Curriculum Vitae
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KAROLINSKA INSTITUTET
1 NAME
Helena Lindgren
2 BIRTH DATA
19650618-0188
3 ADDRESS
Skogsbrynsbyn 40, 15391 Järna, Sweden
4 PHONE AND EMAIL
Phone: +46-733442599
E-mail: helena.lindgren@ki.se
5 COURSES AND DEGREES
Degrees:
Dalarna University, Certified nurse
Mälardalen University, Certified midwife
Mälardalens University, Masters degree
Courses (outside courses for PhD):
1992-93
1998-99
2002-10-10
Supervisor for doctoral students, 7,5 ECTS
Pedagogic for university level I-III, Mälardalen University
Academic leadership, Vårdalstiftelsen
2008
2004-2005
2010
6 DOCTORAL DEGREE
2008-05-16 at Karolinska Institutet. Title of thesis: Home births in Sweden –
Medical outcome and women’s experiences. Supervisors: Ingegerd Hildingsson,
Ingela Rådestad and Kyllike Christensson
7 POSTDOC APPOINTMENTS
Post-doc position at Sahlgrenska academy, Department of Health and Caring Science from 2010-2011 (two years). Mentor: Professor Ingela Lundgren.
8 DOCENT-LEVEL COMPETENCE
Associate professor in Caring science with special focus on reproductive and perinatal health in November 2011, Sahlgrenska Academy.
9 CURRENT POSITION
Senior lecturer at Karolinska Institutet, Dpt of Women’s and Children’s Health
10 PRIOR POSITIONS
Sahlgrenska academy, postdoc position
Dalarna University, lecturer, midwifery program
Head of the midwifery program, Dalarna University
Mälardalen University, doctoral student, lecturer
2011-2012
2008-2011
2008-2009
2003-2008

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11 TIME DEDUCTED FROM ACTIVE RESEARCH TIME
No time deducted from active research time during the past five years.
12 SELECTED ACADEMIC DISTINCTIONS AND OTHER MERITS
I was in the midwifery program when we received The Award for Best education at the Sahlgrenska Academy 2012.
13 LANGUAGE SKILLS
Fluent in English, Swedish mother-tongue.
List of general articles and book chapters
Author of textbook “Midwives’ management in normal birth”,
Studentlitteratur
Editor for Midwives´ textbook in Sweden, Studentlitteratur
Author of book chapter in Midwives´textbook, Studentlitteratur
2013
2013-2014
2009

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1 CURRENT SCIENTIFIC ACTIVITY
Current activity in research 20 percent.
2 SCIENTIFIC PUBLICATIONS
2.1 Bibliometric parameters
C
C f p f5%
123
1.06
20.11
10.5%
∑ JIF 32.49
Total number of citations
Field Normalized Citation Score Average
Total Field Normalized Citation Score
Field Normalized Share of Top Publications
Sum of Latest Known Journal Impact Factor
2.2 List of all original works
1.
Olesen A, Svahn L, Lindgren H , Elden H. Feeling old in a young body:
Women’s experiences of living with consequences of an obstetric anal sphincter rupture: An interview study. Accepted for publication 2014-10-24
2.
Malm MC, Rådestad I, Rubertsson C, Hildingsson I,
Lindgren H . Women’s experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy - a crossover trial BMC Pregnancy and
Childbirth 2014; 14:349 doi:10.1186/1471-2393-14-349
3.
Edqvist M, Lundgren I, Lindgren H.
Midwives’ experiences of a birth where the woman suffers an anal sphincter injury. BMC Pregancy and Childbirth
2014-08-25
4.
Lindgren H, Kjaergaard H, Olofsdottír OA, Blix E. Praxis and guidelines for planned homebirths in the Nordic countries – an overview. Sexual and
Reproductive Health Care e-pub ahead of print,
DOI:10.1016/j.srhc.2013.12.002
5.
Blix E, Kjaergaard H, Kumle M, Lindgren H.
Transfers in planned home births – a systematic review. BMC Pregnancy and Childbirth 2014-04-20
6.
Malm M-C, Lindgren H
, Rubertsson C, Hildingsson I, Rådestad I.
Development of a tool to evaluate fetal movements in full-term pregnancy.
Sexual and Reproductive Health Care 2014;5(1):31-5
7.
Sjöblom I, Idvall E,
Lindgren H.
Creating a safe haven - Women’s experiences of the midwife´s professional skills during planned home birth in four Nordic countries. Birth 2014;4:100-7

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8.
Rådestad I, Malm MC,
Lindgren H, Pettersson K, Franklin Larsson L. Being alone in silence – mothers’ experience upon confirmation of their baby’s death in utero. Midwifery E-pub ahead of print. doi:10.1016/j.midw.2013.10.021
9.
Lindgren H, Malm MC, Rådestad I. You don’t leave your baby – Mothers’ experiences after a stillbirth. Omega Death and Dying e-pub ahead of print
2013; 68:4
10.
Karlström A.
Lindgren H.
Hildingsson I. Maternal and infant complications after caesarean section on maternal request - Findings from a Swedish casecontrol study. BJOG. 2013;120(4):479-86
11.
Sjöblom I, Idvall E,
Lindgren H.
Changing attitudes – women’s experiences of negative reactions to their decision for home birth. Sexual and
Reproductive Health Care, 2012;3:55-6
12.
Rådestad I,
Lindgren H
. Women´s perceptions of fetal movements in fullterm pregnancy. Sexual and Reproductive Health Care 2012; 3:113-6
13.
Erlandsson K, Lindgren H, Davidsson-Bremborg A, Rådestad I. Mothers’ premonitions prior to the death of their baby in utero and how they deal with the feeling that their baby may be unwell. Acta Obstet Gynecol Scand 2012;
91:28-33
14.
Sjöblom I, Idvall E, Rådestad I, Lindgren H . A provoking choice. Swedish women’s experiences of reaction regarding their planned home birth. Women and Birth 2012;3:11-8
15.
Lindgren H, Rådestad I, Hildingsson I. Transfer in planned home births – effects on the birth experience. Sexual and Reproductive Health care
2011;2:101-5
16.
Lindgren H
, Brink Å, Klingberg-Allvin M. Fear causes tears – Perineal injuries in home birth settings. A Swedish interview study. BMC Pregnancy and Childbirth 2011;11:6
17.
Lindgren H, Erlandsson K. She leads – he follows. Fathers’ experiences of a planned home birth. A Swedish interview study. Sexual and Reproductive
Health Care 2011;2:65-70
18.
Lindgren H
, Erlandsson K. Women’s experiences of empowerment in a planned homebirth. A Swedish national cohort study. Birth 2010;37:309-17
19.
Erlandsson K, Lindgren H, Malm M-C, Davidsson-Bremborg A, Rådestad I.
Mothers experience of the time after the diagnosis of an intrauterine death until the induction of the delivery. A qualitative internet based study. Journal of Obstetric and Gynecology Research 2010;37:1677-84
20.
Malm MC, Lindgren H , Rådestad I. Losing contact with one’s unborn baby

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Mothers’ experiences prior to receiving news that their baby has died in utero. Omega Death and Dying 2010;
21.
Lindgren H, Rådestad I, Christensson K, Hildingsson I. Perceptions of risk and risk management among 735 women who opted for a home birth.
Midwifery 2010;26:163-172
22.
Ljunggren Bomarker E, Hildingsson I, Lindgren H . Playing the second fiddle is ok-Swedish fathers' experiences of prenatal care, Journal of
Midwifery & Women's Health 2009; 09-172
23.
Erlandsson K, Lindgren H . From belonging to belonging through a blessed moment of love for a child - the birth of a child from the fathers' perspective.
Journal of Men's Health, 2009;6:338-344
24.
Erlandsson K, Lindgren H.
Being a resource for both mother and child- fathers' experiences following a complicated birth. The Journal of Perinatal
Education, 2011;20:91-9
25.
Hildingsson I, Rådestad I, Lindgren H.
Birth preferences that deviate from the norm in Sweden - Planned Home Birth versus Planned cesarean section.
Birth 2010;37:288-95
26.
Lindgren H, Hildingsson I, Christensson K, Rådestad I. Transfers in planned home births related to midwife availability and continuity. A Nationwide
Population-based study. Birth 2008;35:9-15.
27.
Lindgren H
, Rådestad I, Christensson K, Hildingsson I.
Outcome of planned home births vs hospital births in Sweden between 1992 and 2004. A population-based register study. Acta Obstet Gynecol Scand. 2008;13:1-9.
28.
Lindgren, H
., Hildingsson, I., Rådestad, I. A Swedish interview study: parents' assessment of risks in home births. Midwifery. 2006;22(1):15-22
29.
Hildingsson I, Lindgren H
, Haglund B, Rådestad I. Characteristics of women giving birth at home in Sweden: a national register study. Am J
Obstet Gynecol. 2006;195(5):1366-72
Submitted or re-submitted manuscripts :
30.
Sjöblom I, Lundgren I, Idvall E, Lindgren H . Being a homebirth midwife in the Nordic countries – a phenomenological study. Re-submitted Midwifery
2014-05-05
2.3 The ten most-cited publications

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1.
Lindgren H
, Rådestad I, Christensson K, Hildingsson I.
Outcome of planned home births vs hospital births in Sweden between 1992 and 2004. A population-based register study. Acta Obstet Gynecol Scand. 2008;13:1-9.
Citations: 34
2.
Hildingsson I, Lindgren H
, Haglund B, Rådestad I. Characteristics of women giving birth at home in Sweden: a national register study. Am J
Obstet Gynecol. 2006;195(5):1366-72
Citations: 24
3.
Lindgren H, Hildingsson I, Christensson K, Rådestad I. Transfers in planned home births related to midwife availability and continuity. A Nationwide
Population-based study. Birth 2008;35:9-15.
Citations: 15
4.
Lindgren H, Rådestad I, Christensson K, Hildingsson I. Perceptions of risk and risk management among 735 women who opted for a home birth.
Midwifery 2010;26:163-172
Citations: 11
5.
Ljunggren Bomarker E, Hildingsson I, Lindgren H . Playing the second fiddle is ok-Swedish fathers' experiences of prenatal care, Journal of
Midwifery & Women's Health 2009; 09-172
Citations: 11
The remaining articles on my publication list have between 1 and 10 citations.
2.4 The ten most important publications
From a clinical point of view following publications are the most important:
1.
Lindgren H
, Rådestad I, Christensson K, Hildingsson I.
Outcome of planned home births vs hospital births in Sweden between 1992 and 2004. A population-based register study. Acta Obstet Gynecol Scand. 2008;13:1-9.
2.
Karlström A.
Lindgren H.
Hildingsson I. Maternal and infant complications after caesarean section on maternal request - Findings from a Swedish casecontrol study. BJOG. 2013;120(4):479-86
3.
Lindgren H, Rådestad I, Hildingsson I. Transfer in planned home births – effects on the birth experience. Sexual and Reproductive Health care
2011;2:101-5
4.
Lindgren H , Brink Å, Klingberg-Allvin M. Fear causes tears – Perineal injuries in home birth settings. A Swedish interview study. BMC Pregnancy and Childbirth 2011;11:6
5.
Erlandsson K, Lindgren H . From belonging to belonging through a blessed moment of love for a child - the birth of a child from the fathers' perspective.
Journal of Men's Health, 2009;6:338-344

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6.
Erlandsson K, Lindgren H.
Being a resource for both mother and child- fathers' experiences following a complicated birth. The Journal of Perinatal
Education, 2011;20:91-9
With regard to research methods the following publications are the most interesting:
7.
Sjöblom I, Idvall E,
Lindgren H.
Creating a safe haven - Women’s experiences of the midwife´s professional skills during planned home birth in four Nordic countries. Accepted for publication, Birth November 2013
8.
Hildingsson I, Rådestad I, Lindgren H.
Birth preferences that deviate from the norm in Sweden - Planned Home Birth versus Planned cesarean section.
Birth 2010;37:288-95
9.
Lindgren H, Malm MC, Rådestad I. You don’t leave your baby – Mothers’ experiences after a stillbirth. Omega Death and Dying e-pub ahead of print
2013; 68:4
10.
Karlström A.
Lindgren H.
Hildingsson I. Maternal and infant complications after caesarean section on maternal request - Findings from a Swedish casecontrol study. BJOG. 2013;120(4):479-86
2.5 List of general articles and book chapters
Author of textbook “Midwives’ management in normal birth”,
Studentlitteratur
Editor for Midwives´ textbook in Sweden, Studentlitteratur
Author of book chapter in Midwives´textbook, Studentlitteratur
2013
2013-2014
2009
2.6 List of all other scientific works
3 INTERNATIONAL SCIENTIFIC CONGRESSES
3.1 Invited speaker or chair
Invited speaker Nordic Forum Malmö “Birth and human rights”
Chair for defence of thesis Ewa Andersson 2014-06-13
Chair for defence of thesis Anna-Karin Klint 2014-03-13
Chair at the conference in sexual and reproductive health, Falun
Invited speaker at obstetric conference “Childbirth models” in
Lithuania, Vilnius
Chair at the conference in sexual and reproductive health, Sthlm
Chair at the Nordic Midwifery conference, Oslo
Chair at the Conference in sexual and reproductive health,
Gothenburg
Chair at symposium, Nordic Midwifery congress, Copenhagen
Invited speaker at the National Perinatal conference in Sweden
Invited speaker, presentation of Thesis at the National conference for obstetrics and gynecology, Skövde
Invited speaker at the Perinatal conference, Estonia
Invited speaker at the National conference for obstetrics and gynecology, Luleå
2014
2014
2014
2014
2013
2013
2013
2012
2010
2009
2008
2008
2007

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3.2 Oral presentations of own accepted abstracts
Transfer in planned homebirths in the Nordic countries, Nordic midwifery conference, Oslo
Home births in the Nordic countries, Regional maternity care conference, Gothenburg
Planned homebirths in the Nordic countries, Midwifery conference, Copenhagen
Outcome of planned homebirths, International midwifery conference, Glasgow
Risk factors for transfer during a planned home birth, Sexual and
Reproductive health conference, Stockholm
Reasons and risk factors for transfer during or shortly after a planned home birth, Nordic Midwifery conference, Åbo
Parent’s experience of birth, FIGO conference, Kuala Lumpur,
Malaysia
Parents´assessment of risk in home birth, Sexual and
Reproductive health conference, Stockholm
2013
2010
2010
2008
2007
2007
2006
2005
4 RESEARCH FUNDING OBTAINED IN THE PAST FIVE YEARS
4.1 External research funding obtained in international or national competition as principal applicant
Funding for doctoral student, National Research
Education in Care Sciences (NFV)
Karolinska Institutet funds
Letterstedtska association
Sahlgrenska Academy, doctoral student (four years)
1 080 000 kr
28 000 kr
20 000 kr
2014
2013
2013
Dalarna University, doctoral student (four years)
Karolinska Institutet funds
Karolinska Institutet funds
2 400 000 kr
2 000 000 kr
40 100 kr
18 900 kr
2011
2010
2011
2010
The Swedish Infant Fund
Karolinska Institutet funds
Letterstedtska association
Vivianne Wahlbergs minnesfond
Baby Bag
The Swedish Infant Fund
40 000 kr
27 800 kr
10 000 kr
5 000 kr
8 000 kr
20 000 kr
2010
2009
2009
2007
2004
2003
4.2 External research funding obtained in international or national competition as co-applicant
SIDA, project funding
FAS, project funding
320 000 kr 2011
300 000 kr 2009
4.3 Significant other research funding received (donation, grant in local competition – e.g. ALF project) as principal applicant
4.4 Significant other research funding received (donation, grant in local competition – e.g. ALF project) as co-applicant
5 SCIENTIFIC COLLABORATIONS

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Principal investigator for a) Nordic Homebirths – collaboration between four Nordic countries about experiences and outcomes in planned homebirths and low-risk births in hospital. The project has been going in since 2010 and has resulted in four publications. Data is under analysis and another ten publications are in manuscript.
Partners in this project are Ellen Blix , PhD, RNM. Clinical research center,
Tromsö University hospital, Norway, Pål Öian
, Obstetrician, professor at
Tromsö University hospital,
Hanne Hegaard , PhD, RNM, Juliane Marie
Research center, Copenhagen, Denmark, Olof Ásta Olofsdóttir , Professor,
RNM, Reykjavik University, Iceland b) OPTIMICS – Optimal rate of Caesarean sections. A European collaborative project.
Ank de Jonge, Professor, RNM, and partners at the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The
Netherlands and Midwifery Research Network Netherlands (MRN), Prof. Jos van Roosmalen and Dr. Thomas van den Akker from the Department of
Medical Humanities, Amsterdam Medical Center.
Dr. Serena Donati from the Italian National Health Institute, Rome, Italy,
INOSS, Prof. Jahn Albrecht from Heidelberg University, Germany are collaborative partners in this project. Professor Peter Brocklehurst, Institute for Women’s Health at University College, London/ National Perinatal
Epidemiology Unit, Oxford, U.K. and Dr Jim Zhang from Shanghai Key
Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai
Jiao Tong University School of Medicine, China are associate partners and advisory board. c) MIMA – Midwive’s management in second stage of labor. Clinical studies on first-time mothers. Partners in this project are professor Ingela Lundgren from the Sahlgrenska Academy, University of Gothenburg, professor Vanora
Hundley from Bournemouth University, U.K. and professor Ank de Jonge,
RNM, the EMGO Institute of Health and Care Research, VU University
Medical Center, Amsterdam, The Netherlands and Midwifery Research
Network Netherlands (MRN),
6 SUPERVISION OF GRADUATE STUDENTS
6.1 PhD candidates supervised up to the defence of the candidate’s doctoral thesis, with the applicant serving as main supervisor
6.2 PhD candidates supervised up to the defence of the candidate’s doctoral thesis, with the applicant serving as co-supervisor
6.3 Students supervised up to their licentiate degree, with the applicant serving as main supervisor
6.4 Students supervised up to their licentiate degree, with the applicant serving as co-supervisor
6.5 Ongoing supervision of a PhD candidate, with the applicant serving as main supervisor

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RNM Mari-Cristin Malm, (half-time seminar January 2013)
RNM Ingela Sjöblom (half-time seminar December 2012, dissertation 2014-11-
21)
RNM Malin Edqvist (planned half-time seminar in December 2014)
RNM Susanne Åhlund, registered 2014-06-28
6.6 Ongoing supervision of a PhD candidate, with the applicant serving as co- supervisor
RNM Shurouq Hawamdeh, Sahlgrenska academy, University of Gothenburg
(planned half-time seminar in November 2014)
6.7 Postdoc supervision
6.8 Supervision of other researchers who have defended a thesis
6.9 Ongoing careers of holders of earlier PhDs and of postdocs
7 THESIS EVALUATION
7.1 Serving as thesis opponent
7.2 Serving as a member of a thesis examination committee
Reviewer half-time seminar, doctoral student Charlotte Elfvander
Reviewer half-time seminar, doctoral student Viola Nyman
Member of theses examination committee for Ing-Marie Carlsson
7.3 External thesis reviewer
Reviewer for thesis, Kristin Håland, University of Vestfold and
Sahlgrenska Academy
8 EVALUATION OF OTHERS’ WORK
8.1 Serving as reviewer of candidates proposed for academic positions
2012
2012
2014
2014
Reviewerof candidates proposed for position as senior lecturer in Caring science with focus on Reproductive health, Dalarna University College
2014
8.2 Serving as reviewer for international evaluations
8.3 Evaluator of research applications in international competition
8.4 Evaluator of research applications in national competition
8.5 Evaluator of major research grant applications in local competition
Evaluator of research grant application, Sophiahemmet University
College
Evaluator of research grant application, Sophiahemmet University
College
Evaluator of research grant application, Dalarna Centre for clinical
2013
2012
2009-2011

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8.6 Editor of scientific journals
8.8 Member of an editorial board
Member of editorial board for Jordemodern , Midwives’ professional journal, from
2008-2012.
8.8 Referee for scientific journals
Scientific journal
Journal of Men as Fathers
Lancet
Canadian Midwives Association Journal
BMC Pregnancy and Childbirth
Sexual and Reproductive Health care
Omega Death and Dying
Number
1
1
1
3
7
1
ACTA Obstetrica e Gynecologica Scandinavica
Midwifery
8.8 Reviewer or advisor for other scientific bodies
1
1
Advisor for Stockholm County Council, Health Technology Assessment (systematic review of literature) regarding the risk for first-time mothers who plan for a home birth. Stockholm county council 2012.
8.9 Other relevant evaluation assignments
Abstract evaluator for the Nordic conference in Sexual and Reproductive Health,
Copenhagen 2010.
9 INTERNATIONAL VISITING RESEARCH FELLOWSHIPS
Recurrent stays as at Tromsö University Hospital, Dpt of Clinical Research for research collaboration, 2009-2014 and at the EMGO Institute of Health and Care
Research, VU University Medical Center, Amsterdam.
10 SCIENTIFIC DISTINCTIONS
11 OTHER SCIENTIFIC MERITS
12 RESEARCH PLAN
The results of my previous research could be summoned as follows:
Women who plan to give birth at home in Sweden are few, about 1/ 1000 births. The transfer rate in Sweden and the Nordic countries is low from an international perspective; 12,5 percent. Women who had planned to give birth at home are more likely to have a spontaneous vaginal delivery and an intact perineum compared with women who give birth in the hospital setting. Women who have an instrumental or surgical birth have less positive experiences and medical outcome compared with women who have a spontaneous birth.
The results generate new research questions and initiative towards Nordic collaboration has been taken and a Nordic group for research in normal birth was

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European researchers are involved in the program. To find best practice in order to optimise the use of interventions in maternity care and to improve tools aiming to identify subgroups that benefits from care on different levels are factors emphasized in the program.
Place and mode of birth – A research program for enhanced knowledge of management in normal childbirth
The overall aim with the research project is to enhance knowledge regarding planned home births in the Nordic countries with focus on medical outcome and parent´s experiences and to investigate and compare factors that reduce the prevalence of perineal injuries in normal childbirth. Specific aims are to identify methods for protecting the perineum, to compare the prevalence of perineal injuries in the Nordic countries and to test random assignment for different methods for protecting the perineum based on previous results from the project.
The prevalence of anal sphincter ruptures and perineal injuries has increased in most high-income countries during the last twenty years (1-2). Women who intend to give birth at home or in alternative settings more often give birth without interventions and with an intact perineum (3-11). The reasons for the differences between perineal outcomes in different birth settings are not known. Long-term effects of perineal injuries are fecal and urine incontince, dyspareunia and general pain. Schytt (12) reports that 1,5 percent in a national cohort of women suffered from fecal incontinence one year after childbirth. Anal sphincter ruptures prolonged the time from birth until sexual intercourse was taken up (13). These conditions have impact on women's daily life and quality of health (14). The place of birth could affect mother and infant health. In a national study of home births in Sweden the result showed that planning and starting a home birth was associated with a reduction in perineal injuries, prolonged labor and excessive bleeding, compared to hospital births in a low-risk population. There were no statistically significant differences with regard to infant mortality or morbidity (3). The reduction of perineal injuries in planned home birth is a finding in line with previous studies (4-11). The prevalence of perineal injuries has been increasing during the last decade in the Nordic countries. In Sweden an increase in sphincter ruptures from 0.5 to 3 percent in a twenty-year period has been observed and among primiparas the rate was nine percent in a Swedish study (15). Women who have a planned home birth seem to have a reduced risk for perineal trauma. There might be several explanations to the difference between planned home births and planned hospital births; factors related to the pregnant woman, factors related to the environment and factors related to management in labor and birth.
Perineal injuries in different birth settings
The increasing prevalence of perineal traumas constitutes a problem in several highincome countries. The lower prevalence of anal sphincter ruptures among women with a planned homebirth has not been explained. In an interview study with midwives who assisted births at home or at hospital in the Nordic countries several factors were found that might have effect on the outcome regarding perineal injuries.
These factors were related to 1) the birthing woman; 2) the midwife’s management;
3) the environment surrounding the birth (23). It is not known to what extent the management from alternative birth settings can be transferred and used in hospital care.

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Prevalence and follow-up problems for planned homebirths
In order to study factors that may protect the woman from perineal trauma the homebirth environment provides an interesting research field. In Sweden, the health authorities do not recommend, and seldom finance, home births. A woman who wishes to give birth at home not only has to find a midwife willing to assist her, but also must usually pay for the service herself (24). Register data for planned homebirths are not reliable for the follow-up of outcome (3). The Swedish Medical
Birth register do not separate planned home births from unintentional births outside of the hospital. For a twelve-year period more than half of the planned home births were misclassified and over 100 planned home births were not registered at all (3).
The same problems have been addressed in Norway and Denmark.
The Nordic Homebirth study
A Nordic register including all planned home births has been built up and data regarding medical outcome as well as parents' experiences are being collected during the period 2009-2014. The results of this study will constitute the basis for an intervention study comparing methods for preventing perineal injuries. By collecting register data from all planned home births in Sweden, Iceland, Denmark and Norway and aggregate these data we will gain extended statistical power to study maternal outcomes in home birth settings. Data from the Nordic Homebirth study will provide information regarding low-risk births with few interventions that otherwise may compromise the results. The preliminary results of this project show that there is a lower prevalence of perineal injuries and sphincter ruptures among women who planned to give birth at home in the Nordic countries. This is in line with previous results from the Swedish Homebirth Experience study (3). Midwives’ descriptions of management during labor indicate that a method can be defined and tested in clinical birth settings. This intervention along with women’s experiences of the birth will contribute to enhanced insight regarding prevention of perineum during birth. A preliminary publication list includes eleven original articles, three are already published.
Description of on-going and future research
The overall aim of the present research program is to investigate factors related to the prevalence of perineal injuries and long-term consequences of different modes of birth.
Specific aims are

To investigate and compare midwives’ methods for protecting the perineum from injuries during a planned home birth in the Nordic countries

To compare the prevalence of perineal injuries among women in the Nordic countries who planned to give birth at home irrespective of where the birth was completed; at home or after transfer to hospital.

To test and evaluate an intervention built upon midwifery knowledge to minimize vaginal tearing in childbirth.
 To describe women’s experiences of management for prevention of perineal injuries during birth

To investigate long-term consequences for women comparing different methods for management of second stage of labor

To investigate outcome in relation to mode of birth in a European context with focus on optimal rate of caesarean section.

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
To explore the raise of inductions of labor in relation to birth outcome.
MIMA - A midwifery intervention with focus on midwifes’ management and vaginal tearing in nulliparous women (on-going)
The management during labor (midwife's activity, birth position) will be analyzed as described above and factors related to perineal injuries will be defined and summoned into one test-method. The test-method (study-group) will be compared with conventional perineal protection at the delivery ward. Prevention of the woman's perineum according to the test-method during the pushing phase will be taught to the midwives at two delivery wards in Sweden and Norway.
Hypothesis
The hypothesis is that an intervention based on research and experienced-based midwifery knowledge will reduce vaginal tearing (grade 2) in nulliparous women giving birth.
Design
This is an experimental prospective study that started in September 2013. Midwives perform either the intervention or ordinary care during the second stage of labor.
Since the intervention is complex the midwives performing the intervention are specially trained. The midwives in the intervention group will in all cases perform the intervention and the control group will in all cases perform ordinary care.
The study started by measuring baseline during two months. During this period all midwives at the delivery wards performed ordinary care during the second stage.
After the birth they measured the length and depth of the vaginal and perineal tear.
They also filled out a study protocol after each birth. After this baseline the actual intervention study is being implemented. The midwives will be participating in the study were divided into two cohorts. To avoid contamination between the groups midwives working dayshifts at one delivery unit perform the intervention and midwives working nightshifts perform ordinary care and at the other unit the it will be reversed.
Outcome
The primary outcome is degree of vaginal tearing. Secondary outcomes are frequency of anal sphincter ruptures (degree 3 and 4) the women’s satisfaction with care during the second stage of labor, short- and long-term symptoms due to vaginal tearing, such as urinary incontinence, flatus and anal incontinence, and resumption of sexual intercourse.
OPTIMICS
Maternity care is an important part of every health care system. The way maternity care is organised varies considerably between European countries. In the proposed project, we will use the maternity care system as a stepping stone to create safe and efficient health and care systems in European countries by rationalising the use of health technology. In particular, we will address the huge variation in caesarean section (CS) rates between and within European countries.
The overall aim of the project is to optimise the use of caesarean delivery (CD) in
European countries; the rate should be high enough to ensure good maternal and neonatal outcomes and low enough to prevent unnecessary serious morbidity in mother and newborn due to the operation.

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The large differences in CS rates between European countries and between regions and hospitals within countries suggest that a large number of CS’s may not be medically necessary. Unnecessary CS’s expose women and babies to increased risks of adverse outcomes and a huge increase in health care costs.
We want to identify best practices and develop instruments to optimise the use of CS.
The ideal CS rate would be high enough to ensure good maternal and child outcomes and low enough to prevent unnecessary serious morbidity in mother and baby due to the operation. To achieve optimal use of CS, we need more evidence on the association between CS and maternal and neonatal outcomes and on interventions that are effective in preventing unnecessary CS’s. We will obtain this evidence by summarising evidence from biomedical and behavioural research and by exploring factors underpinning differences in CS rates between and within countries through action oriented research. This will allow us to develop a new model for optimising the use of CS in European countries.
Intended interventions to reduce CS’s will not only take place in secondary care and therefore will change the established norms of operation by requiring cooperation between different health sectors (public health, primary and secondary care) and across sectors (between the health sector, media, voluntary sector and preventive medicine). Preventing unnecessary CS’s shifts the emphasis in maternity care from cure to prevention. Lessons learned in this project will be extremely useful for other areas of health care as well by showing ways of shifting emphasis from curative to preventive medicine. This would be a first stepping stone towards making the entire health system more efficient, safe and sustainable.
References
1.
Elfaghi I, Johansson-Ernste B, Rhydström H. Rupture of the sphincter ani: the recurrence rate in second delivery. BJOG, 2004; 111: 1361-1364
2.
Ekéus C, Nilsson E, Gottvall K. Increasing incidence of anal sphincter tears among primiparas in Sweden: a population-based register study. Acta Obstet
Gynecol Scand. 2008; 87: 564-73
3.
Prager M, Andersson K, Stephansson O, Marchionni M, Marions L. The incidence of obstetric anal sphincter rupture in primiparous women: a comparison between two European delivery settings . Acta Obstet Gynecol
Scand 2008; 87: 209-15
4.
Schytt E, Lindmark G, Waldenström U. Physical symptoms after childbirth: prevalence and associations with self-rated health . BJOG 2005; 112: 210-7
5.
Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. The prevalence of urinary incontinence 20 years after childbirth: a national cohort studiy in singleton primiparae after vaginal or caesarean delivery. BJOG 2013; 120: 144-51
6.
Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. Prevalence and riskfactors for pelvic organ prolapse 20 years after childbirth: a national cohort studiy in

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152-60
7.
Socialstyrelsen. Sveriges officiella statistik, hälso- och sjukvård. Graviditeter, förlossningar och nyfödda barn 1973-2011. 2013. http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/18966/2013-
2-7.pdf
8.
Andrews V, Sultan AH, Thakar R, Jones P. Occult anal sphincter injuries – myth or reality? Br J Obstet Gynecol 2006; 113: 195-200
9.
Handa VL, Zyczynski HM, Burgio KL, Fitzgerald MP, Borello-France D et al. The impact of fecal and urinary incontinence on quality of life 6 months after childbirth. Am J Obstet Gynecol 2007; 197: 636, 1-6
10.
Bergmark K, Åvall-Lundkvist E, Dickman PV, Henningsohn L, Steineck G.
Patientrating of distressful symptoms after treatment for early cervical cancer.
Acta Obstet Gynecol Scand . 2008; 81: 443-50
11.
Chong EC, Khan AA, Anger JT. The financial burden of stress urinary incontinence among women in the United States. Curr Urol Rep 2011; 12:
358-62
12.
Mellgren A, Jensen LL, Zetterström JP, Wong WD, Hofmeister JH, Lowry
AC. Longterm costs of fecal incontinence secondary to obstetric injuries. Dis
Colon Rectum 1999; 42: 857-65
13.
Baghestan E, Irgens LM, Bordahl PE, Rasmussen S. Trends in riskfactors for obstetric anal sphincter injuries in Norway. Obstet Gynecol 2010; 116: 25-34
14.
Andrews V, Sultan AH, Thakar R, Jones PW. Risk factors for obstetric anal sphincter injury: a prospective study. Birth 2006; 33: 117-122
15.
Kearney R, Miller JM, Ashton-Miller JA, DeLancey JO. Obstetric factors associated with levator ani muscle injury after vaginal birth. Obstetrics and
Gynaecology, 2006; 107: 144-149
16.
Räisänen S, Vehviläinen-Julkunen K, Gissler M, Heinonen S. Lateral episiotomy protects primiparous but not multiparous women from obstetric anal sphincter rupture. Acta Obstet Gynecol Scand 2009; 88: 1365-72
17.
Zetterström J, Lopez A, Anzén B, Norman M, Holmström B, Mellgren A.
Anal sphincter ears at vaginal delivery: risk factors and clinical outcome of primary repair. Obstet Gynecol 1999; 94: 21-8
18.
De Leeuw JW, Struijk PC, Vierhout ME, Wallenburg HC. Risk factors for third degree perineal ruptures during delivery. BJOG , 2001; 108: 383-387

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19.
Meyvis I, Van Rompaey B, Goormans K, Truijen S, Mestdagh E, Mistiaen
W. Maternal position and other variables: effects on perineal outcomes in 557 births. Birth 2012; 39: 115-20
20.
Altman D, Ragnar I, Ekström Å, Tydén T, Olsson, S-E. Anal sphincter lacerations and upright delivery postures – a risk analysis from a randomized controlled trial. Int Urogynecol J Pelvic Floor Dysfunc 2007; 18: 141-146
21.
Gottvall K, Allebäck P, Ekéus C. Risk factors for anal sphincter tears: the importance of maternal position at birth. BJOG 2007; 114: 1266-72
22.
Aasheim V, Nilsen AB, Lukasse M, Reinar LM. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database
Syst Rev 2011; 7(12): CD 006672
23.
Waldenström U. Women’s memory of childbirth at two months and one year after the birth. Birth 2003 ; 30: 248-254
24.
Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy and Childbirth 2010 ; http://www.biomedcentral.com/1471-2393/10/81

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KAROLINSKA INSTITUTET
1 SUBJECT AREA COMPETENCE AND CURRENT TEACHING
ACTIVITY
Title: Senior lecturer within the field of Reproductive health at a)
Karolinska Institutet, Department of Women’s and Children’s Health
(temporary position) http://kisefront01.ki.se/programme/2BM13/14-15 b) Sahlgrenska Academy, University of Gothenburg, Department of Health and
Caring Sciences
http://www.utbildning.gu.se/student
2 TEACHING IN THE STUDY PROGRAMME
2.1 Scope/time of teaching
Teaching on basic level Scope/time Year
3 hrs x 12 2005-2007
3 hrs x 12 2005-2007
20 % 2004-2008
Obstetrics and gynecology for nurses
Research methods, qualitative and quantitative design
Teaching on advanced level
Midwifery education 90 ECTS, Mälardalen University:
Normal pregnancy and childbirth
Scientific methods
Complications in childbirth
Midwifery education 90 ECTS, Dalarna University
College:
Anatomy and physiology in reproductive health
Normal pregnancy and childbirth
Scientific methods
Complications in childbirth
Skills training in pregnancy and childbirth
Midwifery education, 90 ECTS, Sahlgrenska Academy:
Normal pregnancy and childbirth
Skills training in pregnancy and childbirth
Master thesis writing in caring sciences, reproductive healthcare, healthcare pedagogics and radiography, 15 and 30 ECTS
Midwifery education, 90 ECTS, Karolinska Institutet:
Normal pregnancy and childbirth
Clinical rotation, management of childbirth
Complicated childbirth
CASE-seminars, Post-experience conferences
Skills training in pregnancy and childbirth
Supervisor for scientific projects, 15 ECTS (10 weeks)
Mälardalen University:
Elin Blom
Dalarna University College:
Ann Jernqvist, Magdalena Selnes
60 %
20%
20 %
80 %
2008-2010
2011-2012
2012- ongoing
2012-ongoing
2008
2008

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Anna Rolfsman
Anneli Ringbäck, Helena Sätterström
Emily Bogren Jungmarker
Anna Åkerlund, Maritza Idberg
Susanne Gabrielli, Lina Olofsson
Maria Leinonen, Ulrika Rollison
Karin Johansson
Maria Blomqvist, Lisa Fork Söderholm
Johanna Olsson, Maria P Ljungberg
Anna-Karin Grundin, Ann-Louise Karlsson
Britt-Marie Backman
Linda Olsson
Matilda Wiberg
Angelica Sjöberg
Åsa Brink
Karin Lilje Gränge
Anna Gate, Eva Norberg
Cathrine Björklund
Ulrica Olofsson, Lillemor Olsson
Linda Löfgren, Jenny Nordström
Linda Ekström, My Wikström
Anna Bröms, Mia Låås
Kristina Otterfjärd- Johannesson, Emma Sällström
Sophia Hoy, Malin Nilsson
Ellinor Norgren, Petra Bertils
Helena Hirvonen
Emelie Tåli, Micaela Sundberg
2008
2008
2008
2009
2009
2009
2009
2009
2009
2010
2010
2010
2010
2010
2010
2010
2010
2010
2010
2010
2010
2011
2011
2011
2011
2011
2012
2012 Kristina Lindblom, Katarina Rask
Carolina Jonasson Lindegren, Sara Karlsson
Sahlgrenska Academy:
Ann-Louise Svensson
Kajsa Erlandsson, Maria Hansson
Klara Stenström
Sandra Frostasson, Petra Hedström
2012
2012
2012
2012
2012
Simone Abrahamsson, Jakob Dahr
Anna Bohlin, Line Tangen Anderssen
Linda Jonsson, Åsa Larsson Lantz
Karolinska Institutet
Susanne Fjärdsäter, Frida Lamberg
Ann Ljungblom, Susanne Holm
Elin Fjällström, Frida Burman
2013
2014
2014
2012
2012
Gunilla Eriksson
2013
2013
2.2 Form of instruction
My experience of teaching covers most forms of instruction, from skills training to leading CASE seminars. During my first years as a teacher I gave lectures and lead seminars . I was also mentor for midwifery students in a mentor programme run at
Mälardalen University 2006-2008. Dalarna University College have a high profile in distance learning and I practised several IT-tools for teaching; streamed lectures, videotaped lectures and instructions, seminars on the web-platform and

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3 / 7 development of an internet-based course in scientific writing for midwifery students in Somaliland.
At KI the above-mentioned forms of instructions have been complemented by CASE methodology, Post Experience Conferences and Inter-professional education within the midwifery program.
2.3 Teaching assignments
Midwifery education, Dalarna University
Assignment
Program director
College, 2008-2010
Psychosocial health in pregnancy and childbirth,
7,5 ECTS, 2007
Mälardalen University
Normal pregnancy and childbirth, 12 ECTS,
Dalarna University College, 2008-2011
Scientific project, 15 ECTS, Dalarna University
College, 2009-2010
Course leader and planner of the course
Course leader and planner of the course
Course leader and planner of the course
Supervision in clinical practice, 7,5 ECTS,
Dalarna University College, 2009
Institutional Board for education, Dalarna
University College, 2008-2010
Course leader and planner of the course
Member of committee 2008-
2009
Head of committee 2010
Member of planning committee Education conferences (five times, 2008-2010)
Dalarna University College
Normal pregnancy and childbirth, 15 ECTS,
Sahlgrenska Academy, 2010-2011
Master thesis writing, 15/30 ECTS, Sahlgrenska
Academy
Sexual, reproductive and perinatal health II, 30
ECTS, Karolinska Institutet, 2012-2014
Application for Sexual and Reproductive health as separate subject area, Dalarna University
College, 2011
National evaluation of education, Master thesis writing, 2013
Course leader and planner of the course
Course leader and planner of the course
Course leader and planner of the course
Planning and writing application
Writing of self assessment
2.4 Examination and assessment
Subject
Normal pregnancy and childbirth
Complications in pregnancy and childbirth
Form of examination
Written, oral and practical examinations
Written, oral and practical examinations
Scientific project, one-year master
Master thesis writing
Supervision in clinical practice
Meta-analysis
Written and oral (seminars) Examinator and assessor
Written and oral, public defence
Examinator
Written and oral Examinator
Written and oral
Assignments
Examinator and assessor
Examinator and assessor
Examinator

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2.5 Production of study materials and instructional materials
Author of textbook “Midwives’ management in normal birth”,
Studentlitteratur
Editor and producer of instruction film; Management of second stage of labor, Sahlgrenska Academy
Editor for Midwives´ textbook in Sweden, Studentlitteratur
Author of chapter in Midwives’ textbook, Studentlitteratur
2014
2014
2014
2011
My experience from clinical practice, teaching and research formed a basis for development of study and instruction materials. Students ask for instructions they can repeatedly study. Clinical skills needs to be practiced and assessed many times and the need for this in management of second stage of labor was the start of producing the 15-minute long film. We wanted to show that there is more than one way to handle this situation and still be clear about the aim with our management; to protect the woman from injuries.
Having been the author of one chapter in the Midwives’ textbook I was asked to be one of three editors for the new textbook for midwives. The development of the new book is based on the international competencies for midwives. This was done since we educate midwives not only for the Swedish context, but also for an international arena.
The textbook “Midwives’ management in normal birth – research and experiences” was developed in collaboration with the Swedish Midwifery Association. The book is supposed to fill a gap in clinical practice for students as well as for practising midwives and nurses. Each chapter ends with “Recommendations for clinical practice” and it contains many instructive illustrations and pictures.
As a course leader I have developed new forms of learning assignments such as writing cases for seminars, developed mentor programs and revised instructions for clinical skills training in collaboration with students.
2.6 Course evaluation, and evaluation of instruction and study programme
During the period I was program director for the midwifery program at Dalarna
University College we revised all curricula and course syllabus for the program with regard to requests from students and clinical supervisors. The courses were all revised so that the progression became clearer and that learning assignments corresponded better with the aims. Evaluations from students are part of the everyday work as a teacher. From 2008 I have shared oral and written evaluations from students and considered their reflections when forming new curricula, course syllabus, lectures and assignments. To mention some examples: In a written examination I found that almost all students were unable to reflect on their own role as promoters for a normal birth; one of the midwifes’ essential tasks according to international standards. I discussed this with the students and colleagues and decided to introduce a seminar based on the outline for the textbook “Midwives’ management in normal birth”. The students found this valuable and the seminar has been a part of the course for several times now. The students also had influence on the final version of the book by their reflections and additional input during the seminars.
I have been a supervisor for a large number of students writing their thesis, 15 ECTS.
This is usually a stressful period for the students and I have developed a structure for their process with a detailed schedule and also guidelines for the different parts in the

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5 / 7 research process. The students have found that helpful and they have also helped in improving the guidelines for future students.
Within the departments and institutions a continuous evaluation of others programmes and courses have been an important part of my profession. For the national review of the midwifery programs I took part in assessments for courses in the programmes.
2.7 Internationalisation

Planning and development of exchange with the midwifery program at the
Institute of Health Sciences, Hargeisa, Somaliland. Exchange of teachers and course development.

Member of the Committee for Internationalism at the unit for reproductive health, KI (MINC).

Applicant for Linneus Palme funding for exchange (students and teachers) with the Kamuzu College of Nursing (KCN), Malawi

Teachers exchange, Dpt of Midwifery, Bournemouth University, United
Kingdom

Student exchange with Bournemouth university, contact person for students in- and out-going.

Contact travel for development of exchange with the midwifery program in
Amsterdam and Groningen, INHolland universtiy, AVAG (Academie
Verloskundige Amsterdam Groningen ).
3 TEACHING IN NURSING AND MEDICINE AND FOR HEALTHCARE
PRACTITIONERS
1.1
Teaching in nursing and medicine
As a clinical midwife I lead parental preparation classes for several years. Hands-on training of breastfeeding and care of the newborn baby was part of the education.
Earlier, as a nurse, I was involved in patient satisfaction and education after homecoming from hospital. By doing home-visits we assessed and trained patients with long-term pain in their everyday life.
1.2
Teaching for healthcare practitioners
I am promoter of inter-professional education for the midwifery program. The aim is to provide at least one occasion for inter-professional learning each semester for the midwife students with professionals in the reproductive field.
4 DEVELOPMENT OF TEACHING SKILLS
4.1 Formal studies in university-level teaching
Inter-professional education, Karolinska Institutet
CASE methodology, Karolinska Institutet
Pedagogic for university level I-III, Mälardalen University
Distance learning, IT-tools, Mälardalen University
2014
2013
2004-2005
2005
4.2 Other teaching activities
5 DEVELOPMENT WORK IN TEACHING/MEDICAL PEDAGOGY

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5.1
Pedagogical development work and projects
I have been a participant at several pedagogic seminars during my years as a university teacher. At the Dalarna Univesity College much attention was focused on the possibilities of distance learning and many seminars aimed at developing the tools for teaching and examination. Some of my assignments are listed below:

National pedagogical conference in midwifery education, 2008, 2010.

Member of development group for assessment forms in theoretical education at Dalarna University.

Teachers exchange within the ERASMUS programme, Bournemouth
University.
5.2 Communication and presentations of pedagogical development work
6 TEACHING DISTINCTIONS
Education award for the midwifery program, Sahlgrenska
Academy
2012
7 OTHER TEACHING MERITS
8 CONCRETE EXAMPLES AND REFLECTIONS ON YOUR OWN
TEACHING
My first interest in teaching goes back to when I as a twenty years old student studied idea and culture history. The learning environment and teaching forms were very different from my previous experiences and an interest for adult learning began to grow. I also realised that learning can go so fast when you really see the need for knowledge in a specific subject. After six years of studies in German as a teen-ager and not being able to say many words, I found that three months of Spanish in a foreign country made med almost fluent.
The rationale for studying the subjects included in the midwifery program is usually clear for the students on university level. By integrated theoretical and practical training the student can reflect on what knowledge is gained and what is still needed. The responsibility for the course leaders and examiners is to provide opportunities for learning in a logic order and encourage reflection and evaluation of the own learning process. This can be done by mentorship, which I have practised for several years, but also by seminars or diaries kept by the students. To have evaluation forms that correspond with the aims of the course and to make them understandable for students and clinical supervisors is another important task in the teaching assignment.
Gender and human rights have a given place in education and research. The profile of the new textbook for midwives has an international basis and we believe this will help teachers and students to broaden their perspective. It is important to give emphasize to the global view of sexual and reproductive health rights. To achieve this we need to continuously scrutinize presentations for lectures, textbooks and assignments as well as tests for the students. I have taken part in evaluation for the national education council three times and the selfassessments of the education programmes have been very informative and

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7 / 7 helped to improve my own teaching. As a research supervisor, teacher and director for education program it is of great value to strengthen the team and work close together with course leaders, clinical supervisors and institutional board. I believe recurrent training and discussions in a positive spirit best do this.

Clinical portfolio
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KAROLINSKA INSTITUTET
1 CLINICAL SPECIALIST EXPERTISE AND CURRENT ACTIVITY
2 CLINICAL EXPERTISE AND FORMAL TRAINING (INCLUDING
PUBLIC HEALTH WORK)
2.1 Completed clinical training
Dalarna University, Certified nurse
2.2 Specialist expertise
Mälardalen University, Certified midwife
Mälardalens University, Masters degree
2.3 Clinical positions
Södertälje hospital, midwife
Danderyd hospital, midwife
Vidarkliniken, midwife in prenatal care
Vidarkliniken, nurse in primary and palliative care
1993
1999
2002
2000-2005
1999
1999-2005
1994-97
2.4 Clinical supervisory positions
2.5 On-call activity
On-call for women who plan for a home births, assisted 150 planned out-of-hospital births during the years 2000-2010.
2.6 Clinical profile area
I have been working with parents who have a strong wish for continuity in childbirth.
Continuous support irrespective of where the woman wants to give birth has been my clinical profile area.
2.7 Assignments
As a clinical midwife I was assigned by the Stockholm County Council to care for women who plan for a home birth.
3 CLINICAL DEVELOPMENT WORK (INCLUDING PUBLIC HEALTH)
3.1 Efforts resulting in significantly improved clinical care provision
Being part of the development of care for out-of-hospital births in the Stockholm area I find that the care for these women has improved significantly. The communication between midwives working at home and clinicians at the hospital is improved. I am currently analysing the records for all planned home births during
2005-2013 in order to detect potential adverse outcomes and describe the care given by the midwives assigned by the Stockholm County council.
3.2 Area of expert knowledge

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33. Responsibility for a diagnostic group
3.4 New treatment forms and diagnostics
3.5 Clinical trials
We are running a clinical trial, for which I am the project leader, at the delivery wards at Danderyds hospital and BB Stockholm. Together with my research group I have planned the study, applied for ethical approval and introduced the intervention.
The study is further described in my research program (MIMA).
3.6 Care programme and clinical guidelines
3.7 Clinical supervision
3.8 Pharmaceuticals
3.9 Clinical use of results achieved in a specific medical field
3.10 Clinical fellowship
3.11 Preventive work
4 CLINICAL DISTINCTIONS
5 OTHER CLINICAL MERITS
6 DEVELOPMENT PLANS IN HEALTHCARE AND PUBLIC HEALTH

Leadership, development and collaboration portfolio
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KAROLINSKA INSTITUTET
1 CURRENT ACTIVITIES INVOLVING MANAGERIAL
RESPONSIBILITY
2 TRAINING IN LEADERSHIP, DEVELOPMENT AND
COLLABORATION
2.1 Formal education and degrees
2.2 Completed courses/study programmes
Supervisor for doctoral students, 7,5 ECTS
Academic leadership, Vårdalstiftelsen
3 MANAGERIAL POSITIONS
3.1 Chairmanship
Head of Institutional board for education, Dalarna university college
Chairman for national association for alternative in childbirth
3.2 Positions as member or delegate
2008
2010
2010
1998-2002
Member of Institutional board for education, Dalarna university 2008-2009
3.3 Responsibility for a section, course coordinator, director of studies, responsibility for a study programme
Program director for the midwifery education at Dalarna University College 2009-
2010.
Coordinator for the courses in master thesis writing at Sahlgrenska Academy 2011- ongoing.
1.3
Research team leadership
The research program described above includes three projects and my role in the program is to lead two of the three parts. For five years I have served as the principal investigator and leader for the Nordic studies on normal birth where researchers from four Nordic countries participate.
4 COMMITTEE WORK, ETC.
4.1 Commissions of trust in academic organisations
Doctoral represent at the committee for research and education at Mälardalen
University, 2005-2008.
4.2 Student union activity

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4.3 Trade union activity
4.4 Other committee work
5 DEVELOPMENT WORK AT EDUCATIONAL INSTITUTIONS OR
HOSPITALS
6 ETHICS, EQUAL TREATMENT, AND ENVIRONMENTAL
CONSIDERATION
7 MANAGEMENT AND COLLABORATION
7.1 Supervisory responsibility
7.2 Responsibility of management/area of responsibility

Working as a clinical nurse in primary care I was the manager of the health care central.
7.3 Administrative assignments within the institution/healthcare sector
7.4 Completed quality assurance work

At Dalarna University College we performed an alumni survey in order to identify level of knowledge and the perceived correspondence with the required knowledge in clinical practice. Taking the results of the survey into consideration we revised two courses.
7.5 Establishment and cooperation
7.6 Management and cooperation
8 CONGRESS ORGANISATION
Member of the committee for the 4 th
International congress of alternatives in childbirth: Joy and pain in childbirth. Stockholm 1997.
9 COLLABORATION WITH THE SURROUNDING COMMUNITY
9.1 School
9.2 Government agencies
9.3 Media
During the last five years I have been in contact with media several times regarding place of birth and perineal injuries in childbirth.

Debate articles (Svenska Dagbladet, Dagens Nyheter, Göteborgsposten)

News (Rapport, TV 4 Nyhetsmorgon, P1 Eko)

Debate program (Uppdrag granskning)
9.4 The larger community
9.5 Communications
I have produced one information folder for the National association for childbirth.

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9.6 Private sector
10 INNOVATION EXPERIENCE
10.1 Patents
10.2 Other intellectual property rights
10.3 Product development
10.4 Innovation work in the private sector
10.5 Other innovation experience
11 ENTREPRENEURSHIP
11.1 Enterprise start-up
11.2 Board assignments
11.3 Other entrepreneurial competence
12 MENTORSHIP
13 DISTINCTIONS IN LEADERSHIP, DEVELOPMENT AND
COLLABORATION
14 OTHER MERITS IN LEADERSHIP, DEVELOPMENT AND
COLLABORATION
15 REFERENCES
1.
Mari-Cristin Malm, RNM, doctoral student. Dalarna University College.
E-mail: mcm@du.se
Phone: 023-778447
2.
Ingela Rådestad, Professor
E-mail: ingela.radestad@shh.se
Phone: 08-4062743