark
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van der Waal R, van Nistelrooij I. Reimagining relationality for reproductive care: Understanding obstetric violence as “separation”. Nurs Ethics 2022; 29:1186-1197. [PMID: 35100071 PMCID: PMC9445229 DOI: 10.1177/09697330211051000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nursing Ethics has published several pleas for care ethics and/or relationality as the most promising ethical foundation for midwifery philosophy and practice. In this article, we stand by these calls, contributing to them with the identification of the structural form of violence that a care ethical relational approach to reproductive care is up against: that of “maternal separation”. Confronted with reproductive and obstetric violence globally, we show that a hegemonic racialized, instrumentalized, and individualized conception of pregnancy is responsible for a severance of relationalities that are essential to safe reproductive care: (1) the relation between the person and their child or reproductive capabilities; and (2) the relation between the pregnant person and their community of care. We pinpoint a separation of the maternal relation in at least two discursive domains, namely, the juridical-political and the ethical-existential. Consequently, we plea for a radical re-imagination of maternal relationality, envisioning what care ethical midwifery, including abortion care, could be.
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Prinds C, Paal P, Hansen LB. Characteristics of existing healthcare workforce education in spiritual care related to childbirth: A systematic review identifying only two studies. Midwifery 2021; 97:102974. [PMID: 33714917 DOI: 10.1016/j.midw.2021.102974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 02/03/2021] [Accepted: 02/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND It has been argued that the beginning of life is one of the most significant, universally-shared life events, impacting parental health biologically, sociologically, psychologically and spiritually. In maternity care settings, only a few educational initiatives exist focusing on increasing competencies in spiritual care. OBJECTIVE To explore the characteristics of content in existing under- and post-graduate education of healthcare professionals in spiritual care in the field of maternity care. METHODS We conducted an integrative review, searching seven databases for studies describing the content of existing education in spiritual care in maternity care settings. RESULTS From 235 studies assessed eligible and full text screened, only two were included, originating from the same project. The majority of existing studies about spiritual care focus on the perspective of women related to loss, sickness or bereavement, whereas research related to the field of maternity care is sparser. Furthermore, the perspective of the professional seems overlooked. CONCLUSION There is a lack of research exploring the content and structure of educational initiatives related to spiritual care in maternity care. In order to strengthen spiritual care competencies in maternity care, for both women/partners and professionals, future research should investigate how education is planned and evaluated.
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Affiliation(s)
- Christina Prinds
- University College South Denmark, Degnevej 16, DK-6705 Esbjerg, Ø, Denmark; University of Southern Denmark, Faculty of Health Sciences, Department of Clinical Institute, Kløvervænget 10, DK-5000 Odense, C, Denmark.
| | - Piret Paal
- WHO Collaborating Centre for Nursing Research and Education, Institute of Nursing Science and Practice, Paracelsus Medical Private University, Strubergasse 21, 5020 Salzburg Austria.
| | - Line Bruun Hansen
- University College South Denmark, Degnevej 16, DK-6705 Esbjerg, Ø, Denmark
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Værland IE. Existential challenges due to severe pre-eclampsia when becoming parents. Midwifery 2021; 97:102967. [PMID: 33721573 DOI: 10.1016/j.midw.2021.102967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/13/2021] [Accepted: 02/22/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To deepen the understanding of parents' existential challenges and experiences when having a premature infant due to the mother's pre-eclampsia. DESIGN Two empirical studies based on reflective lifeworld research (RLR), were conducted to investigate parents' experiences of having a premature infant due to mother's pre-eclampsia. A further abstraction was possible. The two essences were synthesised into a general structure. Then, a philosophical examination of the existential issues was done using Karl Jaspers' concept of limit situation and health theory outlined by Dahlberg and Segesten. SETTING Maternity ward and neonatal intensive care unit. PARTICIPANTS Nine mothers and six fathers. FINDINGS The findings revealed the experiences of a vulnerable group of parents in the maternity ward and in the neonatal intensive care unit (NICU). The parents faced a paradoxical experience. They experienced mothers' severe illness and in some cases accompanied by the possibility of death, at the same time they experienced the joy of becoming parents. The premature birth and the mother's severe symptoms revealed the intertwinement of biological and existential features. Pre-eclampsia restricted the mothers from fulfilling the major project in their lives: to become real mothers. These experiences were elucidated by the concept of limit situations as suffering, struggle, death, and paradoxes of life as well as the health theory with its biological and existential dimensions. KEY CONCLUSION Some parents experienced closeness to death and the beginning of life as almost intertwined. These two fundamental facets of life are connected to existential features and challenges. The study also underlined the antinomies of life; suffering and facing severe illness that could cost both the mother's and infant's lives, and at the same time feeling the happiness of becoming parents. IMPLICATIONS FOR PRACTICE Health professionals should know how these experiences affect parents. They should be sensitive when approaching mothers and fathers in such situations. The families' vulnerability must be considered within the physical space of health services. If the parents needs to talk, time and staff should be available to meet their needs.
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Affiliation(s)
- Inger Emilie Værland
- Nursing and Health Care Research Group, Stavanger University Hospital, Postboks 8100, 4068 Stavanger, Norway.
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Hansen LB, Hvidt NC, Mortensen KE, Wu C, Prinds C. How Giving Birth Makes Sense: A Questionnaire Study on Existential Meaning-Making Among Mothers Giving Birth Preterm or at Term. JOURNAL OF RELIGION AND HEALTH 2021; 60:335-353. [PMID: 33123971 DOI: 10.1007/s10943-020-01106-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Women's reflections on existential meaning-making in relation to giving birth may seem indistinct in maternity services and have not been thoroughly explored in secular contexts. However, research suggests that childbirth accentuates spiritual and existential considerations and needs even in secular contexts highlighting the importance of care for such needs in maternity care practices. The objectives of this study were two-fold: Firstly, to explore how first-time mothers, living in a secular context, experience their first birth in relation to existential meaning-making. Secondly, to describe the relationship between existential meaning-making reflections and gestational week at birth. METHODS A nationwide cross-sectional study in Denmark based on the questionnaire "Faith, existence and motherhood" was conducted in 2011. Eight core items related to birth experience informed this study. The cohort was sampled from the Danish Medical Birth Registry and consisted of 913 mothers having given birth 6-18 months previously. Twenty-eight per cent had given birth preterm (PT) and 72% had given birth at full-term (FT). A total of 517 mothers responded. RESULTS In relation to the birth of their first child, both FT and PT mothers answered, that they had existential meaning-making reflections. The consent to the 8 items ranged from 17 to 73% among FT mothers and from 19 to 58% among PT mothers. Mothers who gave birth preterm mainly identified the negative aspects of birth, whereas mothers, who gave birth at full-term, to a higher degree identified positive aspects. CONCLUSIONS Findings suggest that not only traumatic birth events accentuate existential reflections, but that even normal childbirth to most mothers is an existential event. However, the quality of existential reflections differs when comparing normal and traumatic birth. The study points towards change in education and organization of maternity care to better care for existential needs and reflections specific to every new mother and birthing woman.
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Affiliation(s)
- Line Bruun Hansen
- University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark.
- University Library of Southern Denmark, Niels Bohrs Vej 9-10, 6700, Esbjerg Ø, Denmark.
| | - Niels Christian Hvidt
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000, Odense C, Denmark
| | - Katrine Ernst Mortensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Chunsen Wu
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
- Department of Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark
| | - Christina Prinds
- University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark
- Department of Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark
- OPEN - Odense Patient Data Explorative Network, Odense University Hospital, J.B. Winsløws Vej 9, 5000, Odense C, Denmark
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Eklund MV, Prinds C, Mørk S, Damm M, Möller S, Hvidtjørn D. Parents' religious/spiritual beliefs, practices, changes and needs after pregnancy or neonatal loss-A Danish cross-sectional study. DEATH STUDIES 2020; 46:1529-1539. [PMID: 32960749 DOI: 10.1080/07481187.2020.1821260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study describes religious/spiritual beliefs, practices, changes, and needs among parents bereaved by pregnancy or neonatal loss, and assess gender differences in religiosity/spirituality, in this population. A cross-sectional study using data from the Danish cohort Life After the Loss was conducted. Data were gathered from a questionnaire survey collected between January 2016 and December 2019. Among 713 respondents, several answered in the affirmative to items related to religious/spiritual beliefs and practices. Some experienced changes in religious/spiritual beliefs and practices, and some wished to talk to someone about these questions. Women reported higher levels of religiosity/spirituality than men.
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Affiliation(s)
| | - Christina Prinds
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Development and Research, University College South Denmark, Haderslev, Denmark
| | - Sofie Mørk
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Maiken Damm
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Exploratory Network, Odense University Hospital, Odense, Denmark
| | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Prinds C, der Wal JGV, Crombag N, Martin L. Counselling for prenatal anomaly screening-A plea for integration of existential life questions. PATIENT EDUCATION AND COUNSELING 2020; 103:1657-1661. [PMID: 32268986 DOI: 10.1016/j.pec.2020.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/04/2020] [Accepted: 03/27/2020] [Indexed: 05/09/2023]
Abstract
The availability in many countries of new prenatal anomaly screening methods, such as the non-invasive prenatal test (NIPT), and the potential broadening of testing for genetic conditions, creates an ongoing debate about the accompanying existential dilemmas at both societal level and for individual new parents. In many countries, the main goal of counselling for prenatal anomaly screening is to facilitate the reproductive decision-making process of future parents. Therefore, counsellors share information to enable a woman and her partner to think about the pros and cons of participating in screening, try to clarify possible moral dilemmas, and dwell on existential life questions. In line with the CanMEDS framework, healthcare professionals must combine the role of communicator (providing health education) with that of professional (by recognising and responding to existential life questions while facilitating decision-making). This is not easy but it is essential for providing balanced counselling. At present, counselling tends to be sufficient regarding health education, whereas guidance in decision-making, including attention for existential life questions and philosophy of life, offers room for improvement. In this paper, we suggest slowing down and turning the traditional prenatal counselling encounter upside down by starting as a counselling professional instead of a healthcare information sharing communicator and thus making the story of the woman and her partner, within their societal context, the starting point and the basis of the counselling encounter.
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Affiliation(s)
- Christina Prinds
- University of Southern Denmark, Institute of Clinical Research, Odense C, Denmark; University College South Denmark, Haderslev, Denmark.
| | | | - Neeltje Crombag
- University of Leuven, Department of Development and Regeneration, Biomedical Sciences, Belgium
| | - Linda Martin
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
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Prinds C, Nikolajsen H, Folmann B. Yummy Mummy - The ideal of not looking like a mother. Women Birth 2019; 33:e266-e273. [PMID: 31176586 DOI: 10.1016/j.wombi.2019.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pregnancy and childbirth are important life experiences that entail major changes, both physically, psychologically, socially and existentially for women. Motherhood transition and the accompanying bodily changes involve expectations of body image that are simultaneously naturally and socially produced and culturally informed by public, private and professional discourses about motherhood transition. PROBLEM Much focus is levelled at the antepartum body in maternity services whereas the postpartum body seems left alone, although bodily dissatisfaction is of concern for many mothers, whose expectations of bodily appearance postpartum are sharp and explicit. AIM To explore Danish first-time mothers' experiences of their body postpartum, focusing on body image. METHODS Eleven first-time mothers participated in semi-structured interviews related to the postpartum body image. Data was analysed thematically. FINDINGS Four themes: (1) Reverting the body: on bouncing back and losing weight; (2) Picturing me: on standards of beauty and ideal bodies; (3) Redefining earlier self-images: on meta-reproachment of the body; (4) Idealisation of not looking like a mother: on societal pressure to think positively. Findings were discussed through the theoretical concepts by Scheper-Hughes and Lock: the body as both individual, social and political. CONCLUSION Despite nuanced reflections over the body as subject and object, women identified beauty as a personal trait dependent on visual appearance. Bodily beauty was identified as something individual, yet standardised. Women felt strengthened through motherhood but looking like a mother was not considered worth pursuing. To allow for women's contradictory perspectives, caregivers are advised to communicate reflexively about the postpartum body.
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Affiliation(s)
- Christina Prinds
- University College South Denmark, Applied Research and Development, Lembckesvej, Haderslev, 6100, Denmark; University of Southern Denmark, Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, Kløvervænget 10, Odense C., 5000, Denmark.
| | - Helene Nikolajsen
- University College South Denmark, Department of Physiotherapy, Degnevej, Esbjerg Ø, 6705, Denmark.
| | - Birgitte Folmann
- University College South Denmark, Applied Research and Development, Lembckesvej, Haderslev, 6100, Denmark.
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Hvidtjørn D, Prinds C, Bliddal M, Henriksen TB, Cacciatore J, O'Connor M. Life after the loss: protocol for a Danish longitudinal follow-up study unfolding life and grief after the death of a child during pregnancy from gestational week 14, during birth or in the first 4 weeks of life. BMJ Open 2018; 8:e024278. [PMID: 30580272 PMCID: PMC6318761 DOI: 10.1136/bmjopen-2018-024278] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION After the death of a child during pregnancy, birth or in the neonatal period, parents often experience feelings of guilt, disenfranchisement, feelings of betrayal by one's own body and envy of others. Such bereavement results in high rates of distress: psychologically, emotionally, physiologically and existentially. These data are collected using a national, longitudinal cohort to assess grief in mothers and their partners after the death of a child during pregnancy, birth or in the neonatal period. Our aim is to achieve a general description of grief, emotional health, and existential values after pregnancy or perinatal death in a Danish population. METHODS AND ANALYSIS The cohort comprises mothers and their partners in Denmark who lost a child during pregnancy from gestational week 14, during birth or in the neonatal period (4 weeks post partum). We began data collection in 2015 and plan to continue until 2024. The aim is to include 5000 participants by 2024, generating the largest cohort in the field to date. Parents are invited to participate at the time of hospital discharge or via the Patient Associations homepage. Data are collected using web-based questionnaires distributed at 1-2, 7 and 13 months after the loss. Sociodemographic and obstetric variables are collected. Validated psychometric measures covering attachment, continuing bonds, post-traumatic stress, prolonged grief, perinatal grief and existential values were chosen to reach our aim. ETHICS AND DISSEMINATION The study was approved by The Danish National Data Protection Agency (no. 18/15684, 7 October 2014). The results will be disseminated in peer-reviewed and professional journals as well as in layman magazines, lectures and radio broadcasts.
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Affiliation(s)
- Dorte Hvidtjørn
- University of Southern Denmark and Odense University Hospital, Research Unit for Gynecology and Obstetrics, Institute of Clinical Research, Odense, Denmark
- Unit for Perinatal Loss, Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Prinds
- University of Southern Denmark and Odense University Hospital, Research Unit for Gynecology and Obstetrics, Institute of Clinical Research, Odense, Denmark
- Midwifery College, University College South Denmark, Esbjerg, Denmark
| | - Mette Bliddal
- OPEN Odense Patient Data Explorative Network, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Tine Brink Henriksen
- Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Joanne Cacciatore
- School of Social Work, Arizona State University, Tempe, Arizona, USA
| | - Maja O'Connor
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
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Prinds C, Mogensen O, Hvidt NC, Bliddal M. First child's impact on parental relationship: an existential perspective. BMC Pregnancy Childbirth 2018; 18:157. [PMID: 29747602 PMCID: PMC5946442 DOI: 10.1186/s12884-018-1802-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/30/2018] [Indexed: 01/13/2023] Open
Abstract
Background The first child’s birth is for most mothers a profound experience carrying the potential to change life orientations and values. However, little is known of how becoming a mother influences the existential dimensions of life within the parental relationship for example how motherhood may change how we view our partner and what we find important. The aim of this study was to explore how becoming a mother might change the parental relationship seen from the mother’s perspective with a specific focus on dimensions related to existential meaning-making. Methods In 2011, 499 Danish first time mothers answered a questionnaire, from which five core items related to changes in the partner relationship from the perspective of the mother, informed this study. The cohort consisted of mothers who gave birth before the 32nd week of gestation (n = 127) and mothers who gave birth at full term (n = 372). Item 1 focused on thoughts and conversations with her partner about the life change. Item 2 referred to the potential feeling of stronger ties to the partner. Item 3 related to the feeling of being connected to ‘something bigger than one self’ together with the partner. Item 4 focused on potential conflicts due to having a child, and item 5 referred to the experience of dreams. Possible answers ranged from ‘To a high degree’ to ‘Not at all’. Results Most respondents found birth of the first child to have forged stronger ties to their partner and have led to both thoughts and conversations about how life together as a couple changed. At the same time, some experienced more conflicts with their partner than before giving birth, however, the majority did actually not. More than half felt their relationship linked to ‘something bigger than themselves’ or had had dreams on being a family. Conclusion Findings suggest motherhood transition to be a significant transformer of partnership relation influencing also existential meaning-making. Having the potential to be of importance for the health and vitality of the mother, partner and child, it seems essential to scientifically and clinically address concerns related to existential meaning-making in partner relationship.
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Affiliation(s)
- Christina Prinds
- Department of Clinical Institute, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark. .,University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark.
| | - Ole Mogensen
- Departmen of Gynaecology and Karolinska Institute, Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Niels Christian Hvidt
- University of Southern Denmark, Institute of Public Health, J.B. Winsløws Vej 9, DK-5000, Odense, C, Denmark
| | - Mette Bliddal
- University of Southern Denmark, Institute of Public Health, J.B. Winsløws Vej 9, DK-5000, Odense, C, Denmark.,OPEN - Odense Patient data Explorative Network, Odense University Hospital, J.B Winsløws Vej 9, DK-5000, Odense C, Denmark
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Büssing A, Waßermann U, Christian Hvidt N, Längler A, Thiel M. Spiritual needs of mothers with sick new born or premature infants—A cross sectional survey among German mothers. Women Birth 2018; 31:e89-e98. [DOI: 10.1016/j.wombi.2017.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/31/2017] [Accepted: 08/04/2017] [Indexed: 10/19/2022]
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Prinds C, Hvidtjørn D, Skytthe A, Mogensen O, Hvidt NC. Prayer and meditation among Danish first time mothers-a questionnaire study. BMC Pregnancy Childbirth 2016; 16:8. [PMID: 26786049 PMCID: PMC4719672 DOI: 10.1186/s12884-016-0802-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/08/2016] [Indexed: 11/21/2022] Open
Abstract
Background Mothers’ existential dimensions in the transition to motherhood have not been described thoroughly. They might experience disruption and new perspectives in existential ways and this may especially be the case in preterm birth. The aim of this study was twofold. First we investigated the existential dimension of motherhood transition in a secularized context, through practices of prayer and meditation. Second we described the relationship between time of birth (term/preterm) and the prayer/meditation practices of the mothers. Methods Data were gathered from a nationwide questionnaire survey among first time mothers conducted during the summer 2011. All Danish women who gave birth before the 32nd pregnancy week (n = 255), and double the number of mothers who gave birth at full term (n = 658) in 2010 were included (total n = 913). The questionnaire consisted of 46 overall items categorized in seven sections, which independently cover important aspects of existential meaning-making related to becoming a mother. The respondent rate was 57 % (n = 517). Results Moments of praying or meditation 6–18 months post partum were reported by 65 %, and mothers who responded affirmatively, practiced prayer (n = 286) more than meditation (n = 89), p < 0,001. We did not observe differences in affirmative responses to prayer or meditation between mothers of full term or preterm born children, not even after controlling for perinatal or post partum loss, mode of birth, age, status of cohabiting or education. Conclusions In this explorative study we found specific practices of existential meaning-making through prayer and/or meditation among first time mothers, living in a very secularized context. Yet we know only little about character or importance of these practices among mothers, and hardly anything about existential meaning-making among new fathers. Hence the implications of meaning-making practices related to other dimensions of health are difficult to address in a qualified way in care for new mothers and families.
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Affiliation(s)
- Christina Prinds
- Department of Clinical Institute, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000, Odense, C, Denmark. .,University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark.
| | - Dorte Hvidtjørn
- Department of Clinical Institute, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000, Odense, C, Denmark.
| | - Axel Skytthe
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000, Odense C, Denmark.
| | - Ole Mogensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense C, Denmark.
| | - Niels Christian Hvidt
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000, Odense C, Denmark.
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