Syrian women’s experiences of being pregnant and receiving care at antenatal clinics in Sweden for the first time after migration

ObjectiveTo describe Syrian women’s experiences of being pregnant and receiving care at antenatal clinics for the first time after migration.MethodsA phenomenological lifeworld approach was used. Eleven women from Syria enrolled at antenatal clinics, who were experiencing their first pregnancy in Sweden but who may have given birth before in other countries, were interviewed in 2020. The interviews were open and based on one initial question. Data were inductively analysed using a phenomenological method.ResultsThe essence of Syrian women’s experiences of being pregnant and receiving care at antenatal clinics for the first time after migration was the importance of being met with understanding to create trust to build a sense of confidence. The following four constituents capture the essence of the women’s experiences: “It was important to feel welcomed and to be treated like an equal”; “A good relationship with the midwife strengthened self-confidence and trust”; “Good communication despite language difficulties and cultural differences was important”; and “Previous experience of pregnancy and care influenced the experience of the care received”.ConclusionSyrian women's experiences reveal a heterogeneous group with different experiences and background. The study highlights the first visit and emphasises the importance of this visit for future quality of care. It also points out the negative occurrence of the transferring guilt from the midwife to the migrant woman in case of cultural insensitivity and clashing norm systems.     

“It’s a patient safety issue” A qualitative study with care professionals on their experiences of meeting trans people in obstetric and gynaecological care

ObjectiveThe aim of this explorative study was to analyse how encounters with trans people in the obstetrics and gynaecological department are experienced by healthcare professionals and what needs to be implemented in practice to improve these encounters.MethodsSix participants – physicians, midwives, and a nurse, from four different regions in Sweden – were interviewed, and the interviews were then analysed following inductive thematic analysis according to Braun and Clarke.ResultsThe analysis of the interviews resulted in three themes: “Lack of structure, organization, and medical competence”; “Engaged healthcare professionals push the work forward”; and “Working continuously to improve access to healthcare and the clinical encounter”. The results indicated that the participating healthcare professionals experienced shortcomings regarding different aspects of encountering trans people in care settings. These concerned, for example, structure and organization of care, guidelines, routines, and administrative systems, and a lack of medical competence when it comes to trans people.ConclusionThe results can be interpreted as indicating that there is an inequality in access to healthcare compared to cis people (those who identify with their gender assigned at birth). However, the study also shows that actions can be taken at both the individual level and the organizational level. Education about how to encounter trans people and having clear guidelines and routines are among the improvements that are needed to be more respectful towards trans people and to provide healthcare on equal terms as to cis people.     

Pathomechanism of atopic dermatitis in the perspective of T cell subsets and skin barrier functions – “Which comes first,the chicken or the egg?”

Atopic dermatitis (AD) is a common skin condition that is characterized by a complex, heterogeneous pathogenesis. The possible candidates for its pathogenesis include skin barrier abnormality and allergy/immunology aspects. It has long been asked, “Which comes first, the barrier dysfunction or the allergy/immunology abnormality?” Recently, direct evidence of a link between the incidence of AD and loss-of-function mutations in the gene encoding Filaggrin has been discovered. This finding suggests that barrier dysfunction is a primary cause of AD. It has also been widely recognized that T cells play an important role in the development of AD in the perspective of the Th1/Th2 paradigm. Recently, however, new T cell subsets, Th17, T22, and regulatory T cells have been identified. In this review, we will update the roles of T cell subsets in AD and ascertain how skin barrier abnormality and allergy/immunology interact in a highly interdisciplinary manner.     

The “in’s and outs” of laser hair removal: a mini review

Conventional treatments for excessive hair are tedious and time consuming. Laser hair removal has become the leading therapy option for long–term results. It works on the principle of selective photothermolysis, whereby photons destroy the hair follicle while sparing the surrounding tissue. As demand increases, there has been an increase in the regulation of these treatments. Laser hair removal is not risk-free and side effects are associated with the treatment. Adequate training is vital to minimise adverse side effects. Certain countries have regulatory boards that laser operators need to register with, as well as the completion of mandatory hours. Others require laser operators to register with a Care Quality Commission (CQC) to ensure that minimum training and safety standards are met. Currently, in South Africa, the lack of regulatory boards and mandatory hours poses a risk to the public as anyone with little or no qualification is allowed to perform laser hair removal treatments, placing patients at risk. This review looks at some of the devices used and basic mechanisms of action of laser hair removal, its associated risks, side effects and current regulation.     

“Struggling to settle with a damaged body” – A Swedish qualitative study of women’s experiences one year after obstetric anal sphincter muscle injury (OASIS) at childbirth

ObjectiveThis study aimed to explore women’s experiences related to recovery from obstetric anal sphincter muscle injuries (OASIS) one year after childbirth.MethodThis is a qualitative study based on written responses from 625 women approximately one year after childbirth in which OASIS occurred. Data was obtained from a questionnaire distributed by the national Perineal Laceration Register (PLR) in Sweden. Inductive qualitative content analysis was applied for analysis.ResultsThe theme “Struggling to settle with a damaged body” indicated that the first year after OASIS involved a struggle to settle to and accept living with a changed and sometimes still-wounded body. Many participants described problems related to a non-functional sexual life, physical and psychological problems that left them feeling used and broken, and increased worries for their future health and pregnancies. However, some women had adjusted to their situation, had moved on with their lives, and felt recovered and strong. Encountering a supportive and helpful health care professional was emphasized as vital for recovery after OASIS.ConclusionThis study provides important insights on how women experience their recovery approximately one year after having had OASIS at childbirth, wherein many women still struggled to settle into their damaged bodies. Clear pathways are needed within health care organizations to appropriate health care services that address both physical and psychological health problems of women with prolonged recovery after OASIS.