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ETT KLIPP ÄR INTE BARA ETT KLIPP - his.diva his.diva- 1143920/FULLTEXT01.pdf · PDF fileSAMMANFATTNING Titel: Ett klipp är inte bara ett klipp. Barnmorskors resonemang kring episiotomi

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  • ETT KLIPP R INTE BARA ETT KLIPP Barnmorskors resonemang kring episiotomi A CUT IS NOT JUST A CUT Midwifes` reasoning about episiotomy

    Examensarbete inom huvudomrdet Reproduktiv, perinatal och sexuell hlsa Avancerad niv 15 Hgskolepong Hstterminen 2017 Frfattare: Anna Fossen, Jessica Sabel Handledare: Elisabeth Hertfelt Wahn

  • SAMMANFATTNING

    Titel: Ett klipp r inte bara ett klipp. Barnmorskors resonemang kring episiotomi.

    Frfattare: Anna Fossen, Jessica Sabel

    Institution: Institutionen fr hlsa och lrande, Hgskolan i Skvde

    Kurs: Examensarbete i Reproduktiv, perinatal och sexuell hlsa, RP720A, 15

    hgskolepong

    Handledare: Elisabeth Hertfelt Wahn

    Sidor: 27

    Mnad och r: augusti 2017

    Nyckelord: frlossning, episiotomi, resonemang, perinealskydd.

    _______________________________________________________________________

    Bakgrund: Barnmorskan ska vrda och stdja kvinnan genom hela frlossningsprocessen.

    Situationer kan uppkomma under frlossningen dr olika tgrder kan behva utfras som

    exempelvis episiotomi i samband med att fregende fosterdel framfds. Studier visar att

    bde frdelar och nackdelar r assosierade med episiotomi. Det r drfr viktigt att

    barnmorskor vet sitt resonemang kring episiotomi nr resultaten av studier varierar

    eftersom barnmorskan har ansvar fr den fdande kvinnan. Syfte: Att underska

    barnmorskors resonemang kring episiotomi. Metod: Semistrukturerade intervjuer med nio

    barnmorskor som analyserades med kvalitativ innehllsanalys med induktiv ansats.

    Resultat: Resultatet presenteras i ett tema, En berg- och dalbana, innehllande tv

    kategorier, Blandade knslor till episiotomi samt Det skra fre det oskra, dessa

    utmynnade i sex underkategorier. Barnmorskorna ansg att episiotomi inte var ngot som

    skulle utfras i ondan och med erfarenhet upplevde barnmorskorna det lttare att avgra

    nr episiotomi hade en positiv effekt p frlossningsprocessen. Konklusion:

    Barnmorskorna var restriktiva i utfrandet av episiotomi och att det endast var i speciella

    situationer det ansgs vara ndvndigt med ingreppet. Tlamod var en viktig egenskap fr

    en barnmorska och tillsammans med en kad arbetslivserfarenhet var det lttare att avgra

    nr den fdande kvinnan var i behov av episiotomi.

  • ABSTRACT

    Title: A cut is not just a cut. Midwives` reasoning about episiotomy.

    Author: Anna Fossen, Jessica Sabel

    Department: School of Health and Education

    Course: Master Degree Project in Midwifery, 15 ECTS

    Supervisor: Elisabeth Hertfelt Wahn

    Pages: 27

    Month and year: august 2017

    Keywords: childbirth, episiotomy, reasoning, perineal protection.

    _________________________________________________________________________

    Background: The midwife will care for and support the woman throughout the childbirth

    process. There may occur situations during childbirth when certain measures, like

    episiotomy, need be taken in relation to the advance of the fetus. Studies reveal different

    advantages, as well as disadvantages associated with episiotomy. Given the multitude of

    opinions with regards to episiotomy, it is important that midwives have a clear stance on

    the procedure since they are in charge of the woman who is giving birth. Aim: To

    investigate midwives' reasoning on the subject of episiotomy. Method: Semi-structured

    interviews with nine midwives. The data underwent qualitative content analysis, and

    inductive approach was applied. Results: The results present a theme, A roller coaster,

    containing two categories, Varied attitudes to episiotomy and The secure before the

    insecure, these resulted in six subcategories. The midwives felt that episiotomy should not

    be conducted unless absolutely necessary. Midwives further felt that growing experience

    helped them to determine in what situations episiotomy would have a positive effect on the

    childbirth process. Conclusion: The midwives are cautious about the use of episiotomy

    reserving it for special situations when the procedure is deemed absolutely necessary.

    Patience, an important characteristic for a midwife, in conjunction with work experience

    made it easier to determine when the woman giving birth was in need of episiotomy.

  • FRORD

    Vi vill rikta ett stort tack till alla barnmorskor som valt att medverka i vr studie.

    Vi vill ocks rikta ett stort tack till vr handledare Elisabeth Hertfelt Wahn fr all guidning

    genom arbetets gng.

  • INNEHLLSFRTECKNING

    INLEDNING ......................................................................................................................... 1

    BAKGRUND ......................................................................................................................... 2

    Sexuell och reproduktiv hlsa ............................................................................................ 2

    Barnmorskans professionella roll ....................................................................................... 2

    Stdets olika betydelser .................................................................................................. 2

    Episiotomi .......................................................................................................................... 3

    Skyddandet av perineum ................................................................................................ 3

    Skillnader i vrlden ......................................................................................................... 4

    Sverige ............................................................................................................................ 4

    Analsfinkterskada ........................................................................................................... 5

    Barnmorskor och episiotomi .............................................................................................. 5

    PROBLEMFORMULERING ................................................................................................ 6

    SYFTE ................................................................................................................................... 6

    METOD ................................................................................................................................. 7

    Val av metod ...................................................................................................................... 7

    Milj ................................................................................................................................... 7

    Urval ................................................................................................................................... 7

    Datainsamling .................................................................................................................... 7

    Analys ................................................................................................................................ 8

    Etiska vervganden .......................................................................................................... 9

    RESULTAT ......................................................................................................................... 11

    Blandade knslor till episiotomi ....................................................................................... 11

    Tlamod ........................................................................................................................ 11

    Tilltron till det naturliga ............................................................................................... 12

    Motiverad tgrd .......................................................................................................... 13

    Det skra fre det oskra .................................................................................................. 13

    Olika synstt ................................................................................................................. 13

    Negativa konsekvenser ................................................................................................. 14

    Den nya forskningen ..................................................................................................... 14

    Tema: En berg- och dalbana ............................................................................................ 15

  • DISKUSSION ...................................................................................................................... 16

    Metoddiskussion .............................................................................................................. 16

    Giltlighet ....................................................................................................................... 16

    Tillfrlitlighet ............................................................................................................... 16

    verfrbarhet ............................................................................................................... 18

    Delaktighet ................................................................................................................... 18

    Resultatdiskussion ............................................................................................................ 18

    Konklusion ........................................................................................................

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