Helen Elden

• Professor
• Professor (Full) at University of Gothenburg

Background Mitigation measures implemented in response to the COVID‐19 pandemic led to significant changes in maternity care across Europe, including restrictions on companions during labor and birth. This cross‐sectional study explores the association between the presence of a companion of choice and a positive perception of the birth experience....

Background Opportunistic salpingectomy performed during benign hysterectomy to reduce ovarian cancer risk has uncertain long-term effects on ovarian function, potentially resulting in earlier menopause. As opportunistic salpingectomy is performed as a preventive intervention without a medical indication, it is essential that the decision to undergo...

Background Remote patient monitoring implies continuous follow-up of health-related parameters of patients outside healthcare facilities. Patients share health-related data with their healthcare unit and obtain feedback (which may be automatically generated if data are within a predefined range). The goals of remote patient monitoring are improveme...

Introduction Maternal‐neonatal healthcare services were severely disrupted during the COVID‐19 pandemic in even high‐income countries within the World Health Organization (WHO) European Region. The objective of this study was to compare trends in the quality of maternal and neonatal care (QMNC) in Sweden and Norway to 12 other countries from the WH...

Background Health workers’ (HWs’) perspectives on the quality of maternal and newborn care (QMNC) are not routinely collected. In this cross-sectional study, we aimed to document HWs' perspectives on QMNC around childbirth in 12 World Health Organization (WHO) European countries. Methods HWs involved in maternal/neonatal care for at least one year...

Background As notions of masculinity evolve globally, it is important to understand their dimensions within geographic regions and life contexts. African men’s involvement in their partners’pregnancy and childbirth has been explored to a limited extent in the peer-reviewed literature. This analysis provides a comprehensive examination of the existi...

Background To prevent the spread of SARS‐CoV‐2, hospitals around the world adopted protocols that, in varying ways, resulted in the exclusion of partners from hospital postnatal care wards. The objective of this study was to examine the effect this exclusion had on partners' satisfaction with postnatal care. Methods An online survey (the Swedish P...

Background In Sub-Saharan Africa, the postnatal period is associated with high mortality and accounts for a substantial proportion of maternal deaths. Although postnatal care has been identified as critical in reducing maternal mortality, the quality of care provided is often inadequate. Tanzania and Zanzibar have not made sufficient progress towar...

Background Effective family planning is associated with substantial benefits, including reductions in maternal and neonatal mortality due to the avoidance of unintended pregnancies, and contributions to spacing, timing, and limiting births. However, in Zanzibar, Tanzania, the utilization of modern contraceptive methods is low. This study therefore...

Background: Pre-eclampsia affects 3-5% of all pregnant women and is among the leading causes of maternal morbidity and mortality as well as iatrogenic preterm birth worldwide. Little is known about the experience of partners of women whose pregnancy is complicated by pre-eclampsia. Aim: To describe partners' experience of having a spouse whose p...

Parents are not only caregivers to their children; they also have leisure routines that can impact their own well-being. However, little is known about how leisure activities change within the context of a couple during the transition to parenthood. This study uses latent growth curve models and data from the Swedish Pregnancy Panel to examine how...

Background Induction of labor is increasing worldwide, and some countries have started to introduce outpatient induction in low‐risk women. Objectives To assess current knowledge concerning the safety, efficacy, women's experience, and economic costs of outpatient induction compared with inpatient induction. Search strategy Multiple databases wer...

Background In Uganda, the uptake of maternal health services is very low, with only 41.1% of pregnant adolescent girls attending the eight antenatal visits that are recommended by the World Health Organisation. Uptake of maternal health services is essential in reducing the current level of adolescent pregnancies as well as its adverse effects on a...

Objective To explore the quality of maternal and newborn care (QMNC) during the COVID‐19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean. Methods Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates...

Objective To describe the perception of quality of maternal and newborn care (QMNC) around the time of childbirth among migrant and nonmigrant women in Europe. Methods Women who gave birth at a health facility in 11 countries of the WHO European Region from March 2020 to July 2021 were invited to answer an online questionnaire including demographi...

Objective To investigate potential associations between individual and country‐level factors and medicalization of birth in 15 European countries during the COVID‐19 pandemic. Methods Online anonymous survey of women who gave birth in 2020–2021. Multivariable multilevel logistic regression models estimating associations between indicators of medic...

Background Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates...

Introduction Obstetric brachial plexus palsy (OBPP) is a serious form of neonatal morbidity. The primary aim of this population‐based registry study was to examine temporal trends, 1997–2019, of OBPP in infants delivered vaginally in a cephalic presentation. The secondary aim was to examine temporal changes in the incidence of associated risk facto...

Background Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID19 pandemic, as defined by WHO Standards, are lacking. Methods Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measu...

Introduction According to the World Health Organization, the medicalisation of birth tends “to undermine the woman's own capability to give birth and negatively impacts her childbirth experience”. The COVID-19 pandemic has disrupted maternity care, with potential increase in the medicalisation of birth and in occurrences of disrespectful maternity...

Rationale Holistic antenatal care requires knowledge of individuals’ emotional response to pregnancy. Little is known about how a pregnant woman and her partner influence each other emotionally during a pregnancy. Objective This study examines six discrete emotions that expectant couples experience during pregnancy, how these emotions change mid-t...

[This corrects the article DOI: 10.1016/j.lanepe.2021.100268.].

Purpose There is a trend worldwide to induce pregnant women earlier. However, few studies have focused on women’s experiences. The aim was to gain a deeper understanding of women’s lived experiences of induction of labour in late- and post-term pregnancy. Methods Phenomenology with a reflective lifeworld approach was chosen as the method. Twelve w...

Objectives Develop and validate a WHO Standards-based online questionnaire to measure the quality of maternal and newborn care (QMNC) around the time of childbirth from the health workers’ perspective. Design Mixed-methods study. Setting Six countries of the WHO European Region. Participants and methods The questionnaire is based on lessons lear...

Background Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic, as defined by WHO Standards, are lacking. Methods Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Meas...

Background and Problem Existing healthcare systems have been put under immense pressure during the COVID-19 pandemic. Disruptions in essential maternal and newborn services have come from even high-income countries within the World Health Organization (WHO) European Region. Aim To describe the quality of care during pregnancy and childbirth, as re...

Objective To evaluate the efficacy of a memory-foam mattress and pillow plus standard treatment for nightly pelvic girdle pain (PGP) during pregnancy. Method In this randomised controlled study conducted at a tertiary-care hospital, 66 pregnant women who had nightly PGP were enrolled to receive standard treatment with the mattress and pillow (inte...

Background: Postpartum septic symphysitis (PPSS) is defined as acute onset of severe pain around the symphysis, restricted movement, fever, and elevated inflammatory parameters. It is a rare but serious condition requiring urgent diagnosis and treatment. The aim of this study was to describe the incidence, symptoms, diagnosis, treatment, and long-...

Background Failure to identify severely ill obstetric patients seeking acute care, and hence delaying treatment, can lead to maternal morbidity and mortality. Triage is the prioritization of patients seeking emergency care, based on clinical decision-making tools assessing medical urgency. While triage has been applied in general emergency medicine...

Introduction Pre-eclampsia, a multisystem disorder in pregnancy, is one of the most common causes of maternal morbidity and mortality worldwide. However, we lack methods for objective assessment of organ function in pre-eclampsia and predictors of organ impairment during and after pre-eclampsia. The women’s and their partners’ experiences of pre-ec...

Objective: To assess the cost-effectiveness of induction of labour (IOL) at 41 weeks of gestation compared with expectant management until 42 weeks of gestation. Design: A cost-effectiveness analysis alongside the Swedish Postterm Induction Study (SWEPIS), a multicentre, randomised controlled superiority trial. Setting: Fourteen Swedish hospit...

Background Triage, identifying patients with critical and time-sensitive disorders, is an integrated process in general emergency medicine. Obstetric triage is more specialised, requiring assessment of both woman, fetus and labour status. Failure to identify severely ill obstetric patients has repeatedly led to maternal morbidity and mortality. Rel...

Background Triage, identifying patients with critical and time-sensitive disorders, is an integrated process in general emergency medicine. Obstetric triage is more specialised, requiring assessment of both woman, fetus and labour status. Failure to identify severely ill obstetric patients has repeatedly led to maternal morbidity and mortality. Rel...

Introduction: Induction of labor is increasing in the world. A common indication for Induction of labor is late term and postterm pregnancy at 41 gestational week and thereafter. We aimed to evaluate if there are any differences regarding efficacy, safety, and women's childbirth experience between oral misoprostol and transvaginal balloon catheter...

Objective To compare childbirth experiences in women randomly assigned to either induction of labour at 41 weeks or to expectant management until 42 weeks, in the Swedish Post-term Induction Study. Design A register-based, multicentre, randomised, controlled, superiority trial. Setting Women were recruited at 14 hospitals in Sweden, 2016–2018. P...

Background Many women develop pelvic girdle pain (PGP) during pregnancy and about 10% have chronic pain several years after delivery. Self-administered pain provocation tests are one way to diagnose and evaluate this pain. Their validity in post-partum women is not yet studied. The purpose of this study was to evaluate the validity of self-administ...

Introduction: We aimed to assess cognitive function in women with preeclampsia stratified by severity, before and after onset of disease. Material and methods: Prospective study performed at a referral hospital in Cape Town, South Africa. Pregnant women between 20 and 42 weeks of gestation with eclampsia, pulmonary edema and preeclampsia without...

Background Postpartum septic symphysitis (PPSS) is defined as acute onset of severe pain around the symphysis, restricted movement, fever and elevated inflammatory parameters. It is a rare but serious condition requiring urgent diagnosis and treatment. The aim of this study was to describe the incidence, symptoms, diagnosis, treatment and long-term...

Background Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID19 pandemic, as defined by WHO Standards, are lacking. Methods Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measu...

Background One of the groups that is most vulnerable to the COVID-19 pandemic is pregnant women. They cannot choose to refrain from care; they and their children are at risk of severe complications related to the virus; and they lose comfort and support as clinics prohibit their partners and as societal restrictions demand isolation from friends an...

Background One of the groups that is most vulnerable to the COVID-19 pandemic is pregnant women. They cannot choose to refrain from care; they and their children are at risk of severe complications related to the virus; and they lose comfort and support as clinics prohibit their partners and as societal restrictions demand isolation from friends an...

How stable is gender identity when facing important gendered life events? In the study of gender identity, little research has focused on adulthood experiences that might modify or reinforce self-perceptions of gender traits. This article uses pregnancy and early parenthood to study stability and change in self-perceived female and male traits. We...

How stable is gender identity when facing important gendered life events? In the study of gender identity, little research has focused on adulthood experiences that might modify or reinforce self-perceptions of gender traits. This article uses pregnancy and early parenthood to study stability and change in self-perceived female and male traits. We...

Background Pregnant women living as undocumented migrants navigate multiple and layered liminalities, exacerbating their vulnerability, and accenting ambiguity and uncertainty in their lives. Whilst previous research has addressed these women's interactions with healthcare institutions, the present study's aim was to explore their experiences of da...

Background: Late-term pregnancy is related to increased risk of serious complications for babies and women, as pregnancies proceed. Pregnancy is an individual, complex and existential situation for women, who may experience late-term pregnancy as a mentally strenuous period, characterised by worries and anxiety. However, there is a lack of studies...

Purpose To describe the experiences of non-medical discipline staff of difficulties and possibilities in inter-professional communication within the radiology department and remitting departments. Materials and Methods Three focus group interviews were conducted with 16 non-medical discipline staff in a radiology department at a university hospita...

(Abstracted from BMJ 2019;367:l6131) Adverse perinatal outcomes such as stillbirth and maternal complications have been shown to gradually increase postterm (≥42 weeks [≥294 days]). Despite this, no international agreement exists on how to manage late-term pregnancies (although the World Health Organization does recommend induction of labor at 41 w...

Objective To evaluate if induction of labour at 41 weeks improves perinatal and maternal outcomes in women with a low risk pregnancy compared with expectant management and induction of labour at 42 weeks. Design Multicentre, open label, randomised controlled superiority trial. Setting 14 hospitals in Sweden, 2016-18. Participants 2760 women with...

Purpose: The aims of this study were to translate and culturally adapt The Pelvic Girdle Questionnaire to Swedish, and to evaluate the construct and discriminative validity. Materials and methods: A translation and cultural adaptation process was performed according to international guidelines. Pilot tests were conducted among 16 women during pregn...

Background: Studies from around the world have shown that women living as undocumented migrants have limited and deficient access to perinatal care, increasing their risks of both physical and psychological complications during pregnancy and childbirth. Failures to provide equal access to healthcare have been criticized extensively by the United N...

Background Globally, the prevalence of post term pregnancy (PTP) is about 5-10%, but the rate varies considerably between and within countries. PTP is defined as a pregnancy ≥294 days, but the definition is arbitrary. Many studies focusing on the prevalence, risks and management of PTP include pregnancies ≥41 gestational weeks (GW). However, qualit...

Background Pelvic girdle pain (PGP) is a multifactorial condition, which can be mentally and physically compromising both during and after pregnancy. However, long-term pregnancy-related PGP has been poorly investigated. This longitudinal follow-up study uniquely aimed to describe prevalence and predictors of PGP and its consequences on women’s hea...

Background: Observational data shows that postterm pregnancy (≥42 gestational weeks, GW) and late term pregnancy (≥41 GW), as compared to term pregnancy, is associated with an increased risk for adverse outcome for the mother and infant. Standard care in many countries is induction of labour at 42 GW. There is insufficient scientific support that...

Background: Observational data shows that postterm pregnancy (≥42 gestational weeks, GW) and late term pregnancy (≥41 GW), as compared to term pregnancy, is associated with an increased risk for adverse outcome for the mother and infant. Standard care in many countries is induction of labour at 42 GW. There is insufficient scientific support that i...

Background: The incidence of obstetric anal sphincter rupture (OASR) is increasing. It may cause anal incontinence and dys-pareunia, leading to reduced quality of life and wellbeing. Qualitative studies are lacking. The aim was to describe experiences of living with ongoing severe consequences of an OASR ≥ 8 weeks after childbirth. Method: Twenty w...

Background: Pelvic girdle pain (PGP) is a universally disabling condition affecting approximately 50% of pregnant women. Qualitative research describes how PGP leads to struggle in women's daily lives, makes them question and doubt their roles and identities as professionals and mothers, and test their (marital) relationships. The purpose of this s...

Background: Pelvic girdle pain (PGP) affects 50% of pregnant women worldwide. PGP increases with advancing pregnancy with considerable impact on quality of life, interfering with sleep, daily activities, work, motherhood and close interpersonal relationships. The use of Complementary and Alternative Medicine (CAM) is increasingly prevalent among pr...

Different tests are used in order to classify women with pelvic girdle pain (PGP). One limitation of the tests is that they need to be performed by an examiner. Self-administered tests have previously been described and evaluated by women who performed the tests directly before the examiner performed the original tests. Thus, an evaluation of the s...

Background: Pelvic girdle pain (PGP) is a universal problem affecting approximately 50% of all pregnant women. For 25 to 30% of pregnant women the problem becomes severe. Methods: In-depth interviews were carried out with 27 pregnant women with severe PGP in 2009-2010. Qualitative content analysis was used. Results: The women’s experiences are summ...

Objective To investigate whether acupuncture has a greater treatment effect than non-penetrating sham acupuncture in women with pelvic girdle pain (PGP) during pregnancy. Design Randomised double-blinded controlled trial. Setting East Hospital, Gothenburg, and 25 antenatal primary care units in the region of Västra Götaland, Sweden. Population A to...

Pelvic girdle pain (PGP) is a universally disabling condition affecting three of 10 pregnant women. Qualitative studies on the subject are lacking. To describe pregnant women's experiences of PGP as related to daily life. In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010-2011. Qualitative content...

Pelvic girdle pain (PGP) is a disabling condition affecting 30% of pregnant women. The aim of this study was to investigate the efficacy of craniosacral therapy as an adjunct to standard treatment compared with standard treatment alone for PGP during pregnancy. Randomized, multicenter, single blind, controlled trial. University hospital, a private...

The aim of this study was to investigate sensitivity and specificity of self-administrated tests aimed at pain provocation of posterior and/or anterior pelvis pain and to investigate pain intensity during and after palpation of the symphysis. A total of 175 women participated in the study, 100 pregnant women with and 25 pregnant women without lumbo...

Previous publications indicate that acupuncture is efficient for the treatment of pelvic girdle pain, PGP, in pregnant women. However, the use of acupuncture for PGP is rare due to insufficient documentation of adverse effects of this treatment in this specific condition. The aim of the present work was to assess adverse effects of acupuncture on t...

An earlier publication showed that acupuncture and stabilising exercises as an adjunct to standard treatment was effective for pelvic girdle pain during pregnancy, but the post-pregnancy effects of these treatment modalities are unknown. The aim of this follow-up study was to describe regression of pelvic girdle pain after delivery in these women....

Breast-feeding in the postpartum period is known to induce intense uterine contractions with pain in the lower abdomen. The primary aim of this study was to compare the effects of high and low intensity, high frequency Transcutaneous Electric Nerve Stimulation (TENS) on pain and discomfort of postpartum uterine contractions. The secondary aim was t...

To compare the efficacy of standard treatment, standard treatment plus acupuncture, and standard treatment plus stabilising exercises for pelvic girdle pain during pregnancy. Randomised single blind controlled trial. Settings East Hospital, Gothenburg, and 27 maternity care centres in Sweden. 386 pregnant women with pelvic girdle pain. Treatment fo...

physiotherapist 2 , Hans-Christian Ostgaard, associate professor in ortophedics 3 , Henrik Hagberg, professor in obstetrics and gynecology 1 Abstract Objectives: To compare the efficacy of standard treatment, standard treatment plus