Objective To minimise obese women's total weight gain during pregnancy to less than 7 kg and to investigate the delivery and neonatal outcome.Design A prospective case-control intervention study.Setting Antenatal care clinics in the southeast region of Sweden.Population One hundred fifty-five pregnant women in an index group and one hundred ninety-three women in a control group.Methods An intervention programme with weekly motivational talks and aqua aerobic classes for obese pregnant women.Main outcome measures Weight gain in kilograms, delivery and neonatal outcome. ResultsThe index group had a significantly lower weight gain during pregnancy compared with the control group (P < 0.001). The women in the index group weighed less at the postnatal check-up compared with the weight registered in early pregnancy (P < 0.001). The percentage of women in the index group who gained less than 7 kg was greater than that of women in the control group who gained less than 7 kg (P = 0.003). The percentage of nulliparous women in this group was greater than that in the control group (P = 0.018). In addition, the women in the index group had a significantly lower body mass index at the postnatal check-up, compared with the control group (P < 0.001). There were no differences between the index group and the control group regarding birthweight, gestational age and mode of delivery. ConclusionThe intervention programme was effective in controlling weight gain during pregnancy and did not affect delivery or neonatal outcome.

Fear of childbirth is a predisposing factor for emergency and elective CS even after psychological counseling. Maximal effort is necessary to avoid traumatizing deliveries and negative experiences, especially for nulliparous women.

Design: Descriptive, retrospective case-control study. Main outcome measures: Time to next pregnancy and delivery outcome.Results: More women with secondary FOC had a longer interval to subsequent delivery compared to parous women without FOC (p=0.005). Women with secondary FOC had 5.2 times higher probability of having a cesarean section than the reference group. Women with secondary FOC also had on average 40 minutes longer duration of active labor than women without FOC (p< 0.001).Conclusions: Secondary fear of childbirth prolongs the time to subsequent delivery, the active phase of labor itself and it increases the risk for cesarean section. Secondary fear of childbirth KeywordsFear of childbirth, Pregnancy, fear of childbirth , Delivery, Cesarean section Abbreviations FOC, fear of childbirth; CS, cesarean section, ANC, antenatal clinic, BMI, body mass index. Key MessageWomen with secondary fear of childbirth after a previous traumatic delivery experience had a longer time interval to subsequent delivery and were more often delivered with CS.

BACKGROUND: There are few studies of couples that analyse satisfaction with treatment, adoption plans and relationships in couples after unsuccessful IVF. METHODS: ENRICH marital inventory was used to describe marital dynamics and to gain information about treatment and adoption plans. A specially designed questionnaire was used. Of the 51 couples without previous children who were asked to participate after their first failed IVF cycle, 45 participated. The next stage of the study was carried out when the couples had reached the 6 months point after the first IVF cycle, and the last stage after the couples had been through one to three treatments, 1 1 2 years after the last treatment. RESULTS: The couples displayed a stable relationship from the start as well as 1 year after the last IVF cycle. The vast majority of the couples had decided to go through with an adoption. Seventy-three per cent of the women were interested in more IVF treatment compared to 33% of the men. CONCLUSION: The stresses associated with IVF treatment did not have a negative impact on the couples' appreciation of their relationships during and after the treatment period. After treatment had been completed, the couples seemed to have reoriented themselves toward other solutions to childlessness.

In addition to actual disease and severe discomfort, certain social conditions and attitudes as well, are likely to explain the increase of pregnant women on sick leave.

Sickness absence during pregnancy does not seem to covariate in a simple way with ill health, working conditions or the amount of social benefits available. The increased sick-leave rates in Sweden may possibly be accounted for by a changing attitude towards pregnancy and its natural consequences, especially among younger women.

The differences present between the groups were in favour of the IVF families, and the effects of the infertility crisis were not notable when the children were 1 year old.

The Swedish society has provided ample social benefits to allow the pregnant woman to take leave from work, without having to be labeled as "ill," because of normal conditions such as back pain during pregnancy. Instead of an expected decrease in sick leave because of back pain during pregnancy, an increase was observed.