NJF CONGRESS 2019 ABSTRACT BOOK 2–4 MAY, 2019 REYKJAVÍK, ICELAND Keynote K01 The nature of midwifery provision of care and a few practical situations Helga Gottfreðsdóttir University of Iceland, REYKJAVÍK, Iceland Maternal and newborn health are essential indicators of population health and wellbeing. Good health during pregnancy and at birth extends beyond the perinatal period and is a crusial building block for later health. In the first part of the presentation a brief overview will be given on health and care of pregnant women in the Nordic countries. The Nordic health care model builds on the equity principle, however an analysis of maternity care shows that while there are certainly certain commonalities among the Nordic systems the reality is considerably more complex. In the second part of the presentation a few practical situations of the Icelandic maternity care context will be explored through a lens of national and international researach findings. These situations refer to; women´s expectations and experience of birth, organization of maternity care and migrant childbearing women in Iceland. Many positive achievements have been reached in past decades but new challenges reflect the characteristics of childbearing women as well as healthcare factors in the country. An inconsistency in what is known and what is practized can be seen in some aspects of maternity care. Future planning and decision-making about health practices for pregnant women can benefit from increased preventive and supportive care. K02 Childbearing and long-term maternal health: Studies from the Danish National Birth Cohort Ellen Aagaard Nøhr Southern Denmark / Odense University Hospital, ODENSE, Denmark Most women become mothers, and the effect of motherhood on health depends on the experiences, biology and vulnerability of the individual woman. Pregnancy, childbirth and lactation involve high physical demands and major biological changes of importance for later disease susceptibility. From early to late motherhood, psychological and social challenges related to parenting, care giving, and providing for a family have both positive and negative effects on health. Mothers are typically young women, who are valuable members of the work force. Their health is of paramount importance, not only for themselves and their families, but also for society. Within the Danish National Birth Cohort which recruited app. 100,000 pregnancies 1996-2002, a Maternal Follow-up was carried out when the mothers were in the mid-forties, and 53,000 mothers responded to a web-based questionnaire. Detailed register information provided information about all births of each woman and disease development after childbearing. We have studied how mode of delivery is associated with short- and long-term mental health, and also how a woman’s long-term sexual health is associated with her full birth history and history of perineal tears. Extended lactation is frequent in the Nordic countries, and we have examined how it is associated with long-term maternal cardio-vascular health. In the overall frame of understanding motherhood in a life-course perspective, results from these studies will be presented and discussed. K03 Medical vs social model of childbirth Edwin Van Teijlingen Bournemouth University, BOURNEMOUTH, United Kingdom Social scientists can bring different perspectives and theoretical understandings to research into midwifery and maternity care. The medical model is ‘easy’ to understand, widely used in the media, based on science, claiming to rely on objective measurement of symptoms and clinical observation. Thus thisedical model offers individual solutions to individual patients. The social model argues that there is inter-dependency between the ill person and their environments. Itfocuses on everyday life and socio-economic, cultural and environmental aspects of health. The social model considers a wider range of factors that affect someone’s health, i.e. lifestyle, gender, poverty or discrimination. It is generally not individualist, but complex and multi-dimensional and often withouteasy solutions. The social model maintains that pregnancy/childbirth are largely physiological events common in most women’s lives. Thus pregnancy and childbirth do not normally need medical intervention or the transfer to hospital. A social model of care accepts childbirth as a normal social event in which preventative measures can be used. The medical model portrays a different view, namely that childbirth is potentially pathological, and therefore every woman is potentially at risk when she is pregnant and/or in labour. In short the medical model wants us to believe that pregnancy and childbirth are only safe in retrospect. The medical model is often portrayed in the media as the most appropriate and hence safest approach to pregnancy and childbirth not only ‘controls’ women, but also their families and friends and their health care providers. Understanding key sociological models of pregnancy and childbirth can help politicians, journalists, policy-makers, midwives, doctors, and other health care providers, childbirth activists as well as pregnant women and new mothers (and their partners) to put issues around ‘normal birth’ into perspective. Oral session 1 1.1-Midwifery models of care I O-1.1.1 Mothers´ experiences in relation to a new Swedish postnatal home-based model of midwifery care - Prospective cross sectional study Margareta Johansson1, Michael Wells2, Li Thies-Lagergren2 1Uppsala University, UPPSALA, Sweden Background: The goal of postnatal care is to provide the highest possible quality of care and medical safety with the least possible intervention in order to optimize health and wellbeing of the new family. The aim of the study was to describe mothers´ experiences in relation to a new postnatal home-based model of midwifery care. Method: Prospective cross sectional study based on quantitative and qualitative data (mixed method). A new postnatal home- based model of midwifery care was introduced and evaluated in Sweden. Healthy mothers with an uncomplicated pregnancy and childbirth, with a healthy baby answered an on-line questionnaire. Data were collected during one year (2017-2018) and analyzed with descriptive statistics and content analysis. Findings: In total, 180 mothers with 1-5 children were included. They were most likely to have been discharged between 6 and 12 hours after childbirth (56%) and felt the time for discharge as good (90%). The postnatal check-up included telephone contact (100%), home visit (94%) and hospital visit (94%). The mothers were most likely to have had a positive postnatal care experience by the new postnatal model of midwifery care (mean VAS 8.74, Std. Deviation 1.438). For next childbirth 75% of the mothers would prefer home based postnatal care. Conclusion: Home-based postnatal care is well accepted by mothers who were early discharged after childbirth. Mothers with a positive experience of the new postnatal model of midwifery care would prefer home-based postnatal care for next childbirth. Midwifery care should include home-based postnatal care. O-1.1.2 Work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care. Malin Hansson1, Ingela Lundgren1, Anna Dencker1, Charles Taft1, Gunnel Hensing2 1Institute of Health and Care Sciences, Gothenburg University, GOTHENBURG, Sweden 2Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, GOTHENBURG, Sweden Background: The work situation for midwives in different countries is related to high levels of stress, burnout and heavy work load. One aspect of the professional role of midwives is woman-centeredness, theoretically described in midwifery models of care. However, no studies are found about the outcome for midwives work related to midwifery models of care. Therefore, the aim of this study was to explore and analyse the experience of work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care (MiMo). Method: A simultaneous qualitative and quantitative mixed method approach was used in this longitudinal study. The core component comprised of a qualitative inductive secondary content analysis of three focus group interviews with 16 midwives exploring how midwives experienced and described their work situation and professional role pre and post implementation of MiMo. The supplemental component were a quantitative survey analysis of the work situation for midwives (n=58) pre and post the intervention, and the deductive analysis was driven by the qualitative result. Findings: The qualitative core component consisted of the concepts Balance between Women and Organisation, Midwives - Diverse as both Profession and Person and Strained Work Situation pre intervention. Post intervention Balance between Midwifery and Organisation, Midwives - An Adaptable Profession, Strained Work Situation and lastly a new category Ability to concretise midwifery emerged. The quantitative items that had corresponding measures connected to the qualitative categories were analysed. There were no significant differences in any of the quantitative analyses pre and post the introduction of MiMo. Conclusion: Working according to MiMo appears not to have any effect on the strained work situation in midwives, in the context and with the measurements studied here. Although MiMo contributed to raise awareness of the professional role. O-1.1.3 Evaluation of a midwifery model