{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:24:35Z","timestamp":1791390275384,"version":"4.3.3"},"reference-count":38,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T00:00:00Z","timestamp":1527811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T00:00:00Z","timestamp":1527811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"name":"County Council of V\u00e4sterbotten and Norrbotten","award":["VLL-751341"],"award-info":[{"award-number":["VLL-751341"]}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Midwifery"],"published-print":{"date-parts":[[2018,6]]},"DOI":"10.1016\/j.midw.2018.02.015","type":"journal-article","created":{"date-parts":[[2018,2,20]],"date-time":"2018-02-20T02:42:24Z","timestamp":1519094544000},"page":"22-28","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":45,"special_numbering":"C","title":["\u2018A worse nightmare than expected\u2019 - a Swedish qualitative study of women's experiences two months after obstetric anal sphincter muscle injury"],"prefix":"10.1016","volume":"61","author":[{"given":"Maria","family":"Lindqvist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Persson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Uustal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Lindberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.midw.2018.02.015_bib1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1186\/s12884-015-0742-6","article-title":"Sexual life and dysfunction after maternal morbidity: a systematic review","volume":"15","author":"Andreucci","year":"2015","journal-title":"BMC Pregnancy and Childbirth"},{"key":"10.1016\/j.midw.2018.02.015_bib2","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.ejogrb.2007.06.005","article-title":"Evaluation of postpartum perineal pain and dyspareunia--a prospective study","volume":"137","author":"Andrews","year":"2008","journal-title":"European Journal of Obstetrics&Gynecology and Reproductivel"},{"key":"10.1016\/j.midw.2018.02.015_bib3","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1177\/104973202129120016","article-title":"Postpartum depression: a metasynthesis","volume":"12","author":"Beck","year":"2002","journal-title":"Qualitative Health Researchs"},{"key":"10.1016\/j.midw.2018.02.015_bib4","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1463-1318.2005.00801.x","article-title":"Is it possible to predict or prevent third degree tears?","volume":"7","author":"Byrd","year":"2005","journal-title":"Colorectal Disease"},{"key":"10.1016\/j.midw.2018.02.015_bib5","doi-asserted-by":"crossref","first-page":"520","DOI":"10.12968\/bjcn.2004.9.12.17239","article-title":"Women's experiences of faecal incontinence: a study","volume":"9","author":"Collings","year":"2004","journal-title":"British Journal of Community Nursing"},{"key":"10.1016\/j.midw.2018.02.015_bib6","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1007\/s00192-016-3017-5","article-title":"Obstetric anal sphincter injury: a follow-up questionnaire study on longer-term outcomes","volume":"27","author":"Cornelisse","year":"2016","journal-title":"International Urogynecology Journal"},{"key":"10.1016\/j.midw.2018.02.015_bib7","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.gyobfe.2016.05.007","article-title":"Evaluation of long-term pelvic floor symptoms after an obstetric anal sphincter injury (OASI) at least one year after delivery: a retrospective cohort study of 159 cases","volume":"44","author":"Desseauve","year":"2016","journal-title":"Gyn\u00e9cologie Obst\u00e9trique&Fertilit\u00e9"},{"key":"10.1016\/j.midw.2018.02.015_bib8","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1080\/00016340802030629","article-title":"Increasing incidence of anal sphincter tears among primiparas in Sweden: a population-based register study","volume":"87","author":"Ekeus","year":"2008","journal-title":"Acta Obstetricia Et Gynecologica Scandinavica"},{"key":"10.1016\/j.midw.2018.02.015_bib9","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/j.1471-0528.2004.00400.x","article-title":"Obstetric anal sphincter injury ten years after: subjective and objective long term effects","volume":"112","author":"Fornell","year":"2005","journal-title":"BJOG"},{"key":"10.1016\/j.midw.2018.02.015_bib10","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/00152192-200501000-00009","article-title":"Breaking the cycle of stigmatization: managing the stigma of incontinence in social interactions","volume":"32","author":"Garcia","year":"2005","journal-title":"Journal of Wound Ostomy&Continence Nursing"},{"key":"10.1016\/j.midw.2018.02.015_bib11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness","volume":"24","author":"Graneheim","year":"2004","journal-title":"Nurse Education Today"},{"key":"10.1016\/j.midw.2018.02.015_bib12","unstructured":"GynOp registret. Bristningsregistret. Retrieved from \u3008http:\/\/www.gynop.org\/webhelp\/gynopnet\/gynopnet.htm-bristning\/faq_bristning.htm\u3009."},{"key":"10.1016\/j.midw.2018.02.015_bib13","doi-asserted-by":"crossref","first-page":"601","DOI":"10.3109\/00016349709024592","article-title":"Can women with intrapartum rupture of anal sphincter still suffer after-effects two decades later?","volume":"76","author":"Haadem","year":"1997","journal-title":"Acta Obstetricia Et Gynecologica Scandinavica"},{"key":"10.1016\/j.midw.2018.02.015_bib14","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.midw.2006.04.005","article-title":"A Q methodology study of women's experience of enduring postnatal perineal and pelvic floor morbidity","volume":"23","author":"Herron-Marx","year":"2007","journal-title":"Midwifery"},{"key":"10.1016\/j.midw.2018.02.015_bib15","first-page":"275","article-title":"The social, psychological, emotional morbidity and adjustment techniques for women with anal incontinence following obstetric anal sphincter","volume":"16","author":"Keighley","year":"2016","journal-title":"Injury: Use Of A Word Picture to Identify a Hidden Syndrome"},{"key":"10.1016\/j.midw.2018.02.015_bib16","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1186\/s12884-016-1065-y","article-title":"The social, psychological, emotional morbidity and adjustment techniques for women with anal incontinence following Obstetric Anal Sphincter Injury: use of a word picture to identify a hidden syndrome","volume":"16","author":"Keighley","year":"2016","journal-title":"BMC Pregnancy and Childbirth"},{"key":"10.1016\/j.midw.2018.02.015_bib17","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1752-0606.2009.00112.x","article-title":"Suffering in silence: a qualitative meta-data-analysis of postpartum depression","volume":"35","author":"Knudson-Martin","year":"2009","journal-title":"Journal of Marital and Family Therapy"},{"key":"10.1016\/j.midw.2018.02.015_bib18","series-title":"Content Analysis: an Introduction to Its Methodology","author":"Krippendorff","year":"2004"},{"key":"10.1016\/j.midw.2018.02.015_bib19","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s00404-011-2003-x","article-title":"Anal incontinence and quality of life following obstetric anal sphincter injury","volume":"285","author":"Kumar","year":"2012","journal-title":"Archives of Gynecology and Obstetrics"},{"key":"10.1016\/j.midw.2018.02.015_bib20","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/jmwh.12283","article-title":"Obstetric anal sphincter injury and anal incontinence following vaginal birth: a systematic review and meta-analysis","volume":"60","author":"LaCross","year":"2015","journal-title":"Journal of Midwifery&Women's Health"},{"key":"10.1016\/j.midw.2018.02.015_bib21","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ejogrb.2009.04.033","article-title":"Changing incidence of anal sphincter tears in four Nordic countries through the last decades","volume":"146","author":"Laine","year":"2009","journal-title":"European Journal of Obstetrics&Gynecology and Reproductive Biology"},{"key":"10.1016\/j.midw.2018.02.015_bib22","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.1111\/j.1365-2702.2008.02755.x","article-title":"Women's experiences of recovery from childbirth: focus on pelvis problems that extend beyond the puerperium","volume":"18","author":"O'Reilly","year":"2009","journal-title":"Journal of Clinical Nursing"},{"key":"10.1016\/j.midw.2018.02.015_bib23","first-page":"1397","article-title":"Anal incontinence after vaginal delivery: a five-year prospective cohort study","volume":"104","author":"Pollack","year":"2004","journal-title":"Obstetrics&Gynecologyl"},{"key":"10.1016\/j.midw.2018.02.015_bib24","doi-asserted-by":"crossref","first-page":"e008346","DOI":"10.1136\/bmjopen-2015-008346","article-title":"Does the finnish intervention prevent obstetric anal sphincter injuries? A systematic review of the literature","volume":"5","author":"Poulsen","year":"2015","journal-title":"BMJ Open"},{"key":"10.1016\/j.midw.2018.02.015_bib25","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1111\/jan.12005","article-title":"Women's experiences following severe perineal trauma: a meta-ethnographic synthesis","volume":"69","author":"Priddis","year":"2013","journal-title":"Journal of Advanced Nursing"},{"key":"10.1016\/j.midw.2018.02.015_bib26","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1472-6874-14-32","article-title":"Women's experiences following severe perineal trauma: a qualitative study","volume":"14","author":"Priddis","year":"2014","journal-title":"BMC Women's Health"},{"key":"10.1016\/j.midw.2018.02.015_bib27","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/1471-2393-14-236","article-title":"\"A patchwork of services\"--caring for women who sustain severe perineal trauma in New South Wales--from the perspective of women and midwives","volume":"14","author":"Priddis","year":"2014","journal-title":"BMC Pregnancy and Childbirth"},{"key":"10.1016\/j.midw.2018.02.015_bib28","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/j.1471-6712.2009.00693.x","article-title":"Being involved in an everlasting fight--a life with postnatal faecal incontinence. A qualitative study","volume":"24","author":"Rasmussen","year":"2010","journal-title":"Scandinavian Journal of Caring Sciences"},{"key":"10.1016\/j.midw.2018.02.015_bib29","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1111\/j.1463-1318.2007.01445.x","article-title":"Long-term anal continence and quality of life following postpartum anal sphincter injury","volume":"10","author":"Samarasekera","year":"2008","journal-title":"Colorectal Disease"},{"key":"10.1016\/j.midw.2018.02.015_bib30","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1046\/j.0001-6349.2001.10182.x","article-title":"A prospective observational study on tears during vaginal delivery: occurrences and risk factors","volume":"81","author":"Samuelsson","year":"2002","journal-title":"ACTA Obstetricia Et Gynecologica Scandinavica"},{"key":"10.1016\/j.midw.2018.02.015_bib31","unstructured":"Socialstyrelsen, 2015.\u00a0Graviditeter, fo\u00a8rlossningar och nyfo\u00a8dda barn \u2013 Medicinska f\u00f6delseregistret 1973\u20132014 \u2013 Assisterad befruktning 1991\u20132013 Retrieved from."},{"key":"10.1016\/j.midw.2018.02.015_bib32","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/j.1600-0412.2012.01398.x","article-title":"Long-term outcome after obstetric injury: a retrospective study","volume":"91","author":"Sundquist","year":"2012","journal-title":"Acta Obstetricia Et Gynecologica Scandinavica"},{"key":"10.1016\/j.midw.2018.02.015_bib33","unstructured":"Patientdatalag (2008:355), 2008."},{"key":"10.1016\/j.midw.2018.02.015_bib34","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/ajo.12230","article-title":"Teetering near the edge; women's experiences of anal incontinence following obstetric anal sphincter injury: an interpretive phenomenological research study","volume":"54","author":"Tucker","year":"2014","journal-title":"Australian and New Zealand Journal of Obstetrics and Gynaecology"},{"key":"10.1016\/j.midw.2018.02.015_bib35","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.0001-6349.2004.00367.x","article-title":"Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study","volume":"83","author":"Uustal Fornell","year":"2004","journal-title":"Acta Obstetricia Et Gynecologica Scandinavica"},{"key":"10.1016\/j.midw.2018.02.015_bib36","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1034\/j.1600-0412.2003.00088.x","article-title":"Clinical symptoms after anal sphincter rupture: a retrospective study","volume":"82","author":"Wagenius","year":"2003","journal-title":"Acta Obstetricia Et Gynecologica Scandinavica"},{"key":"10.1016\/j.midw.2018.02.015_bib37","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.0730-7659.2005.00356.x","article-title":"Women's experiences after a third-degree obstetric anal sphincter tear: a qualitative study","volume":"32","author":"Williams","year":"2005","journal-title":"Birth"},{"key":"10.1016\/j.midw.2018.02.015_bib38","doi-asserted-by":"crossref","first-page":"204","DOI":"10.12968\/bjon.2007.16.4.22978","article-title":"The impact of faecal incontinence on the quality of life","volume":"16","author":"Wilson","year":"2007","journal-title":"British Journal of Nursing"}],"container-title":["Midwifery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0266613818300573?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0266613818300573?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:52:51Z","timestamp":1759420371000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0266613818300573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":38,"alternative-id":["S0266613818300573"],"URL":"https:\/\/doi.org\/10.1016\/j.midw.2018.02.015","relation":{},"ISSN":["0266-6138"],"issn-type":[{"value":"0266-6138","type":"print"}],"subject":[],"published":{"date-parts":[[2018,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"\u2018A worse nightmare than expected\u2019 - a Swedish qualitative study of women's experiences two months after obstetric anal sphincter muscle injury","name":"articletitle","label":"Article Title"},{"value":"Midwifery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.midw.2018.02.015","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}