Christine Rubertsson

• RN, RM, MA, PhD
• Professor at Lund University

Introduction Postnatal perineal pain is prevalent following childbirth and can impact women both physically and emotionally. The aim of the study was to study the effect of collegial midwifery assistance on perineal pain and pain medication 1 month after birth and to investigate the associations between the type of tear and perineal pain, satisfact...

Objective To compare experiences of the second stage of labour in women randomised to assistance by one or by two midwives to reduce severe perineal trauma (SPT). Design Analysis of a secondary outcome within the Swedish Oneplus multicentre randomised trial. Setting Five obstetric units in Sweden between December 2018 and March 2020. Participant...

Objectives To study informed consent to midwifery practices and interventions during the second stage of labor and to investigate the association between informed consent and experiences of these practices and interventions and women’s experiences of the second stage of labor. Methods This study uses an observational design with data from a follow...

Background Learning is a lifelong process and the workplace is an essential arena for professional learning. Workplace learning is particularly relevant for midwives as essential knowledge and skills are gained through clinical work. A clinical practice known as ‘Collegial Midwifery Assistance’ (CMA), which involves two midwives being present durin...

Background Male involvement in maternal health care has proven to be beneficial for improving maternal and child health and is often crucial in areas of family planning and contraceptive use. However, compared to male involvement in maternal health care, male involvement in contraceptive counselling is complex and controversial and thus faces certa...

Background Despite a flux of global initiatives to increase and sustain breastfeeding rates, challenges persist. The decision to commence and sustain breastfeeding is influenced by multiple, complex factors. Feelings of social embarrassment, shame, fear of judgement, and lack of confidence when breastfeeding in public, compound women’s decisions to...

Background It has been reported that caseload midwifery, which implies continuity of midwifery care during pregnancy, childbirth, and the postnatal period, improves the outcomes for the mother and child. The aim of this study was to review benefits and risks of caseload midwifery, compared with standard care comparable to the Swedish setting where...

Background Breastfeeding in the public sphere is known to be experienced as a problem for many women. It has been shown to arouse negative feelings among the public, depending on the attitude of those in the immediate surroundings. This contributes to the fact that many women hesitate to breastfeed in public and prepare themselves for potential adv...

Background Collegial midwifery assistance during the active second stage of labor that involves a second midwife being present has been shown to reduce severe perineal trauma (SPT) by 30%. The aim of this study was to investigate primary midwives' experiences of collegial midwifery assistance with the purpose of preventing SPT during the active sec...

Background: Negative encounters in healthcare might affect women's health. During their reproductive life span, women are exposed to various health examinations, and have reported disrespectful care and obstetric violence. Such experiences might be a basis for fear of birth. Aim: to explore and describe the prevalence, associated factors and exp...

Background Despite a flux of global initiatives to increase breastfeeding, disparate rates persist. The decision to commence and sustain breastfeeding is influenced by a myriad of variables, not least by the prospect of breastfeeding in public. Feelings of social embarrassment, shame, fear of judgement, and lack of confidence when breastfeeding in...

Qualitative evidence has revealed that women face challenges breastfeeding in public. It is important to gain a greater understanding of these challenges, and, also, how women manage breastfeeding in the presence of someone they are uncomfortable with. Insight into what women perceive as helpful when considering whether to breastfeed in public warr...

Immigrant women in Sweden often have unmet sexual and reproductive health (SRH) needs. Successful contraceptive counselling may improve their sexual and reproductive health and rights. The unique Swedish model, with midwives as the main providers of contraceptive counselling, is important for immigrant women's health at both individual and societal...

(Abstracted from Lancet 2022;399:1242–1253) In many high-income countries, severe perinatal trauma (SPT), affecting the anal sphincter muscle complex, has been on the rise over the last decade. However, effective strategies to prevent SPT are scarce.

Introduction: Self-compassion and satisfaction derived from helping others is part of healthcare providers' professional quality of life. The aim of this study was to explore and psychometrically test two instruments measuring self-compassion and professional quality of life among midwives and nurse assistants. Methods: This was a cross-sectiona...

Background: Screening immigrant mothers for postpartum depression has been shown to be challenging for health care professionals in handling cultural implications of postpartum depression, communicating through interpreter and applying translated versions of the screening scale. Aim: The aim of the study was to test the feasibility of an evidenc...

Background Many high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described. Aim To describe midwifery preceptors and midwifery students’ experiences’ of teaching and learning how to manage the second stage of labour, with the...

The aim of this study was to investigate the prevalence of depressive symptoms and associated factors in women who underwent treatments for fear of birth; internet-based cognitive therapy, counseling with midwives, continuity with a known midwife or standard care. A secondary analysis was performed using data collected from four samples of women id...

Background Severe perineal trauma (SPT) affecting the anal sphincter muscle complex is a serious complication following childbirth, associated with short-term and long-term maternal morbidity. Effective preventive strategies are still scarce. The aim of the Oneplus trial was to test the hypothesis that the presence of a second midwife during the se...

Background There has been an increased focus on clinical practice that may reduce severe perineal trauma due to awareness of the associated morbidity. Knowledge regarding the best practice to reduce these injuries is limited. Collegial midwifery assistance during the second stage of labour that involves an additional midwife being present has recen...

Background Co-morbidity is prevalent in women with fear of birth. Depressive symptoms and lack of prenatal attachment might influence the postpartum bonding between the mother and the new-born. Aim To examine the underlying dimensions of the Postpartum Bonding Questionnaire and to investigate associations between depressive symptoms, prenatal atta...

Background The second stage of labour is generally considered as an intensive part of labour. Despite this, knowledge about women’s experiences of the second stage of labour is scant. Aim To explore experiences of the second stage of labour in women with spontaneous vaginal birth. Methods This is a qualitative study where twenty-one women with a...

Introduction: Despite preeclampsia being one of the most severe obstetrical complications there is only scant research describing women's experiences of preeclampsia. The aim of this study was to explore women's experience during pregnancy and the postpartum period regarding the provided information and care concerning preeclampsia. Methods: A q...

Objective: To evaluate the associations of depressive symptoms and antidepressant use during pregnancy with the risks of preterm birth, low birth weight, small for gestational age (SGA), and low Apgar scores. Data sources: MEDLINE, EMBASE, ClinicalTrials.gov, and PsycINFO up to June 2016. Methods of study selection: Data were sought from studi...

Introduction: Continuity models are rare in Sweden. The aim was to compare the intrapartum care experiences between women who had or not a known midwife attending their birth. Methods: A cohort study was conducted in a rural area with long distance to a labor ward in Sweden. From August 2017 to June 2019, a continuity model with a known midwife...

This article offers an analysis of three popular Swedish handbooks for new parents, written by authors in the “media class.” In these texts breastfeeding as a gendered, embodied practice collides with the Swedish ideal of gender-equal parenting. The analysis explores the various ways that gendered bodies, gendered (parental) rights, and gender equa...

Objective: The aim was to investigate birth outcome and birth experience in relation to women's emotional heslth. An additional aim was to explore the relationship between emotional health, continuity with a known midwife, and the birth experience. Methods: A prospective longitudinal cohort study of 243 women enrolled in a continuity of care pro...

An amendment to this paper has been published and can be accessed via the original article.

Background Severe perineal trauma sustained during childbirth is a serious complication since it can lead to both short- and long-term consequences for women. Some of the methods used to prevent perineal injuries have been evaluated in clinical trials, but there are still gaps in the evidence. A new clinical practice has been introduced, adopted by...

Background: Breastfeeding in public continues to be contentious with qualitative evidence confirming that women face many challenges. It is therefore important to gain understanding of not only the challenges but also what women perceive is helpful to breastfeed in public. Methods: A cross-sectional study was conducted with women living in Austr...

Background: Breastfeeding provides health benefits to both women and children. The rationale behind an individual woman's decision to breastfeed or not can depend on several factors, either independently or in combination. The aim of the current study was to explore attitudes towards breastfeeding among pregnant women in Sweden who intend to breas...

Background Continuity models of midwifery care are rare in Sweden, despite its well-known positive effects. The aim was to describe pregnancy and birth outcome in women participating in a continuity of care project in a rural area of Sweden. Method A register-based study of 266 women recruited to the project and a control group of 125 women from t...

Objective: The aim of this study was to explore the “Birth Attitude Profile Scale (BAPS)” in a selected sample of women with fear of birth. Another aim was to develop profiles of women according to their birth attitudes and levels of childbirth fear in relation to background characteristics. Methods: A secondary analysis of data collected in two di...

Objective: Although fear of birth is common during pregnancy and childbirth, the best treatment for fear of birth in clinical care remain unclear. Strong evidence suggests that continuity models of midwifery care can benefit women and birth outcomes, though such models are rare in Sweden. Because women with fear of birth could benefit from such mo...

Background The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. Few women achieve this recommendation in Sweden, and they often stop breastfeeding earlier than they would like. Investigating women’s advice to healthcare professionals...

This article explores if conversations about literary texts that thematize abortion can provide new knowledge about the clinical everyday practice of midwives. The empirical material consists of conversations with seven clinical midwives after shared reading of a sample of fictional and biographical Swedish texts from the 1930s, 1950s, 1990s, and 2...

Background: Although women with fear of birth often report negative birth experiences, few studies have focused on their experiences in the long term. The aim of this study was to compare birth experiences a year after childbirth in two groups of women receiving treatment for experiencing fear of birth during pregnancy. Methods: As part of the U-CA...

Background: There is evidence that continuity of midwifery care is beneficial to women. Women with fear of childbirth in Sweden are offered counselling, but receiving care from a known midwife during labour is unusual, despite its effects in reducing interventions and increasing birth satisfaction. The aim of this study was to describe and compare...

Background: Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive B...

Background Depressive symptoms negatively impact on breastfeeding duration, whereas early breastfeeding initiation after birth enhances the chances for a longer breastfeeding period. Our aim was to investigate the interplay between depressive symptoms during pregnancy and late initiation of the first breastfeeding session and their effect on exclus...

Many pregnant women experience fear, worry or anxiety relating to the upcoming childbirth. The aim of this cross‐sectional study was to investigate possible subgroups in a sample of 206 pregnant women (mean age 29.4 years), reporting fear of birth in mid‐pregnancy. Comparisons were made between nulliparous and parous women. In a series of cluster a...

Aim: Having a known midwife at birth is valued by women across the world, however it is unusual for women with fear of childbirth to have access to this model of care. The aim of this study was to describe the prevalence and factors related to having access to a known midwife for women referred to counseling due to childbirth fear. We also wanted...

Objective To describe mothers’ experiences of providing their preterm infants with Kangaroo Mother Care (KMC). Study design A qualitative descriptive design. Setting Two level III neonatal intensive care units (NICUs) in Sweden. Participants Thirteen mothers of preterm infants. Methods The mothers were interviewed when their infant had reached...

Background: Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women's views about counselling for childbirth fe...

Background: Although many pregnant women report fear related to the approaching birth, no consensus exists on how fear of birth should be handled in clinical care. Objective: This randomized controlled trial aimed to compare the efficacy of a guided internet-based self-help program based on cognitive behavioral therapy (guided ICBT) with standar...

Objective Continuity with a known midwife might benefit women with fear of birth, but is rare in Sweden. The aim was to test a modified caseload midwifery model of care to provide continuity of caregiver to women with fear of birth. Methods A feasibility study where women received antenatal and intrapartum care from a known midwife who focused on...

Aim: The aim of this pilot study was to explore the Fear of Birth Scale in a mixed sample of women of childbearing age, by investigating the levels of childbirth fear and the content of women's thoughts when completing the scale. Methods: A cross-sectional mixed method study of 179 women who completed a short questionnaire and a think aloud inte...

Background Breastfeeding rates in Sweden are declining, and it is important to identify women at risk for early cessation of exclusive breastfeeding. Objective The aim of this study was to investigate factors associated with exclusive breastfeeding lasting less than two months postpartum. Methods A population-based longitudinal study was conducte...

Fear of birth is a concern that requires evidence based treatment. The aim of this study is to present the protocol of a randomized controlled multi-center trial to compare internet-based cognitive therapy with counseling as standard care for pregnant women reporting fear of birth. Participants will be recruited in mid-pregnancy. Women who score 60...

Background: In order to improve the health and survival of mothers/newborns, the quality and attendance rates of postpartum care (PPC) must be increased, particularly in low-resource settings. Objective: To describe outcomes of a collegial facilitation intervention to improve PPC in government-owned health institutions in a low-resource suburb in D...

Background: Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Methods:...

Aim: This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home. Methods: The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fa...

Background: Breastfeeding initiation rates in some developed countries are high (98 % in Sweden and 96 % in Australia) whereas in others, they are not as favourable (46 % to 55 % in Ireland). Although the World Health Organization recommends exclusively breastfeeding for six months, 15 % of Australian women, 11 % of Swedish women and less than 7 %...

Background Enabling women to make informed decisions is a key objective in the guidelines governing prenatal screening and diagnostics. Despite efforts to provide information, research shows that women’s choice of prenatal screening is often not based on informed decisions. The aim of this study was to investigate pregnant women’s perceptions of th...

Objective: To explore healthcare providers' perceptions of the current postpartum care (PPC) practice and its potential for improvement at governmental health institutions in low-resource suburbs in Dar es Salaam, Tanzania. Design: Qualitative design, using focus group discussions (8) and qualitative content analysis. Setting: Healthcare insti...

Aim: This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored. Methods: A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28+0 to 33+6 and followed up t...

https://uu.diva-portal.org/smash/get/diva2:891889/FULLTEXT01.pdf

Objective: To investigate the association between the magnitude of foetal movements and level of prenatal attachment within a 24h period among women in the third trimester of pregnancy. Design: a prospective population-based survey. Setting: A county in central Sweden. Participants: Low risk pregnant women from 34 to 42 weeks gestation, N=45...

Background: Counseling by experienced midwives is offered to women with childbirth fear in most obstetric clinics in Sweden, but information about the content of such counseling is lacking. Aim: To study comprehensiveness, content and organization of the midwife-led counseling for childbirth fear in all obstetric clinics in Sweden. Methods: In...

Background: Fear of childbirth is common during pregnancy but rarely assessed in clinical practice. The Fear of Birth Scale has been proposed as a valid measure suitable for assessing fear of birth in an antenatal clinical context. To make sure that the scale makes sense in relation to the known constructs of fear of birth, it is important to find...

That society divides its members into females and males is the point of departure for much research on gender and language and yet the situated accomplishment of the primordial sex categorisation of the newborn child has not attracted much scholarly attention. The present study fills this research gap by exploring the interactional organisation of...

Studies of breastfeeding patterns during preterm infants' first year of life are scarce but are important for providing breastfeeding mothers of preterm infants with optimal support. This study aimed to describe breastfeeding patterns in preterm infants up to 1 year of corrected age. As part of a larger study on kangaroo mother care in Sweden, a 24...

Objective: The objective of this study was to evaluate attachment and its association to obstetric and demographic factors as well as emotional well-being using a standard measure of prenatal attachment during pregnancy. Background: The strength of the mothers’ relationship with her baby has important implications in the postnatal period, influenci...

Objective To investigate women's experiences of attending existing counseling programs for childbirth-related fear and the effect of this counseling over time.DesignA longitudinal survey. Setting: Three hospitals in the middle-north of Sweden.SampleA selected sample of 936 women. Of these, 70 received counseling due to fear of childbirth (study-gro...

to investigate the prevalence of childbirth related fear (CBRF) in early pregnancy among both Swedish born and foreign born women living in Sweden. a cross sectional prevalence study. Data was collected by a questionnaire, which was available in Swedish and eight other languages. a university hospital in the middle of Sweden. the recruitment took p...

Background Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women’s compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women’s experiences using two different self-assessment methods for monitoring fetal movem...

AimEarly parental bonding with preterm babies is particularly important, and the aim of our study was to explore when parents experienced what they regarded as important events for the first time while their infant was in the neonatal intensive care unit (NICU). Methods The study was part of a longitudinal project on Kangaroo Mother Care at two Swe...

Objective: The aim of this study was to investigate the prevalence of healthcare professionals' use of the hands-on approach during the first breastfeeding session postpartum and its possible association with the mothers' experience of their first breastfeeding session. Materials and methods: This was a population-based longitudinal study conduc...

To study women's description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis. Data were collected by distributing questionnaires including an open que...

ABSTRACT Objective: To explore the underlying structure of the Prenatal Attachment Inventory (PAI) and to assess the psychometric properties of the subscales. Background: The establishment of the mother–fetus relationship is an important developmental task for successful adaption to pregnancy, with implications for the well-being of mother and chil...

Antenatal anxiety symptoms are not only a health problem for the expectant mother. Research has found that maternal anxiety may also have an impact on the developing baby. Therefore, it is important to estimate the prevalence of maternal anxiety and associated factors. The current study aims to estimate the prevalence of anxiety symptoms during the...

To investigate the prevalence of soft markers identified at second trimester ultrasound in a low-risk population and their association with trisomies and invasive testing. Prospective observational study. Setting: Swedish University Hospital. All women with fetuses examined by ultrasound at 15(+0) -22(+0) weeks gestation between July 2008 and March...

to compare self-rated health and perceived difficulties during pregnancy as well as antenatal attendance, birth experience and parental stress in fathers with and without childbirth related fear. a longitudinal regional survey. Data were collected by three questionnaires. three hospitals in the middle-north part of Sweden. 1047 expectant fathers re...

To compare perceptions of antenatal and intrapartum care in women categorized into three profiles based on attitudes and fear. Prospective longitudinal cohort study using self-report questionnaires. Profiles were constructed from responses to the Birth Attitudes Profile Scale and the Fear of Birth Scale at pregnancy weeks 18 to 20. Perception of th...

This paper has two main aims: to explore fathers' postnatal care experiences with a specific focus on deficiencies and to investigate which service deficiencies remained important for fathers one year after childbirth. This is a prospective longitudinal study. Two months and one year after birth, the overall satisfaction with care were sought. A ca...

Objective: to investigate the prevalence of childbirth related fear in Swedish fathers and associated factors. Design: a regional cohort study. Data was collected by a questionnaire. Setting: three hospitals in the middle-north part of Sweden Participants: 1047 expectant fathers recruited in mid-pregnancy during one year (2007) who completed...

Objective To compare self rated health and perceived difficulties during pregnancy as well as antenatal attendance, birth experience and parental stress in fathers with and without childbirth related fear. Design A longitudinal regional survey. Data were collected by three questionnaires. Setting Three hospitals in the middle-north part of Sweden...

Background Women’s fears and attitudes to childbirth may influence the maternity care they receive and the outcomes of birth. This study aimed to develop profiles of women according to their attitudes regarding birth and their levels of childbirth related fear. The association of these profiles with mode and outcomes of birth was explored. Methods...

To describe initiation and extent of parents’ application of skin-to-skin care (SSC) with their preterm infants at two Swedish neonatal intensive care units. The duration of SSC was recorded in 104 infants’ medical charts during their hospital stay, and the parents answered a questionnaire. Both parents were involved in the practice of SSC. Three i...

Background: Kangaroo Mother Care (KMC) supports parents' role at the neonatal intensive care unit (NICU). To enhance parents' provision of KMC, it is essential to obtain knowledge of what parents perceive as supportive factors and barriers regarding their opportunities to perform KMC. Aim: To identify factors that parents of preterm infants perc...

Background: Satisfaction with antenatal care could differ depending on the organisation and the context of care. Aim: To compare antenatal care in Australia and Sweden, to identify deficiencies in the content of antenatal care and what aspects contributed most in dissatisfaction with antenatal care. Methods: A longitudinal survey of 123 Austra...

Women's fears and attitudes to childbirth may influence the maternity care they receive and the outcomes of birth. This study aimed to develop profiles of women according to their attitudes regarding birth and their levels of childbirth related fear. The association of these profiles with mode and outcomes of birth was explored. Prospective longitu...

While attending birth mostly has a positive impact on becoming a father, it has also been described as including feelings of discomfort and is more demanding than expected. The objective was to explore Swedish fathers' birth experiences, and factors associated with a less-positive birth experience. Mixed methods including quantitative and qualitati...

This article is a report on a descriptive study of fathers’ experiences of providing their preterm infants with Kangaroo Mother Care. During neonatal intensive care, fathers describe the incubator as a barrier and the separation from their infant as stressful. Fathers consider it important to be close to the infant, and performing Kangaroo Mother C...

Background: the rate of caesarean in Australia is twice that of Sweden. Little is known about women's attitudes towards birth in countries where the caesarean rate is high compared to those where normal birth is a more common event. Objectives: to compare attitudes and beliefs towards birth in a sample of Australian and Swedish women in mid-preg...

Around 10-15% of women suffer from depressive illness during pregnancy or the first year postpartum. Depression during pregnancy constitutes a risk for prenatal stress and preterm birth. No validated screening instrument for detecting depression during pregnancy was available in Swedish. We aimed to validate the Edinburgh Postnatal Depression Scale...

Kangaroo Mother Care (KMC) is an alternative model of care that prevents parent-infant separation when preterm infants need neonatal intensive care by skin-to-skin contact between infants and their parents. KMC is also a strategy that involves parents in their infants’ care and enables them to assume the responsibility for the care. Furthermore, KM...

To identify areas in need of quality improvement by investigating inpatients' perceptions of quality of care, and to identify differences in perceptions of care related to patient gender, age and type of admission. Nursing managers play an important role in the development of high-quality care. Quality of care was assessed using the Quality from th...

Background Fathers involvement in pregnancy and childbirth has increased and this can benefit their own health as well as their partners' and children's health The objective of this study was to investigate the sources of pregnancy and childbirth information that expectant fathers used in pregnancy with a specific focus on the Internet Methods This...

Cesarean section performed in the absence of medical indication is of concern in many countries, but studies focusing on its prevalence are inconclusive. The objective of this study was, first, to describe the prevalence of cesarean section without medical reason in terms of the diagnostic code listed in the Swedish Medical Birth Register, and to a...

Please cite this paper as: Johansson M, Rådestad I, Rubertsson C, Karlström A, Hildingsson I. Few fathers-to-be prefer caesarean section for the birth of their baby. BJOG 2010; DOI: 10.1111/j.1471-0528.2010.02508.x. The objective of this study was to investigate prospective fathers’ preferences for caesarean section and associated factors. Data wer...