OBJECTIVE:Massage during childbearing has been shown to benefit women's health and well-being, such as reducing pain and stress and enhancing satisfaction with the labour experience. Despite these documented benefits, massage is not routinely offered as a complementary method by midwives within standard maternity care in Sweden, leaving women's lived experiences of massage in this context unexplored. Therefore, this study aimed to explore women's experiences of massage during childbearing. METHODS:The research was conducted as a qualitative study using an inductive approach. Semi-structured interviews with 12 women in Sweden were carried out, and data were analysed using qualitative content analysis. RESULTS:Analysis of the data yielded one overall theme-seen, heard and touched-and three categories: being mentally present in the body, a vulnerability needed to be respected and sharing experiences. Massage promoted present-moment awareness, trust and safety and relieved pain and stress. It also strengthened the connection with one's own body and deepened closeness to both partner and unborn child. However, it was associated with vulnerability and the recall of bodily memories. CONCLUSION:Massage during childbearing is a supportive practice that integrates physical and emotional well-being with mental recovery, making women feel seen, heard and touched. For optimal benefits and positive experiences, massage must be provided with respect to boundaries. This is particularly important because it may evoke sensitive memories, which involve a vulnerability that needs to be respected. Massage is a valuable complementary method alongside maternity care.

IntroductionProfessional support is known to promote parents' transition to parenthood, however, there is a need for continued development in parental support to meet parents' needs and support them in their couple relationship. In Scandinavia a digital parental support tool, Interplay, has been developed for parents to use in their relationship during the transition to parenthood. However, research is needed on how a digital support tool such as Interplay can be included in care and professional support for parents. Therefore, the current study aims to explore how professionals perceive Interplay as a digital support tool for parents' couple relationship and parenting.MethodsSemi-structured interviews were conducted with 15 professionals who had used Interplay. The professionals were working with parental support in Swedish antenatal care, child health care and family counselling. Data were analyzed using phenomenographic analysis method.ResultsThe results are presented in two descriptive categories: A complementary interactive parental support tool and May facilitate parental transition and be valuable to include in care.ConclusionInterplay has the potential to be a valuable complement to existing parental support, as it could function as a modern tool that can be used by both parents together in their everyday lives to communicate on topics related to their relationship and parenting. It would be valuable to include Interplay in care as it could be combined with professional expertise, which may lead to enhanced parental support.

OBJECTIVE:The couple's relationship is affected by the transition to parenthood, but research findings are mixed, with some studies showing positive effects on the relationship and others indicating negative impacts. This study aims to explore first-time mothers' and their partners' perceived quality of dyadic relationship (QDR36) during pregnancy and the following eight years after childbirth as well as what factors that are associated with a higher QDR36. METHODS:A prospective longitudinal cohort study on 917 Swedish parents, with repeated questionnaires at: gestational week 25 (T1); first week after childbirth (T2); six months (T3); one year (T4); two years (T5); four years (T6), and eight years (T7) after childbirth. Non-parametric tests and Cohen's effect size calculation were conducted to analyze change over time in QDR36. Multiple linear regressions were carried out with index for QDR36 as dependent variable, at all time points (T1-T7). RESULTS:QDR36 varied over time among both first-time mothers and partners, showing an increase between T1 and T2, followed by a decrease between each point in time. QDR36 was statistically lower at T7 compared to all other points in time (T1-T6). Variations were observed in the variables that were associated with a higher QDR36 at different time points, however higher sense of coherence (SOC-13) and social support (MSPSS) were consistently associated. CONCLUSION:First-time mothers and partners' perceived quality of couple relationship declines the first eight years after birth. To support them in their couple relationship, healthcare professionals should acknowledge parents' sense of coherence and social support.

OBJECTIVE:In recent years, digital health interventions have increased in society. Swedish midwifery care is no exception, as digital solutions are increasingly being used during pregnancy and postpartum care for expectant and new parents. Therefore, the aim of this study was to explore midwives' experiences of digital midwifery care and information during pregnancy and postpartum. METHODS:Focus groups and individual interviews were held with fourteen Swedish midwives working within antenatal care. Data analysis was conducted using thematic analysis. RESULTS:The results are presented in one overall theme: Digital Midwifery Care - Blurring boundaries and finding new paths for midwifery care, and three themes: Digital midwifery care is shaped by organizational prerequisites constraining and supporting; Digital midwifery care poses challenges establishing trustful relationships, and Digital midwifery care enhances accessibility, enabling participation. CONCLUSION:Digital midwifery care is experienced by midwives as blurring the boundaries and finding new paths for midwifery care. Midwives negotiate with themselves, not losing the caring relationship as a core dimension of midwifery. Digital transformation within midwifery care has altered midwives' way of working, and thus probably also their approach to caring.

For fathers, the transition to parenthood can be experienced as an emotional phase. Fathers often state feeling overlooked and unsupported during their transition to parenthood. This study addressed this issue by exploring what it means to become a father—a qualitative design with a phenomenological hermeneutical approach. Data were collected through open-ended interviews with 19 fathers living in Sweden. The participants were encouraged to reflect on the meaning of becoming a father. Becoming a father means feeling connectedness to their child, their partner, and their friends, as well as creating strategies entailing flexibility, engagement, management, support, and solitude in their new situation. Fathers use digital media for support to create strategies, but it can evoke anxiety. The meaning of becoming a father concludes that they are deeply affected by the new situation. To support fathers during their transition to parenthood, midwives and child healthcare nurses should facilitate reflective conversations with them about their experiences of becoming a father. This study was guided by the Consolidated Criteria for Reporting Qualitative Research Checklist.

BACKGROUND AND AIM:The transition to motherhood is a life-changing period with dilemmas relating to meaning and relationships. These experiences are described as individual and can be related to existential questions and relationships with family and others, as well as whether healthcare professionals, when meeting with becoming mothers, miss promoting existential aspects. This study aimed to illuminate the meaning of becoming a mother during the transition to motherhood. METHODOLOGICAL DESIGN:The study used an explorative design with a phenomenological hermeneutic approach. Data were collected through open-ended interviews with 22 mothers, eight of whom were pregnant at the time of the interview. RESULTS:The meaning of becoming a mother was experienced as being profoundly touched and changed. By a sense of belonging and being present in the moment, mothers open up to the possibility of being profoundly emotionally affected, which is understood as essential to their meaning of becoming a mother. CONCLUSION:This study reveals that mothers experience intense emotions that can make them vulnerable and open to change, which seems to promote their development of themselves.

OBJECTIVE:Globally, the use of digital solutions in midwifery care, parental information, and antenatal classes is increasing. However, research on how these digital solutions function for mothers has not kept pace. Therefore, the aim of this study was to describe expectant and new mothers' experiences from digital midwifery care and information during pregnancy and postpartum. METHODS:This is a Swedish study with a qualitative method and an inductive approach. Twelve expectant and new mothers were individually interviewed, and data was analysed using thematic analysis. RESULTS:The results are presented in one overall theme: An ongoing Negotiation between digital and physical midwifery care is required to promote engagement and address needs, and three themes: A complement that creates flexibility but request balance; Enable participation and inclusion of partners, and The needs of being seen and heard are met to various extends. CONCLUSION:While the flexibility offered through digital midwifery care and parental information is beneficial and facilitates convenience for mothers, digital midwifery care is not entirely interchangeable with physical midwifery care, including antenatal classes. An ongoing negotiation between digital and physical midwifery care is essential to achieve balanced midwifery care that addresses the unique, individual needs of mothers throughout different stages during pregnancy and postpartum.

Parental transition means a change in the parents’ couple relationship as the baby becomes the focus, thereby affecting the parents’ communication and intimacy. Such a transition may either strengthen or strain the relationship. As becoming parents poses new challenges to the parental couple, the objective of this Swedish study was to explore how parents perceive Interplay, a digital support tool for their couple relationship and parenting. Swedish expectant and new parents were offered the digital support tool ‘Interplay’ (in Swedish: Samspel), which they played mutually with their partner for minimum two weeks. Semi-structured interviews were conducted with 12 expectant and 10 new parents, and the data were analysed using the phenomenographic method. The results are presented in three descriptive categories: An opportunity to shed light on the couple’s relationship and shared parenting; Reflections about yourself and your partner; The design, sense of trust, interest and willingness to play. Interplay was perceived by the parents as supporting them in their couple relationships and shared parenting. The parents described that Interplay functioned as a catalyst for communication and reflection within the parenting couple, which broadened the parents’ perspective. Nevertheless, parents varied in their perceptions on whether Interplay was sufficiently developed to be implemented within healthcare and offered to parents. The current study contributes knowledge on how parents perceive that a digital tool, can be designed to support them in their couple relationship and parenting during the transition to parenthood. The research project is registered (02/10/2020) within the ISRCTN, with ID: ISRCTN18017741 .

BackgroundGlobally, the digital sources developed and available in antenatal care differ, and infrastructure challenges may impede the further development of such sources. Challenges accompanying digital developments can include the commonly occurring high workload, which affects healthcare professionals' ability to acquire professional knowledge about how to best support parents in using digital sources. Including healthcare professionals in the development process of digital sources may increase the likelihood that such sources will be adopted and employed by these professionals in their future care work. Therefore, the present research explored healthcare professionals' perceptions of the digital support intervention Childbirth Journey, which was constructed as a serious game for expectant parents. MethodsData were collected through semi-structured focus-group interviews with 11 midwives at antenatal, labour and postnatal clinics as well as with child healthcare nurses. Prior to the interviews, all participants were provided the intervention, Childbirth Journey, which is a serious game in a mobile application format consisting of two distinct parts: (1) a story-driven game and (2) a Knowledge Portal. The data were analysed using phenomenographic methods. ResultsThe perceptions of Childbirth Journey by healthcare professionals, midwives and child healthcare nurses are presented in four descriptive categories: extended professional support, trustworthy contents, diversity or individuality, and both appealing and in need of development. ConclusionsCurrent study revealed that Childbirth Journey may be utilised as a digital support for parents, allowing healthcare professionals to offer a digital solution as a complementary support to standard, face-to-face meetings with caregivers. However, the research results also revealed that some elements of Childbirth Journey must be improved, thereby representing a main contribution of this study: insights into how to better develop digital tools under the umbrella of health care. Thus, we conclude that in order to create sustainable and safe digital care solutions that function as trustworthy professional supports instead of technical products that risk harming users, the perspectives of both patients and healthcare professionals should be considered in the exploration and development of these solutions.

Child-centered care is based on the fact that children are individuals with their own rights. Since January 2020, The United Nations Convention on the Rights of the Child (CRC) is law in Sweden. Children's meeting with professionals is important because it becomes the children's impression of healthcare that may reflect the children's future image of and feelings about the whole healthcare system. This prospective cross-sectional study aimed to explore child healthcare competence among nurses within primary healthcare. Data were collected through a web-based questionnaire among 101 primary healthcare district nurses, specialist nurses, and registered nurses. The study was compliant with the STROBE checklist. The results showed that the nurses have a good ability to apply child-centered care during children's visits to primary healthcare. To further implement a child-centered approach in primary healthcare, nurses need to have access to workplace educational opportunities continually, to enhance their child competence throughout their nursing careers.

Aim:The aim of this study was to explore healthcare professionals' experiences of working with extended home visits for parents. Background:It is essential to identify parents, both expectant and with a newborn child, who need support in their parenting abilities at an early stage because children's health and well-being are affected by their home environment as well as by their parents' health and social relationships. Home visits represent a cost-effective way of identifying and supporting families with a newborn. Further research is needed to explore healthcare professionals' experiences working with extended home visits for parents. Methods:This was a qualitative interview study focusing on an intervention introduced in the Enhanced Parenting-Extended Home Visits project in Sweden. Data were collected via 13 semi-structured interviews with healthcare professionals who provide the intervention in antenatal care (midwives) and child health care (CHC nurses and family supporters), and a qualitative content analysis was performed. Findings:Data analysis resulted in one theme and four categories. The theme - to provide multidimensional adapted professional support, - and the four categories - strengthened collaboration between professionals enriches their work. Home visits provide time for conversation, which promotes continuity of care and relationships with parents; being humble guests in parents' homes provides insight; and home visits provide the opportunity to strengthen parenting and participation in the family centre. The goals of the Enhanced Parenting-Extended Home Visits project were to strengthen parents' confidence in their parenting abilities and to build trusting relationships with healthcare professionals. The conclusion of this study, from the participants' perspective, is that these goals can be achieved with the intervention. Implications for Practice:Extended home visits seem to help healthcare professionals provide collaborative, multi-professional support for parents, both expectant and with a newborn child, with unique support needs.

Background: During the COVID-19 pandemic, the workload on the intensive care unit (ICU) increased nationally in Sweden as well as globally. Certified registered nurse anaesthetists (CRNAs) in Sweden were transferred at short notice to work with seriously ill patients with COVID-19 in the ICU, which is not part of the CRNAs' specialist area. However, limited research has shed light on healthcare professionals' experiences of the pandemic. Objectives: This study illuminates CRNAs' experiences of working in the ICU during the COVID-19 pandemic. Methods: This study used a qualitative method with an inductive approach to interview nurse anaesthetists who worked in the ICU during the COVID-19 pandemic. Findings: The participants experienced ambivalent feelings towards their work in the ICU. They also lacked information, which created feelings of uncertainty and resulted in expectations that did not correspond to the reality. They described that owing to an inadequate introduction, they could only provide "sufficient" care, which in many cases caused ethical stress. Not being able to get to know their new colleagues well enough to create effective cooperation created frustration. Even though the participants experienced the work in the ICU as demanding and challenging, overall, they enjoyed their time in the ICU and were treated well by their colleagues. Conclusions: Although CRNAs cannot replace intensive care nurses, they are a useful resource in the ICU in the care of patients with COVID-19. Healthcare workers who are allocated from their ordinary units to the ICU need adequate information and support from their work managers to be able to provide the best possible care and to stay healthy themselves. (c) 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Objective To explore parents’ experiences using digital tools in relation to pregnancy, labor and birth, and the child’s first 18 months. Background Parents find relevant information using digital healthcare tools, material obtained from professionals, as well as personal opinions and experiences that vary in quality. Method Fifteen parents were interviewed and data were analyzed beginning with content analysis and followed by thematic analysis. Results The main theme was insecurity and responsibility for own choices and knowledge. Parents use digital tools to take responsibility for their insecurity and need for knowledge when entering parenthood. Conclusion The parents’ experiences highlighted that (1) insecurity can be both eased and enhanced using digital tools, (2) they took responsibility for feelings of insecurity and the search for knowledge, and (3) they needed knowledge to make the right choices and feel secure that these choices are made in the best interest of their new family.

Abstract Background Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing. Aim The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites. Design Discourse paper. Methods This discourse paper is based on our own experiences and is supported by literature and theory. Results Well‐functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered.

Background In today's society, people are experiencing the rapid development of digitalisation. Expecting parents may have difficulties evaluating the information online; they are not always sure which sources of information are trustworthy, and this exacerbates their feelings of anxiety. More research is needed to broaden the knowledge about how their use of digital sources may influence their health. Question The focus of this study was to explore expecting parents' use of digital sources and how this influences their health during pregnancy. Methods A systematic review covered the thematic analysis of 39 articles. Findings The analysis resulted in the following theme: The digitalised society involves both opportunities and challenges, and expecting parents express a need for a variety of digital sources to improve their health, and sub-themes: Digital sources could promote parents' health and well-being in a digitalised society; Consuming digital health information facilitates understanding, different feelings and social connections; and A variety of digital sources may facilitate parental identification and adaption to parenthood. Conclusion Different digital sources in our digitalised society mean access to information and opportunities to extend social connections for expecting parents. This can promote their ability to understand and adapt to parenthood, as well as to improve their health and well-being and make the parental transition. However, professional support during face-to-face consultations cannot always be exchanged to digital sources. It is important to base digital sources devoted to expecting parents and digitalisation overall on multi-sectorial collaborations and coordination between different organisations and the digital sources they provide.

Objective The aim of this study was to explore expecting parents’ perceptions of the Childbirth Journey as an intervention that includes medical information for parental support, constructed as a serious game. Methods In this qualitative study, semi-structured interviews were held with expecting parents in Sweden who were able to talk about specific parts of the Childbirth Journey they appreciated or found difficult to understand. A phenomenographic methodology was employed for data analysis. Results Participants perceived the Childbirth Journey to be easily accessible and customized with reliable information. The design and features of the intervention were perceived by the expecting parents to enhance the intervention’s usability, appeal, and trustworthiness. When parental couples used the Childbirth Journey together, it gave them an opportunity to discuss and better understand each other’s situation. The participants proposed several changes to the existing version of the game, mostly related to extending practical information and illustrated scenarios but also to the further development of the game’s design and animations. The participants found the Knowledge portal to be the most appealing part of the Childbirth Journey. Conclusions The Childbirth Journey intervention was concluded to be a valuable digital complement to in-person professional support, especially given the current COVID-19 pandemic restrictions in place in Sweden, which do not allow antenatal visits by partners. However, in its current form, the Childbirth Journey has some deficiencies and would therefore benefit from further development and exploration.

Social contextual circumstances have an influence on parental transition, and social support has been shown to facilitate the transition to parenthood, among other states. Further knowledge is, however, needed to explore how partners of pregnant women use their social networks during pregnancy. Therefore, the aim of this study was to explore how partners of pregnant women use their social networks when preparing for childbirth and parenting. Within this study, a social network is defined as social connections such as family, friends and significant others. In total, 14 partners (expectant fathers and co-mothers) were interviewed. Data were analysed using qualitative content analysis. EQUATOR Network guidelines and the COREQ checklist were applied. The analysis resulted in one theme of meaning: Partners use their social networks to receive social support, which facilitates understanding about how to prepare for childbirth and parenthood, which was described through three sub-themes. The results highlight the importance of social networks for partners when preparing for childbirth and parenthood. Professionals should aim to strengthen and extend partners’ social networks and access to social support. This could be done not only to support partners to attend parental classes, but also to participate socially as well as engage with other expectant parents within the classes.

Background: Parents use digital sources (such as the internet or online forums and applications) during pregnancy and after childbirth to receive informative support. Research shows that there is further need for innovation development in digital parental support despite informative support available in digital form.Purpose: To explore parents' perceptions of future digital parental support concerning pregnancy and the first 18 months of parenthood.Method: A phenomenographic interview study with an inductive approach including 15 semi-structured interviews was conducted.Results: The analysis process resulted in three descriptive categories: Opportunities for virtual and in-person meetings, Individualized digital parental support, and Professional knowledge and trustworthiness concerning future digital parental support.Conclusion: The results broaden the knowledge about how future digital parental support can be designed to facilitate the functional, interactive, and critical digital health literacy of new and would-be parents. To succeed, healthcare organizations should allow healthcare professionals to assume an active role in developing digital parental support, both as health educators (i.e., providing parents with knowledge) and facilitators (i.e., facilitating parents' use of digital parental support). However, parents perceived that future digital parental support should complement standard care instead of replacing in-person meetings with healthcare professionals.

Background: The access to digital tools for parents is increasing, and further exploration is needed to gain knowledge about parents' experiences in using such tools, for example, when preparing for childbirth and parenthood. This study protocol describes a prospective study that will explore serious games as digital tools for parental support, and both parents' and healthcare professionals' views will be included. The objectives of the prospective study are to explore two different serious games: (1) Childbirth Journey (Swedish: Förlossningsresan), relating to pregnancy, childbirth and parenthood; and (2) Interplay (Swedish: Samspel), relating to parental couple relationships and parenthood.Methods: An intervention study will be conducted. The study will include four different sub-studies (A–D) with both qualitative and quantitative methods and a longitudinal design. Both parents (A, B and D) and healthcare professionals (C) will be included, and data will be collected through interviews (A–C) and repeated web-based questionnaires (D). Data will be analysed using phenomenography and qualitative content analysis (A–C), and descriptive and analytical analyses will be performed for comparisons and associations (D).Discussion: The value of monitoring and reporting on developments and trends in digital innovation for public health has been stipulated by the World Health Organization. The prospective study will contribute further knowledge about multidisciplinary development of digital tools as professional support for parents, as well as knowledge about parents' and healthcare professionals' experiences using digital tools concerning pregnancy, labour, parenthood and parental couple relationships.Trial Registration: This study was retrospectively registered (02/10/2020) within the ISRCTN with ID: ISRCTN18017741. http://www.isrctn.com/ISRCTN18017741.

Background: While becoming a parent can be challenging for all, it can particularly be challenging for those parents and children who are in a vulnerable situation—e.g., in families whose members have problems related to health, relationships, or socioeconomic status. It is essential for health care professionals to identify the more vulnerable families at an early stage. Home visits are one cost-effective way of identifying and supporting such families. This study describes the parental experiences of an intervention that involves professional support in the form of extended home visits. The aim of the study is to describe the parents' understanding of their experiences of receiving professional support through extended home visits both during pregnancy and the first 15 months of their child's life. Methods/Design: A phenomenographic approach was used. Semi-structured interviews were conducted with 12 parents who had received the intervention. The interviews were analyzed using the seven-step phenomenography model described by Sjöström and Dahlgren. Results: The following three descriptive categories emerged from the analysis: (1) conceptions concerning the meaning of the physical environment, (2) conceptions concerning extended home visits promoting feelings of self-confidence in the parental role, and (3) conceptions concerning extended home visits promoting parental participation and relations. Conclusion and Clinical Implications: Extended home visits as a form of professional support appear to promote parental self-confidence in parenting ability, giving parents a feeling of security that facilitates conversation with professionals. Children and their entire families had natural roles during home visits, which allowed the children to behave more characteristically. Furthermore, the home visits were understood to facilitate social support through social activities at the child health center as well as integration into Swedish society for migrant parents. Professional support should be adjusted to the unique individual needs of parents, which demands a variety of supportive interventions—for example, reorganizing one or two of the regular clinical visits currently being scheduled as home visits instead.