In recent years, the study of body image shifted from focusing on the negative aspects to a more extensive view of body image. The present study seeks to validate a measure of positive body image, the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a) in Denmark, Portugal, and Sweden. Participants (N = 1012) were adolescents and young adults aged from 12 to 19. Confirmatory factor analyses confirmed the one-dimensional factor structure of the scale. Multi-group confirmatory factor analyses indicated that the scale was invariant across sex and country. Further results showed that BAS-2 was positively correlated with self-esteem, psychological well-being, and intuitive eating. It was negatively correlated with BMI among boys and girls in Portugal but not in Denmark and Sweden. Additionally, boys had higher body appreciation than girls. Results indicated that the BAS-2 has good psychometric properties in the three languages.

Preventive work in maternal and child health care has a long history in Sweden. Today, Sweden has achieved the lowest maternal and child mortality rates globally based on a maternal health care system regulated by national recommendations; offered to every woman, free of chare, on a continuity basis, by registered midwives at municipal clinics within the community with the purpose of being assessable for all women. Despite the availability of antenatal care, immigrant women living in Sweden often have a different pattern of utilising care and in some cases immigrant women have been shown to be at risk for a negative delivery outcome. The overall aim of this thesis was to investigate differences due to country of birth and utilisation of antenatal care and the experiences of antenatal care, from the perspectives of the both the parents to be. Epidemiological design and explorative qualitative research has been used for the purpose of finding patterns of the utilisation of maternal health care as well as experiences from foreign born men and women concerning maternal health care in general, and maternal health care in the city of Malmö Sweden in particular. Qualitative research has been used to add depth and thereby attain a greater understanding in a social context. In the study population, according to the definitions set in Studies I, IV, the main finding was that 28.3-48.7% of the women had unplanned visits to a midwife and/or to a physician at the delivery ward. Women born in Sweden and in Eastern and Southern Europe had a linear relationship with few planned visits to the midwife at the municipal clinic and more unplanned visits to a midwife at the delivery ward. The women in Study II were positive to the individualised and professional care given at the MHC by empathic and professional midwives. They were positive to the increased involvement of their partner in the area of reproduction and family life since migrating to Sweden. According to the women, this may lead to an increased understanding by the fathers of the woman’s situation during pregnancy, 10 birth and caring for the children as well as it could increase the fathers own emotional as well as practical involvement in their children. The foreign born men, in Study III, were positive towards antenatal care and to be able to take part as support to women at MHC, and during the delivery process. They experienced problems with their situation of being fathers, partners and, as men living in Sweden, due often to their being un-employed and the changed situation that their migration had brought about. The health care system manager need to be aware of the fact that there are groups of women, in a low risk population, who tend to make contact with the maternal care system in a more of less unplanned fashion. By not utilising the planned care offered these women miss an opportunity to meet a midwife who is specialised in preventive care during pregnancy with the focus of treating pregnancy a normal health life event, while at the same time, ensuring the detection of eventual risk factors. A conversation with a midwife in a calm environment is beneficial to the pregnant woman. The immigrant groups need our special attention aimed at making the maternal health care system easily accessible for them, as well as making the maternity staff aware of their own attitudes towards preventive work involving pregnancy in a multiethnic setting. The organisation of care must also, in itself; offer such possibilities for both the staff and the women.

I denna bok presenteras olika tvärkulturella perspektiv som hjälper studenter och andra intresserade att nå kunskap om hur kulturell bakgrund, både den egna och andras, kan spela roll vid inhämtande av data. Författarna delar med sig av sina välgrundade erfarenheter som forskare inom vården. De visar hur man kan planera och genomföra undersökningar med informanter från minoritetsgrupper som annars har svårt att göra sig hörda genom att ta hjälp av nyckelpersoner och tolkar. De visar också hur man kan genomföra studier utomlands. Men det är inte bara en fråga om praktiska lösningar, utan författarna ger även redskap för den (själv)kritiska reflektion som krävs för tillförlitlig tvärkulturell forskning.

Boken riktar sig till studenter, forskare och yrkesverksamma som intresserar sig för hur vården kan utvecklas och förbättras för alla, oavsett bakgrund.

In this study, we used a narrow, but easily measured, indicator of how communication proceeded among health workers and women in Southern India. Anemia prevention during pregnancy was studied using a semistructured questionnaire. Participants included 5 nurses, 10 health aides, and 10 (traditional birth attendants) TBAs working with maternal health care and education, as well as 32 women seeking maternal health care. Those women who received health education where they lived, from health workers they knew, and together with participants familiar to them learned more about anemia prevention than others.

Background. The aim of this study was to investigate differences in use of antenatal care in a multi-ethnic population in Malmö, Sweden, over a 4-year period. Age, parity, cohabiting status, use of an interpreter, and tobacco-use were examined to assess the potential effects of confounding factors. Methods. A 4-year (2000–2003) retrospective community-based register study was performed. Low-risk singleton pregnancies (n = 5,373) registered for antenatal care at 5 municipal clinics and at the delivery ward at Malmö University Hospital were included, and divided into 6 subgroups by country of origin. The odds for utilisation of antenatal care were analysed by means of logistic regression. Results. Significantly increased odds of lower utilisation of planned antenatal care were found among some groups of foreign-born women. Women born in Eastern and Southern Europe, Iraq and Lebanon, and Asia had fewer antenatal visits than recommended, and all foreign-born women (except for women born in Iraq and Lebanon, and South and Central America) had a late first visit compared to Swedish-born women. Foreign-born women had, in general, fewer unplanned visits to a physician at the delivery ward, but women originating from Asia, Iraq and Lebanon, and Africa had higher utilisation visits to midwives at the delivery ward compared to Swedish-born women. Conclusions. Foreign-born women had lower utilisation of planned antenatal care. Approximately 50% of women had higher utilisation of care, by making unplanned visits to the delivery ward. This puts strain on both economical as well as staff resources. The delivery clinic at the hospital level is not intended to handle routine visits, and, moreover, some of these women do not receive the full benefits of planned routine antenatal care.

Women immigrating with their children are a vulnerable group often exposed to ill health and a bad environment. In Europe, women from the Middle East have a complex situation, but immigrant women from low socioeconomic status backgrounds are at highest risk, also with regard to the perinatal period in life. In Sweden all women, independent of their immigrant status are offered free high-quality perinatal care performed by midwives free of charge and nearly 100% use this care, though differently than the nonmigrant population. Often care is sought late in pregnancy, and problems with regard to communication affects the situation as well as care-seeking patterns. However, experiences from families’ originating from the Middle East show their high trust in midwives in Sweden. This trust must be handled with care since it is a great challenge for the health-care organization in Sweden as well as in other countries to host large migrating population, reaching out and communicating in a satisfactory way.

Background

Traditional patterns relating to how to handle pregnancy and birth are often challenged due to migration. The purpose of this study was to describe Middle Eastern mothers' experiences of the maternal health care services in Sweden and the involvement of their male partner.

Methods

Thirteen immigrant mothers from the Middle East who had used the maternal health services in Sweden were interviewed using focus group discussions and individual interviews. These were taped, transcribed and analysed according to Content analysis.

Results

The four main categories that developed were:

• Access to the professional midwife

• Useful counselling

• Stable motherhood in transition

• Being a family living in a different culture

Conclusion

According to the respondents in this study, understanding the woman's native language or her culture was not vital to develop a good relationship with the midwife. Instead the immigrant woman developed trust in the midwife based on the knowledge and the empathy the midwife imparted.

Increasing the amount of first trimester antenatal visits could avoid spontaneous visits to the emergency clinic. There was a greater need for involvement and support by the father during the perinatal period, such as caring for older children and carrying out household chores since the mothers' earlier female network was often lost.

Clinical implications

There is a need to involve immigrant parents in the available parental education in order to prepare them for parenthood in their new country as well as to explore their altered family situation. Collecting immigrant women and their partner's, experiences of maternal health care services offers a possibility to improve the existing care, both in content, access and availability where the timing of visits and content require further evaluation.

This study reviewed the literature concerning the involvement by European men in pregnancy and childbirth and examined how this is related to health outcomes; for the men themselves, their partners, and their children. The study also reflects on the literature in relation to other existing research on men, masculinities, and fatherhood. The literature review support the idea that the father’s involvement during pregnancy and delivery can positively influence health outcomes for the man, his partner, and their children. However, little help is offered to the majority of men regarding parenting. It is therefore crucial for the maternal and child healthcare services to develop new ways of reaching out to men. In order to develop new knowledge earlier research needs to be complemented with a multidisciplinary approach where the existing research material, on social science regarding men, masculinities, and fatherhood is also taken into consideration.

Objective: to describe the experiences of immigrant parents of an ultrasound examination in the second trimester of pregnancy, highlighting information, communication, thoughts, feelings and well-being. Methods: An exploratory, qualitative study using in-depth interviews with parents separately. Content analysis was used. A total of nine Farsi-speaking couples, in all 18 persons, who now live in Sweden, were interviewed. Results: Four main categories emerged from the parents’ descriptions: experiencing professionals who were informative and communicative, experiencing the first encounter with their unborn child, experiencing a well-planned routine and experiencing a humanistic encounter within the healthcare organisation. Conclusion: Parents saw the ultrasound examination as a means of: getting visual confirmation of their pregnancy, reassurance about the health and well-being of their foetus and making connection with their baby; and receiving confirmation of their baby’s gender. The parents were impressed by the quality of their communication with the care-givers, which influenced their judgement of the whole procedure, including the technical quality of the care.