Ingvil Krarup Sørbye

• Bains, Sukhjeet Kaur; Tellum, Tina; Abebe, Dawit Shawel; Michelsen, Trond Melbye & Sørbye, Ingvil Krarup (2026). Influence of migration status on hysterectomy surgical approach and indications for benign conditions—a nationwide cohort register study. European Journal of Public Health. ISSN 1101-1262. 36(5), p. 1–10. doi: 10.1093/eurpub/ckag176. Full text in Research Archive
• Røe, Kjerstine; Sørbye, Ingvil Krarup; Torkildsen, Cecilie Fredvik; Engeland, Anders; Engjom, Hilde Marie & Nilsen, Roy Miodini [Show all 7 contributors for this article] (2026). Incidence and risk factors for postpartum infections: A Norwegian cohort study, 2012–2020. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. p. 1–15. doi: 10.1111/aogs.70355. Full text in Research Archive Show summary

  Introduction: Few epidemiological studies have examined postpartum infections in the Nordic countries. This study aimed to assess the incidence and risk factors for postpartum infections in Norway. Material and Methods: We conducted a historical cohort study including all deliveries in Norway from 2012 to 2020, using linked nationwide data from the Medical Birth Registry of Norway, the Norwegian Patient Registry, and Statistics Norway. We defined two outcomes: endometritis/puerperal sepsis (O85, International Classification of Diseases 10th version (ICD-10); the code does not differentiate between endometritis and puerperal sepsis, and endometritis predominates) and other postpartum infections (O86, ICD-10). Associations were estimated as relative risks (RR) with 95% confidence intervals (CI) using log-binomial regression. Results: Among 516 874 deliveries, we identified 5942 cases (1.15%) of endometritis/puerperal sepsis (O85) and 8833 (1.71%) of other postpartum infections (O86). The incidence of endometritis/puerperal sepsis increased over time from 0.93% in 2012 to 1.38% in 2020 (test for trend, p < 0.001). After adjusting for all covariates, delivery-related factors demonstrated the strongest associations with both outcomes, especially emergency cesarean section (aRRO85 2.8; 95% CI 2.6–3.0/aRRO86 5.1; 95% CI 4.8–5.5) and postpartum hemorrhage (aRRO85 3.2; 2.9–3.4/aRRO86 2.0; 1.9–2.2). Risk factors not directly related to delivery, such as multifetal gestation, obesity, nulliparity and maternal single status, were also associated with both outcomes (aRRs in the range of 1.2–2.5). Chorioamnionitis lies on the same infectious continuum as postpartum endometritis and is treated with intrapartum antibiotics, usually discontinued after delivery unless persisting signs of infection. We found a strong association between chorioamnionitis/intrapartum infection and postpartum infections (aRRO85 5.7; 5.1–6.4/aRRO86 3.2; 2.9–3.6). Alongside the strong associations with postpartum infections, we also observed an increasing incidence over time in chorioamnionitis/intrapartum infection (p < 0.001) and postpartum hemorrhage (p < 0.001). Conclusions: Postpartum infections are common, and the incidence of endometritis/puerperal sepsis is increasing. For all postpartum infections, delivery-related factors demonstrate the strongest associations. Postpartum hemorrhage and chorioamnionitis/intrapartum infection may represent key targets for prevention/prevention of progression. Revision of the coding system is necessary to enable differentiation between puerperal sepsis and endometritis for better surveillance.

• Miltenburg, Andrea Solnes; Kiritta, Richard; Kidenya, Benson R.; Amoakoh, Hannah Brown; Schielen, Peter C.J.I. & Manyogote, Felix [Show all 15 contributors for this article] (2026). PRESHA — Preventing severe hypertensive adverse events in pregnancy and childbirth: a study protocol for establishing a prospective cohort study and biobank in urban Tanzania. Frontiers in Global Women's Health. 7. doi: 10.3389/fgwh.2026.1812275. Full text in Research Archive
• Zykova, Svetlana; Plaksienko, Anna; Solevåg, Anne Lee; Brigtsen, Anne Karin; Michelsen, Trond Melbye & Sørbye, Ingvil Krarup [Show all 12 contributors for this article] (2026). Neonatal reference intervals for salivary steroids: focus on prematurity, stressful events and perinatal betamethasone. Frontiers in Pediatrics. 14. doi: 10.3389/fped.2026.1808446. Full text in Research Archive
• Marsdal, Kjersti Engen; Bernitz, Stine; Sørbye, Ingvil Krarup & Lukasse, Mirjam (2026). Real-time reflections during induction of labor: A qualitative study of women’s perspectives. Sexual & Reproductive HealthCare. ISSN 1877-5756. 47. doi: 10.1016/j.srhc.2026.101194. Full text in Research Archive Show summary

  Background The World Health Organization emphasizes the importance of a positive childbirth experience for future mental health. Induction of labor (IOL) is increasingly common and may increase the risk of negative childbirth experiences. To separate the IOL experience from later events during labor, we collected women’s real-time reflections during the IOL process. Objective This study aimed to explore and describe what is important to women during IOL, based on their in-the-moment reflections. Methods As part of the Labor Induction Inpatient and Outpatient (LINO) project, we conducted a qualitative study from February 2021 to December 2022 at two Norwegian maternity wards. The study included healthy women expecting a healthy baby, who responded to a daily questionnaire during their IOL process. Data were analyzed using content analysis as described by Graneheim and Lundman. Results We identified with one overarching theme: The need to feel secure when facing the unfamiliar and life-altering experience of childbirth, along with three categories: 1) Demanding mental processes, 2) The crucial role of supportive relationships, and 3) Essential practical needs. Women highlighted the importance of having their partners present, receiving comprehensive information, and choosing their preferred care setting for emotional and medical security. Conclusion To support women during, it is essential to meet their fundamental need for both medical and emotional security. Ensuring access to healthcare professionals, partner support, and comprehensive information can enhance their well-being. Adapting care to support these needs can help improve women’s experiences with IOL.

• Leeves, Lisa Tangnes; Michelsen, Trond Melbye; Jacobsen, Anne Flem; Solhoff, Aslak Vimme; Gunnes, Nina & Sørbye, Ingvil Krarup (2025). Is indication for induction of labor associated with mode of delivery in term first births? A Norwegian registry-based study. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 104(11), p. 2165–2177. doi: 10.1111/aogs.70060. Full text in Research Archive Show summary

  Introduction Few previous studies have examined the association between the indication for induction of labor (IOL) and the mode of delivery. To improve information for clinicians and women undergoing IOL, our study aimed to assess the association between the indication for IOL and the risk of cesarean and operative vaginal birth among nulliparous women with single cephalic term pregnancies. Furthermore, we examined whether associations varied by gestational length. Lastly, we evaluated reasons for cesarean and operative vaginal birth across indications for IOL. Material and Methods Data were extracted from the Medical Birth Registry of Norway from 2020 to 2021. We used the registered main indication for IOL. Multinomial logistic regression was applied to estimate relative risk ratios (RRRs) with associated 95% confidence intervals (CIs) of cesarean and operative vaginal birth versus spontaneous vaginal birth for the different IOL indications, using prelabor rupture of membranes (PROM) as the reference indication. Results Risk of cesarean versus spontaneous vaginal birth was four times higher for women induced due to large fetus compared to women induced due to PROM (adjusted RRR: 4.39; 95% CI: 3.21 to 5.99). Indications such as maternal request, post-term pregnancy, oligo−/polyhydramnios, preeclampsia/hypertension, and diabetes were associated with a 40%–91% increased relative risk of cesarean versus spontaneous vaginal birth compared to PROM. Relative risk of operative vaginal versus spontaneous vaginal birth was increased by 23%–29% for oligo−/polyhydramnios, diabetes, and post-term pregnancy compared to PROM. Indication large fetus had similar relative risk ratios at all gestational lengths. Rate of operative delivery for fetal distress was highest for IOL due to intrauterine growth restriction (IUGR). For secondary outcomes, IOL due to IUGR had the highest proportions of cesarean and operative vaginal birth for fetal distress. Indication post-term pregnancy had the highest proportion of cesarean birth for prolonged labor, while large fetus had the highest proportion of operative vaginal birth for prolonged labor. Conclusions Nulliparous women undergoing IOL for indications such as large fetus, post-term pregnancy, oligo-/polyhydramnios, preeclampsia/hypertension, and diabetes are at an elevated relative risk of cesarean versus spontaneous vaginal birth compared to IOL for PROM. In contrast, the relative risk of operative vaginal birth showed less variation by indication for IOL.

• Michelsen, Trond Melbye; Sajjad, Muhammad Umar; Haugen, Guttorm Nils; Moore, Lorna; Julian, Colleen G. & Sørbye, Ingvil Krarup [Show all 7 contributors for this article] (2025). Maternal body mass index is related to fetal uptake of glucose and oxygen via fetal insulin resistance rather than fetal glucose levels. Philosophical Transactions of the Royal Society of London. Biological Sciences. ISSN 0962-8436. 380(1933). doi: 10.1098/rstb.2024.0178. Full text in Research Archive
• Bjørnerem, Åshild Marit; Kolstad, Caroline Renland; Helmersen, Tonje Agnete Gravvold; Michelsen, Trond Melbye & Sørbye, Ingvil Krarup (2025). Fødselsmåte etter igangsatt fødsel ved pregravid overvekt og fedme. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(7). doi: 10.4045/tidsskr.24.0643. Full text in Research Archive
• Misje, Ragnhild; Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil Krarup & Dahl, Cecilie (2025). Increased risk of adverse maternal pregnancy outcomes among undocumented migrants in Norway. Journal of Migration and Health. 11. doi: 10.1016/j.jmh.2025.100318. Full text in Research Archive
• Marsdal, Kjersti Engen; Sørbye, Ingvil Krarup; Bernitz, Stine; Adan, Nasreen; Grødal, Elin Baustad & Jacobsen, Anne Flem [Show all 7 contributors for this article] (2025). Clinical outcomes and feasibility of implementing outpatient labor induction with misoprostol: A prospective cohort study. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. p. 647–657. doi: 10.1111/aogs.15029. Full text in Research Archive
• Aanstad, Kristin Jerve; Marsdal, Kjersti Engen; Blix, Ellen; Kaasen, Anne; Lukasse, Mirjam & Sørbye, Ingvil Krarup [Show all 7 contributors for this article] (2024). Needs led research: ensuring relevant research in two PhD projects within maternity care. Research Involvement and Engagement. 10(1), p. 1–12. doi: 10.1186/s40900-024-00627-6. Full text in Research Archive Show summary

  Background There has been a growing concern regarding research waste and the mismatch between conducted research and the research needs of knowledge users. The Needs Led Research (NLR) approach is proposed as an effective method to ensure that research address actual evidence gaps that are relevant to the users of the knowledge. By search and reviewing literature and involving knowledge users, NLR aims to identify, verify, and prioritize research needs. This paper describes and compares the implementation of the NLR approach in two separate PhD projects within maternity care, and addresses the challenges encountered throughout the processes, aiming to offer valuable insights for future NLR initiatives. Methods The NLR processes consisted of four phases: (1) defining the scope (2) identifying and verifying research needs (3) prioritizing research needs and (4) designing the PhD projects. Literature searches were conducted during Phase 2, while knowledge user involvement took place in Phases 2 and 3. The knowledge user involvement, at a co-thinker and advocatory level, included knowledge user groups and surveys. Project groups, who were responsible for all decision-making, conducted Phases 1 and 4. The scopes of the PhD projects were labor induction (NLR-LINO) and fetal monitoring in low-risk deliveries (NLR-LISTEN). Results In NLR-LINO, 17 research needs were identified and verified as actual evidence gaps relevant for the knowledge users. Among these, ten were rated as “very important” by a majority of the 322 survey respondents. The aim of the PhD LINO project was defined as “To investigate whether outpatient induction of labor is beneficial in a Norwegian setting.” In NLR-LISTEN, seven research needs were identified and verified as actual evidence gaps relevant for the knowledge users. These were prioritized by 466 survey respondents, and the aim of the PhD LISTEN project was defined as “To investigate the methods used for fetal monitoring in low-risk deliveries in Norway and evaluate adherence to evidence-based practice while also exploring potential reasons for any deviations.” Conclusions This paper shows that the NLR is a viable approach for prioritizing research. The findings highlight the impact of the initial scope on subsequent phases and emphasize the importance of pragmatic decision-making throughout the process. However, it is crucial to acknowledge that NLR requires dedicated resources, and if integrated into PhD projects, additional time and training should be allocated accordingly.

• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi E; Sørbye, Ingvil Krarup; Valberg, Morten & Dahl, Cecilie (2024). Perinatal mortality among pregnant undocumented migrants in Norway 1999–2020: A register-based population study. Social Science and Medicine. ISSN 0277-9536. 353. doi: 10.1016/j.socscimed.2024.117055. Full text in Research Archive Show summary

  Background Irregular legal status is a recognized health risk factor in the context of migration. However, undocumented migrants are rarely included in health surveys and register studies. Adverse perinatal outcomes are especially important because they have long-term consequences and societal risk factors are modifiable. In this study, we compare perinatal outcomes in undocumented migrants to foreign-born and Norwegian-born residents, using a population-based register. Methods We included women 18–49 years old giving birth to singletons as registered in the Medical Birth Registry of Norway from 1999 to 2020. Women were categorized as ‘undocumented migrants’ (without an identity number), ‘documented migrants’ (with an identity number and born abroad), and ‘non-migrants’ (with an identity number and born in Norway). The main outcome was perinatal mortality, i.e., death of a foetus ≥ gestational week 22, or neonate up to seven days after birth. We used log-binominal regression to estimate the association between legal status and perinatal mortality, adjusting for several maternal pre-gestational and gestational factors. Direct standardization was used to adjust for maternal region of origin. Ethical approval Regional Ethical Committee (REK South East, case number 68329). Results We retrieved information on 5856 undocumented migrant women who gave birth during the study period representing 0.5% of the 1 247 537 births in Norway. Undocumented migrants had a relative risk of 6.17 (95% confidence interval 5.29 ̶7.20) of perinatal mortality compared to non-migrants and a relative risk of 4.17 (95% confidence interval 3.51 ̶4.93) compared to documented migrants. Adjusting for maternal region of origin attenuated the results slightly. Conclusion Being undocumented is strongly associated with perinatal mortality in the offspring. Disparities were not explained by maternal origin or maternal health factors, indicating that social determinants of health through delays in receiving adequate care and factors negatively influencing gestational length may be of importance.

• Marsdal, Kjersti Engen; Sørbye, Ingvil Krarup; Bernitz, Stine; Sve, Ranveig Elise Tulluan; Ask, Kristine & Lukasse, Mirjam (2024). Outpatient labor induction—Exploring future potential by assessing eligibility in a historical cohort. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 103(6), p. 1101–1111. doi: 10.1111/aogs.14799. Full text in Research Archive Show summary

  Introduction: Labor induction rates have increased over the last decades, and in many high-income countries, more than one in four labors are induced. Outpatient man- agement of labor induction has been suggested in low-risk pregnancies to improve women's birth experiences while also promoting a more efficient use of healthcare resources. The primary aim of this paper was to assess the proportion of women in a historical cohort that would have been eligible for outpatient labor induction with oral misoprostol. Second, we wanted to report safety outcomes and assess efficacy out- comes for mothers and infants in pregnancies that met the criteria for outpatient care. Material and methods: Criteria for outpatient labor induction with oral misoprostol were applied to a historical cohort of women with induction of labor at two Norwegian tertiary hospitals in the period January 1, through July 31, 2021. The criteria included low-risk women with an unscarred uterus expecting a healthy, singleton baby in ce- phalic position at term. The primary outcome was the proportion of women eligible for outpatient labor induction. Secondary outcomes included reasons for ineligibility and, for eligible women, safety and efficacy outcomes. Results: Overall, 29.7% of the 1320 women who underwent labor induction in a sin- gleton term pregnancy met the criteria for outpatient labor induction. We identified two serious adverse events that potentially could have occurred outside the hospital if the women had received outpatient care. The mean duration from initiation of labor induction to administration of the last misoprostol was 22.4 h. One in 14 multiparous women gave birth within 3 h after the last misoprostol dose. Conclusions: In this historical cohort, three in ten women met the criteria for outpa- tient management of labor induction with oral misoprostol. Serious adverse events were rare. The average time span from the initiation of labor induction to the last misoprostol was nearly 24 h. This suggests a potential for low-risk women with an induced labor to spend a substantial period of time at home before labor onset.

• Gaudernack, Lise Christine; Einarsen, Angeline Elisabeth Styve; Sørbye, Ingvil Krarup; Lukasse, Mirjam; Gunnes, Nina & Michelsen, Trond Melbye (2024). The effect of intravenous hyoscine butylbromide on slow progress in labor (BUSCLAB): A double-blind randomized placebo-controlled trial. PLoS Medicine. ISSN 1549-1277. 21(3), p. 1–24. doi: 10.1371/journal.pmed.1004352. Full text in Research Archive Show summary

  Background: Prolonged labor is a common condition associated with maternal and perinatal complications. The standard treatment with oxytocin for augmentation of labor increases the risk of adverse outcomes. Hyoscine butylbromide is a spasmolytic drug with few side effects shown to shorten labor when used in a general population of laboring women. However, research on its effect on preventing prolonged labor is lacking. We aimed to assess the effect of hyoscine butylbromide on the duration of labor in nulliparous women showing early signs of slow labor. Methods and findings In this double-blind randomized placebo-controlled trial, we included 249 nulliparous women at term with 1 fetus in cephalic presentation and spontaneous start of labor, showing early signs of prolonged labor by crossing the alert line of the World Health Organization (WHO) partograph. The trial was conducted at Oslo University Hospital in Norway from May 2019 to December 2021. One hundred and twenty-five participants were randomized to receive 1 ml hyoscine butylbromide (Buscopan) (20 mg/ml), while 124 received 1 ml sodium chloride intravenously. Randomization was computer-generated, with allocation concealment by opaque sequentially numbered sealed envelopes. The primary outcome was duration of labor from administration of the investigational medicinal product (IMP) to vaginal delivery, which was analyzed by Weibull regression to estimate the cause-specific hazard ratio (HR) of vaginal delivery between the 2 treatment groups, with associated 95% confidence interval (CI). A wide range of secondary maternal and perinatal outcomes were also evaluated.Time-to-event outcomes were analyzed by Weibull regression, whereas continuous and dichotomous outcomes were analyzed by median regression and logistic regression, respectively. All main analyses were based on the modified intention-to-treat (ITT) set of eli- gible women with signed informed consent receiving either of the 2 treatments. The follow- up period lasted during the postpartum hospital stay. All personnel, participants, and researchers were blinded to the treatment allocation. Median (mean) labor duration from IMP administration to vaginal delivery was 401 (440.8) min in the hyoscine butylbromide group versus 432.5 (453.6) min in the placebo group. We found no statistically significant association between IMP and duration of labor from IMP administration to vaginal delivery: cause-specific HR of 1.00 (95% CI [0.77, 1.29]; p = 0.993). Among 255 randomized women having received 1 dose of IMP, 169 women (66.3%) reported a mild adverse event: 75.2% in the hyoscine butylbromide group and 57.1% in the placebo group (Pearson’s chi-square test: p = 0.002). More than half of eligible women were not included in the study because they did not wish to participate or were not included upon admission. The participants might have repre- sented a selected group of women reducing the external validity of the study. Conclusions One intravenous dose of 20 mg hyoscine butylbromide was not found to be superior to pla- cebo in preventing slow labor progress in a population of first-time mothers at risk of pro- longed labor. Further research is warranted to answer whether increased and/or repeated doses of hyoscine butylbromide might have an effect on duration of labor.

• Langen, Ingrid; Langesæter, Eldrid; Gunnes, Nina; Almaas, Vibeke Marie; Haugen, Guttorm Nils & Estensen, Mette-Elise [Show all 7 contributors for this article] (2024). Hypertensive disorders of pregnancy among women with cardiovascular disease in Norway: A historical cohort study. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 103(7), p. 1457–1465. doi: 10.1111/aogs.14841. Full text in Research Archive Show summary

  Introduction Women with cardiovascular disease may be at increased risk of hypertensive disorders of pregnancy (HDP). We aimed to: (1) Investigate the occurrence of HDP in a cohort of pregnant women with cardiovascular disease and compare it with the occurrence in the general population. (2) Assess the association between maternal cardiovascular risk and risk of HDP. Material and methods We reviewed clinical data on a cohort of 901 pregnancies among 708 women with cardiovascular disease who were followed at the National Unit for Pregnancy and Heart Disease and gave birth at Oslo University Hospital between 2003 and 2018. The exposure under study was maternal cardiovascular risk, classified as low, moderate, or high based on a modified classification by the World Health Organization. The main outcome of interest was HDP, which included pre-eclampsia and gestational hypertension. The proportion of HDP cases in the general population in the same period was extracted from the Medical Birth Registry of Norway. We used logistic regression to estimate crude and adjusted odds ratios (OR) of HDP, with associated 95% confidence intervals (CIs), for women with moderate- and high cardiovascular risk compared to women with low risk. Results The occurrence of HDP in the study cohort was 12.1% (95% CI: 10.0%–14.4%) and varied between 8.7% (95% CI: 6.5%–11.3%) in the low-risk group, 15.7% (95% CI: 11.1%–21.4%) in the moderate-risk group, and 22.2% (95% CI: 15.1%–30.8%) in the high-risk group. By contrast, the nationwide occurrence of HDP was 5.1% (95% CI: 5.1%–5.2%). In the study cohort, the proportions of pregnancies with gestational hypertension and pre-eclampsia were similar (6.3% and 5.8%, respectively). Compared to pregnancies with low cardiovascular risk, the adjusted OR of HDP was 2.04 (95% CI: 1.21–3.44) in the moderate-risk group and 2.99 (95% CI: 1.73–5.18) in the high-risk group. Conclusions The occurrence of hypertensive disease of pregnancy in the study cohort was more than doubled compared to the general population in Norway. The risk of HDP increased with maternal cardiovascular risk group. We recommend taking into account maternal cardiovascular risk group when assessing risk and prophylaxis of HDP.

• Grønningsæter, Lasse; Langesæter, Eldrid; Sørbye, Ingvil Krarup; Quattrone, Alessia; Almaas, Vibeke Marie & Skulstad, Helge [Show all 7 contributors for this article] (2023). High prevalence of pre-eclampsia in women with coarctation of the aorta. European Heart Journal Open (EHJ Open). 3(4). doi: 10.1093/ehjopen/oead072. Full text in Research Archive Show summary

  Aims The aim was to study pregnancy outcomes in women with coarctation of the aorta (CoA) and associations to hypertensive disorders of pregnancy. Maternal morbidity and mortality are higher in women with heart disease and pre-eclampsia. Chronic hypertension, frequently encountered in CoA, is a risk factor for pre-eclampsia. Methods and results Clinical data from the National Unit for Pregnancy and Heart Disease database was reviewed for pregnant women with CoA from 2008 to 2021. The primary outcome was hypertensive pregnancy disorders. The secondary outcomes were other cardiovascular, obstetric, and foetal complications. Seventy-six patients were included, with a total of 87 pregnancies. Seventeen (20%) patients were treated for chronic hypertension before pregnancy. Fifteen (20%) patients developed pre-eclampsia, and 5 (7%) had pregnancy-induced hypertension. Major adverse cardiac events developed in four (5%) patients, with no maternal or foetal mortality. Maternal age at first pregnancy [odds ratio (OR) 1.37], body mass index before first pregnancy (OR 1.77), and using acetylsalicylic acid from the first trimester (OR 0.22) were statistically significantly associated with pre-eclampsia. At follow-up (median) 8 years after pregnancy, 29 (38%) patients had anti-hypertensive treatment, an increase of 16% compared to pre-pregnancy. Five (7%) patients had progression of aorta ascendens dilatation to >40 mm, seven (9%) had an upper to lower systolic blood pressure gradient >20 mmHg, and six (8%) had received CoA re-intervention. Conclusion Pre-eclampsia occurred in 20% of women with CoA in their first pregnancy. All pre-eclamptic patients received adequate anti-hypertensive treatment. All CoA patients were provided multi-disciplinary management, including cardiologic follow-up, to optimize maternal–foetal outcomes.

• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil; Ruud, Sven Eirik & Dahl, Cecilie (2023). Use of emergency primary care among pregnant undocumented migrants over ten years: an observational study from Oslo, Norway. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 41(3), p. 317–325. doi: 10.1080/02813432.2023.2237074. Full text in Research Archive Show summary

  Objective To compare consultations with pregnant undocumented migrants at emergency primary health care to consultations with pregnant residents of Norway. Design A cross-sectional study of consultations at several time points. Setting The study was conducted at the Oslo Accident and Emergency Outpatient Clinic (OAEOC), the main emergency primary care service in Oslo, Norway. Subjects Consultations with pregnant patients without a Norwegian identity number seeking care at the Department of Emergency General Practice at the OAEOC were identified through a manual search of registration lists from 2009 to 2019. The consultations were categorized by women’s residency status as ‘probably documented migrant’, ‘uncertain migrant status’, or ‘probably undocumented migrant’. We also extracted aggregated data for women with a Norwegian identity number (i.e. residents) presenting in consultations with pregnancy-related (ICPC-2 chapter W) conditions. Main outcome measures Manchester Triage System urgency level at presentation, and hospitalization. Results Among 829 consultations with female patients categorized as probably undocumented migrants, we found 27.1% (225/829) with pregnant women. About half of the pregnant women (54.6% (123/225)) presented with a pregnancy-related condition. Pregnant women that were probably undocumented migrants had an increased risk of being triaged with a high level of urgency at presentation (relative risk (RR) 1.86, 95% CI 1.14–3.04) and being hospitalized (RR 1.68, 95% CI 1.21–2.34), compared to pregnant residents. Conclusion Pregnant undocumented migrants were more severely sick when presenting to emergency primary care services than pregnant residents. Increased access to primary care and emergency primary care services for pregnant undocumented migrants is urgently needed.

• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil; Storkås, Guro & Ekrem, Marthe [Show all 11 contributors for this article] (2022). Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway. BMC Pregnancy and Childbirth. 22, p. 1–13. doi: 10.1186/s12884-022-05112-0. Full text in Research Archive Show summary

  Background In 2011 Norway granted undocumented women the right to antenatal care and to give birth at a hospital but did not include them in the general practitioner and reimbursement schemes. As a response to limited access to health care, Non-Governmental Organizations (NGO) have been running health clinics for undocumented migrants in Norway’s two largest cities. To further facilitate universal health coverage, there is a need to investigate how pregnant undocumented women use NGO clinics and how this affects their maternal health. We therefore investigated the care received, occurrence of pregnancy-related complications and pregnancy outcomes in women receiving antenatal care at these clinics. Methods In this historic cohort study we included pregnant women aged 18–49 attending urban NGO clinics from 2009 to 2020 and retrieved their medical records from referral hospitals. We compared women based on region of origin using log-binominal regression to estimate relative risk of adverse pregnancy outcomes. Results We identified 582 pregnancies in 500 women during the study period. About half (46.5%) the women sought antenatal care after gestational week 12, and 25.7% after week 22. The women had median 1 (IQR 1–3) antenatal visit at the NGO clinics, which referred 77.7% of the women to public health care. A total of 28.4% of women were referred for induced abortion. In 205 retrieved deliveries in medical records, there was a 45.9% risk for any adverse pregnancy outcome. The risk of stillbirth was 1.0%, preterm birth 10.3%, and emergency caesarean section 19.3%. Conclusion Pregnant undocumented women who use NGO clinics receive substandard antenatal care and have a high risk of adverse pregnancy outcomes despite low occurrence of comorbidities. To achieve universal health coverage, increased attention should be given to the structural vulnerabilities of undocumented women and to ensure that adequate antenatal care is accessible for them.

• Waldum, Åsa; Lukasse, Mirjam; Staff, Anne Cathrine; Falk, Ragnhild Sørum; Sørbye, Ingvil & Jacobsen, Anne Flem (2022). Intrapartum pudendal nerve block analgesia and childbirth experience in primiparous women with vaginal birth: A cohort study. Birth. ISSN 0730-7659. 50(1), p. 1–10. doi: 10.1111/birt.12697. Full text in Research Archive Show summary

  Background A negative childbirth experience has short- and long-term consequences for both mother and child. This study aimed to investigate the association between intrapartum pudendal nerve block (PNB) analgesia and childbirth experience. Methods Primiparous women with a singleton cephalic vaginal live births at term at Oslo University Hospital from January 1, 2017, to June 1, 2019, were eligible for inclusion. The main outcome was total score on a childbirth experience questionnaire (range 1.0–4.0, higher score indicates better childbirth experience). An absolute risk difference of 0.10 was considered clinically relevant. Propensity score matching was used to adjust for differences in baseline characteristics between women with and without PNB. The analyses were stratified by spontaneous vs instrumental birth. Subanalyses of the questionnaire's domains (own capacity, professional support, perceived safety, and participation) were performed. Results Of 979 participating women, mean age was 32 years. Childbirth experience did not differ between women with and without PNB, either in spontaneous (absolute risk difference of the mean: −0.05, P value 0.36) or in instrumental birth (absolute risk difference of the mean: 0.03, P value 0.61). There were no statistically significant differences between PNB group scores for the separate domains. Conclusions Women's childbirth experiences did not differ between birthing people with or without PNB, either in spontaneous or in instrumental births. The clinical implications of our study should be interpreted in light of the pain-relieving effects of PNB.PNB should be provided on clinical indication, including for individuals with severe labor pain.

• Taraldsen, Sølvi; Vangen, Siri; Øian, Pål & Sørbye, Ingvil (2022). Risk of obstetric anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 101(10), p. 1163–1173. doi: 10.1111/aogs.14424. Full text in Research Archive Show summary

  Introduction: A greater risk of obstetric anal sphincter injury has been reported among African migrants in several host countries compared with the general population. To what degree female genital mutilation/cutting affects this risk is not clear. In infibulated women, deinfibulation prevents anal sphincter injury. Whether the timing of deinfibulation affects the risk, is unknown. This study aimed to investigate the risks of anal sphincter injury associated with female genital mutilation/cutting and timing of deinfibulation in Norway, and to compare the rates of anal sphincter injury in Somaliborn women and the general population.<p> <p>Material and methods: In a historical cohort study, nulliparous Somali-born women who had a vaginal birth in the period 1990–2014 were identified by the Medical Birth Registry of Norway and data collected from medical records. Exposures were female genital mutilation/cutting status and deinfibulation before labor, during labor or no deinfibulation. The main outcome was obstetric anal sphincter injuries. <p>Results: Rates of obstetric anal sphincter injury did not differ significantly by female genital mutilation/cutting status (type 1–2: 10.2%, type 3: 11.3%, none: 15.2% P = 0.17). The total rate of anal sphincter injury was 10.3% compared to 5.0% among nulliparous women in the general Norwegian population. Women who underwent deinfibulation during labor had a lower risk than women who underwent deinfibulation before labor (odds ratio 0.48, 95% confidence interval 0.27–0.86, P = 0.01). <p>Conclusions: The high rate of anal sphincter injury in Somali nulliparous women was not related to type of female genital mutilation/cutting. Deinfibulation during labor protected against anal sphincter injury, whereas deinfibulation before labor was associated with a doubled risk. Deinfibulation before labor should not be routinely recommended during pregnancy

• Sørbye, Ingvil; Haualand, randi; Moen, Henriette; letting, anne-sofie; Langesæter, Eldrid & Estensen, Mette-Elise (2022). Maternal beta-blocker dose and risk of small-for gestational-age in women with heart disease. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 101(7), p. 794–802. doi: 10.1111/aogs.14363. Full text in Research Archive Show summary

  Introduction Beta-blockers are prescribed for many pregnant women with heart disease, but whether there is a dose-dependent effect on fetal growth remains to be examined. We aimed to investigate if antenatal beta-blocker use and dose were associated with delivering a small-for-gestational-age infant among women with heart disease. Material and methods Our cohort included women with heart disease who delivered at Oslo University Hospital between 2006 and 2015. Maternal heart disease was classified into modified WHO risk scores. Women with beta-blocker treatment were dichotomized into whether they had been treated with a low or high dose based on clinical factors. We compared the risk of delivering a small-for-gestational-age infant in women exposed to high doses, low doses, or with no exposure to antenatal beta-blockers while adjusting for severity of maternal heart disease in logistic regression models. Results Of a total of 540 pregnancies among women with heart disease, 163 (30.2%) were exposed to beta-blocker treatment. The majority were treated with metoprolol (86.5%). Almost twice as many babies in the beta-blocker group were small-for-gestational-age, compared with the non-exposed group (19.8 vs 9.5%, P < 0.001). Women using a high-dose beta-blocker had a five-fold increased risk of delivering a small-for-gestational-age infant compared with non-exposure (adjusted odds ratio [aOR] 4.89, 95% confidence interval [CI] 2.22–10.78, P < 0.001). Women using a low dose of beta-blocker had a two-fold increased risk of delivering a small-for-gestational-age infant; however, the confidence interval included the null (aOR 1.75, 95% CI 0.83–3.72, P = 0.143). Results when restricting the analyses to metoprolol showed the same pattern, but with attenuation of risks. Conclusions We found a five-fold increased risk of delivering a small-for-gestational-age infant in women with heart disease treated with a high dose of beta-blocker, and a two-fold increased risk among those treated with a low dose, showing an apparent dose–response relation. Close monitoring of fetal growth is warranted among women with heart disease treated with beta-blockers. As drug therapy in pregnancy concerns both mother and fetus, an optimum balance for both should be the goal.

• Ottesen, Hanna; Sørbye, Ingvil; Lindskog, Benedikte V; Vangen, Siri; Sundby, Johanne Sommerchild & Owe, Katrine Mari (2022). Keisersnitt blant utenlandsfødte kvinner med ulike utdanningsnivåer. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.22.0256. Full text in Research Archive Show summary

  BAKGRUNN Studier har vist at innvandrerkvinner, spesielt kvinner født i Afrika sør for Sahara, har høy forekomst av akutt keisersnitt. Samtidig varierer risikoen for planlagt og akutt keisersnitt med mors utdanningsnivå. Blant kvinner født i land i Afrika sør for Sahara og andre lav- og mellominntektsland er det en høyere andel med lav eller ingen utdanning sammenlignet med kvinner født i Norge. Vi ønsket derfor å undersøke sammenhengen mellom mors fødested, utdanningsnivå og risikoen for keisersnitt. MATERIALE OG METODE Studien tok utgangspunkt i alle fødsler i Norge registrert i Medisinsk fødselsregister i perioden 2008–17 koblet til data fra Statistisk sentralbyrå. Mors fødested, inndelt i fire kategorier, var eksponeringen. Endepunktet var planlagt eller akutt keisersnitt. Vi benyttet multinomial logistisk regresjon og stratifiserte analysene etter utdanningsnivå. Norskfødte kvinner utgjorde referansegruppen. RESULTATER Av 572 349 fødsler sto utenlandsfødte kvinner for 26,6 %. Keisersnitt utgjorde 15,1 % av alle fødslene. 9,6 % av alle fødslene var akutte keisersnitt. Norskfødte kvinner hadde den høyeste andelen planlagte keisersnitt (5,7 %), mens kvinner født i Afrika sør for Sahara hadde den høyeste andelen akutte keisersnitt (16,3 %). Blant kvinner med høyere utdanning var andelen akutte keisersnitt 8,3 % blant norskfødte kvinner og 18,1 % blant kvinner født i Afrika sør for Sahara (justert relativ risiko 2,41, 95 %-konfidensintervall 2,18 til 2,66). FORTOLKNING Utdanningsnivå påvirket risikoen for keisersnitt ulikt hos innvandrerkvinner og norskfødte kvinner.

• Jatta, Fatou; Sundby, Johanne Sommerchild; Vangen, Siri; Lindskog, Benedikte V; Sørbye, Ingvil & Owe, Katrine Mari (2021). Association between Maternal Origin, Pre-Pregnancy Body Mass Index and Caesarean Section: A Nation-Wide Registry Study. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(11). doi: 10.3390/ijerph18115938. Full text in Research Archive Show summary

  Aims: To explore the association between maternal origin and birthplace, and caesarean section (CS) by pre-pregnancy body mass index (BMI) and length of residence. Methods: We linked records from 118,459 primiparous women in the Medical Birth Registry of Norway between 2013 and 2017 with data from the National Population Register. We categorized pre-pregnancy BMI (kg/m2) into underweight (<18.5), normal weight (18.5–24.9) and overweight/obese (≥25). Multinomial regression analysis estimated crude and adjusted relative risk ratios (RRR) with 95% confidence intervals (CI) for emergency and elective CS. Results: Compared to normal weight women from Norway, women from Sub-Saharan Africa and Southeast Asia/Pacific had a decreased risk of elective CS (aRRR = 0.57, 95% CI 0.37–0.87 and aRRR = 0.56, 0.41–0.77, respectively). Overweight/obese women from Europe/Central Asia had the highest risk of elective CS (aRRR = 1.42, 1.09–1.86). Both normal weight and overweight/obese Sub-Saharan African women had the highest risks of emergency CS (aRRR = 2.61, 2.28-2.99; 2.18, 1.81-2.63, respectively). Compared to women from high-income countries, the risk of elective CS was increasing with a longer length of residence among European/Central Asian women. Newly arrived migrants from Sub-Saharan Africa had the highest risk of emergency CS. Conclusion: Women from Sub-Saharan Africa had more than two times the risk of emergency CS compared to women originating from Norway, regardless of pre-pregnancy BMI.

• Taraldsen, Sølvi; Owe, Katrine Mari; Bødtker, Anne Sejersted; Bjørntvedt, Ida Waagsbø; Eide, Birgitte & Sandberg, Marit [Show all 10 contributors for this article] (2021). Omskjæring hos kvinner bosatt i Norge – konsekvenser og behandling. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 141(15). doi: 10.4045/tidsskr.21.0509. Full text in Research Archive Show summary

  BAKGRUNN Poliklinikktilbud for kvinner som har gjennomgått omskjæring finnes ved syv norske sykehus. I vår studie presenteres symptomer, funn og behandling hos kvinner som ble undersøkt ved poliklinikkene i perioden 2004–15. MATERIALE OG METODE Hvert sykehus identifiserte pasienter ved søk etter relevante diagnose- og behandlingskoder. Alle som hadde vært til undersøkelse ved poliklinikkene, ble inkludert. Data ble innhentet fra journaler. RESULTATER 913 kvinner ble inkludert. Median alder ved omskjæring var syv år og ved konsultasjon 26 år. Nær halvparten var gravide. De fleste (81 %) hadde type 3-omskjæring (infibulering). Av disse hadde 87 % gynekologiske plager. Blant kvinner med omskjæring type 1 og type 2 rapporterte henholdsvis 55 % og 70 % gynekologiske plager. I alt 64 % fikk kirurgisk behandling, hovedsakelig deinfibulering (98 %). Det var registrert få komplikasjoner etter deinfibulering. FORTOLKNING Hos mange yngre og ikke-gravide infibulerte kvinner kan omskjæringsrelaterte plager som kan behandles med deinfibulering, ha vært til stede fra barne- og ungdomsalder. Det finnes trolig et udekket behandlingsbehov blant omskårne kvinner, uavhengig av omskjæringstype.

• Waldum, Åsa; Staff, Anne Cathrine; Lukasse, Mirjam; Falk, Ragnhild Sørum; Sørbye, Ingvil & Jacobsen, Anne Flem (2021). Intrapartum pudendal nerve block analgesia and risk of postpartum urinary retention: a cohort study. International Urogynecology Journal. ISSN 0937-3462. 32(32), p. 2383–2391. doi: 10.1007/s00192-021-04768-0. Full text in Research Archive Show summary

  Introduction and hypothesis: Pudendal nerve block analgesia (PNB) is used as pain relief in the final stage of childbirth. We hypothesized that PNB is associated with higher rates of postpartum urinary retention. Methods: We performed a cohort study among primiparous women with a singleton, cephalic vaginal birth at Oslo University Hospital, Norway. Women receiving PNB were included in the exposed group, while the subsequent woman giving birth without PNB was included in the unexposed group. We compared the likelihood of postpartum urinary retention, defined as catheterization within 3 h after birth. Logistic regression analysis stratified by mode of delivery was performed adjusting for epidural analgesia, episiotomy and birth unit. Results: Of the 1007 included women, 499 were exposed to PNB and 508 were unexposed. In adjusted analyses, women exposed to PNB did not differ in likelihood of postpartum urinary retention compared to women unexposed to PNB in either spontaneous (odds ratio[OR]: 0.82, 95% confidence interval [CI] 0.55–1.22) or instrumental (OR 1.45, 95% CI 0.89–2.39) births. Furthermore, no differences between the groups were observed with excessive residual urine volume or catheterization after > 3 h. Conclusions: PNB was associated with neither risk of postpartum urinary retention nor excessive residual urine volume and is therefore unlikely to hamper future bladder function.

• Bains, Sukhjeet; Skråning, Susanne; Sundby, Johanne Sommerschild; Vangen, Siri; Sørbye, Ingvil & Lindskog, Benedikte V. (2021). Challenges and barriers to optimal maternity care for recently migrated women - a mixed-method study in Norway. BMC Pregnancy and Childbirth. 21(1), p. 1–14. doi: 10.1186/s12884-021-04131-7. Full text in Research Archive Show summary

  Background: Migrant women are at increased risk for complications related to pregnancy and childbirth, possibly due to inadequate access and utilisation of healthcare. Recently migrated women are considered a vulnerable group who may experience challenges in adapting to a new country. We aimed to identify challenges and barriers recently migrated women face in accessing and utilising maternity healthcare services. Methods: In the mixed-method MiPreg-study, we included recently migrated (≤ fve years) pregnant women born in low- or middle-income countries and healthcare personnel. First, we conducted 20 in-depth interviews with migrant women at Maternal and Child Health Centres (MCHC) and seven in-depth interviews with midwives working at either the hospital or the MCHCs in Oslo. Afterwards, we triangulated our fndings with 401 face-to-face questionnaires post-partum at hospitals among migrant women. The data were thematically analysed by grouping codes after careful consideration and consensus between the researchers. Results: Four main themes of challenges and barriers faced by the migrant women were identifed: (1) Navigating the healthcare system, (2) Language, (3) Psychosocial and structural factors, and (4) Expectations of care. Within the four themes we identifed a range of individual and structural challenges, such as limited knowledge about available healthcare services, unmet needs for interpreter use, limited social support and conficting recommendations for pregnancy-related care. The majority of migrant women (83.6%) initiated antenatal care in the frst trimester. Several of the challenges were associated with vulnerabilities not directly related to maternal health. Conclusion: A combination of individual, structural and institutional barriers hinder recently migrated women in achieving optimal maternal healthcare. Suggested strategies to address the challenges include improved provision of information about healthcare structure to migrant women, increased use of interpreter services, appropriate psycho-social support and strengthening diversity- and intercultural competence training among healthcare personnel

• Sørbye, I.K.; Bains, Sukhjeet; Vangen, Siri; Sundby, Johanne Sommerschild; Lindskog, Benedikte V & Owe, Katrine Mari (2021). Obstetric anal sphincter injury by maternal origin and length of residence: a nationwide cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 129(3), p. 423–431. doi: 10.1111/1471-0528.16985. Full text in Research Archive Show summary

  Objective: To estimate the association between maternal origin and obstetric anal sphincter injury (OASI), and assess if associations differed by length of residence. Design: Population-based cohort study. Setting: The Medical Birth Registry of Norway. Population: Primiparous women with vaginal livebirth of a singleton cephalic fetus between 2008 and 2017 (n = 188 658). Methods: Multivariable logistic regression models estimated adjusted odds ratios (aORs) for OASI with 95% CI by maternal region of origin and birthplace. We stratified models on length of residence and paternal birthplace. Main outcome measures: OASI. Results: Overall, 6373 cases of OASI were identified (3.4% of total cohort). Women from South Asia were most likely to experience OASI (6.2%; aOR 2.24, 95% CI 1.87–2.69), followed by those from Southeast Asia, East Asia & the Pacific (5.7%; 1.59, 1.37–1.83) and Sub-Saharan Africa (5.2%; 1.85, 1.55–2.20), compared with women originating from Norway. Among women born in the same region, those with short length of residence in Norway (0–4 years), showed the highest odds of OASI. Migrant women across most regions of origin had the lowest risk of OASI if they had a Norwegian partner. Conclusions: Primiparous women from Asian regions and Sub-Saharan Africa had up to two-fold risk of OASI, compared with women originating from Norway. Migrants with short residence and those with a foreign-born partner had higher risk of OASI, implying that some of the risk differential is due to sociocultural factors. Some migrants, especially new arrivals, may benefit from special attention during labour to reduce morbidity and achieve equitable outcomes.

• Bains, Sukhjeet; Sundby, Johanne Sommerchild; Lindskog, Benedikte V; Vangen, Siri; Diep, Lien My & Owe, Katrine Mari [Show all 7 contributors for this article] (2021). Satisfaction with maternity care among recent migrants: an interview questionnaire-based study. BMJ Open. 11(7). doi: 10.1136/bmjopen-2020-048077. Full text in Research Archive Show summary

  Objective: To examine factors associated with recently migrated women’s satisfaction with maternity care in urban Oslo, Norway. Design: An interview-based cross-sectional study, using a modified version of Migrant Friendly Maternity Care Questionnaire. Setting: Face-to-face interview after birth in two maternity wards in urban Oslo, Norway, from January 2019 to February 2020. Participants: International migrant women, ≤5 years length of residency in Norway, giving birth in urban Oslo, excluding women born in high-income countries. Primary outcome: Dissatisfaction of care during pregnancy and birth, measured using a Likert scale, grouped into satisfied and dissatisfied, in relation to socio-demographic/clinical characteristics and healthcare experiences. Secondary outcome: Negative healthcare experiences and their association with reason for migration. Results: A total of 401 women answered the questionnaire (87.6% response rate). Overall satisfaction with maternal healthcare was high. However, having a Norwegian partner, higher education and high Norwegian language comprehension were associated with greater odds of being dissatisfied with care. One-third of all women did not understand the information provided by the healthcare personnel during maternity care. More women with refugee background felt treated differently because of factors such as religion, language and skin colour, than women who migrated due to family reunification. Conclusions: Although the overall satisfaction was high, for certain healthcare experiences such as understanding information, we found more negative responses. The negative healthcare experiences and factors associated with satisfaction identified in this study have implications for health system planning, education of healthcare personnel and strategies for quality improvement.

• Bains, Sukhjeet; Sundby, Johanne Sommerchild; Lindskog, Benedikte V; Vangen, Siri & Sørbye, Ingvil (2021). Newly Arrived Migrant Women’s Experience of Maternity Health Information: A Face-to-Face Questionnaire Study in Norway. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(14). doi: 10.3390/ijerph18147523. Full text in Research Archive Show summary

  Limited understanding of health information may contribute to an increased risk of adverse maternal outcomes among migrant women. We explored factors associated with migrant women’s understanding of the information provided by maternity staff, and determined which maternal health topics the women had received insufficient coverage of. We included 401 newly migrated women (≤5 years) who gave birth in Oslo, excluding migrants born in high-income countries. Using a modified version of the Migrant Friendly Maternity Care Questionnaire, we face-to-face interviewed the women postnatally. The risk of poor understanding of the information provided by maternity staff was assessed in logistic regression models, presented as adjusted odds ratios (aORs), with 95% confidence intervals (CI). The majority of the 401 women were born in European and Central Asian regions, followed by South Asia and North Africa/the Middle East. One-third (33.4%) reported a poor understanding of the information given to them. Low Norwegian language proficiency, refugee status, no completed education, unemployment, and reported interpreter need were associated with poor understanding. Refugee status (aOR 2.23, 95% CI 1.01–4.91), as well as a reported interpreter need, were independently associated with poor understanding. Women who needed but did not get a professional interpreter were at the highest risk (aOR 2.83, 95% CI 1.59–5.02). Family planning, infant formula feeding, and postpartum mood changes were reported as the most frequent insufficiently covered topics. To achieve optimal understanding, increased awareness of the needs of a growing, linguistically diverse population, and the benefits of interpretation services in health service policies and among healthcare workers, are needed.

• Oommen, Hanna; Ranjan, Kunal; Murugesan, Sudha; Gore, Aboli; Sonthalia, Sunil & Ninan, Pradeep [Show all 9 contributors for this article] (2021). Implementation of the Moyo fetal heart rate monitor in district hospitals in Bihar, India: a feasibility study. BMJ Open. 11(2), p. 1–10. doi: 10.1136/bmjopen-2020-041071. Full text in Research Archive Show summary

  Objectives: Globally, half of all stillbirths occur during birth. Detection of fetal distress with fetal heart rate monitoring (FHRM), followed by appropriate and timely management, might reduce fresh stillbirths and neonatal morbidity. This study aimed to investigate the barriers and facilitators for the implementation of Moyo FHRM use in Bihar state, and secondarily, the feasibility of collecting reliable obstetrical and neonatal outcome data to assess the effect of implementation. Setting: CARE Bihar and the hospital management at four district hospitals (DHs) in Bihar state, each with 6500 to 15 000 deliveries a year, agreed to testing the implementation of Moyo FHRM through a process of meetings, training sessions and collecting data. At each hospital, a clinical training expert was trained to train others, while a clinical assessment facilitator collected data. Methodology: Observational notes were taken at all training sessions and meetings. Individual interviews (n=4) were conducted with clinical training experts (CTEs) on training experiences and barriers and facilitators for Moyo FHRM implementation. The CTEs recoded field notes in diaries. Descriptive analyses performed on pre-implementation and post-implementation data (n=521) assessed quality and completeness. Results: Main barriers to implementation of Moyo FHRM were health system and cultural challenges involving (1) existing practices, (2) insufficient human resources, (3) action delays and (4) cultural and local challenges. Another barrier was insufficient involvement of doctors. Facilitators for implementation were easy use of the Moyo FHRM device and adequate training for staff. Electronic collection of obstetrical data worked well but had substantial missing data. Conclusion: Health system and cultural challenges are a major constraint to Moyo FHRM implementation in low-resource settings. Improvements at all levels of infrastructure, practices and skills will be critical in busy DHs in Bihar. Full-scale implementation needs doctor-led leadership and ownership. Obstetrical data collection for the purpose of scientific analysis needs to be improved.

• Taraldsen, Sølvi; Vangen, Siri; Øian, Pål & Sørbye, Ingvil (2021). Female genital mutilation/cutting, timing of deinfibulation, and risk of cesarean section. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 100(4), p. 587–595. doi: 10.1111/aogs.14111. Full text in Research Archive Show summary

  Introduction The impact of female genital mutilation/cutting on obstetric outcomes in high-income countries is not clear. In general, women with female genital mutilation/cutting type 3 (infibulation) seem to be most at risk of adverse outcomes such as cesarean section. Deinfibulation is recommended to prevent obstetric complications. Whether the timing of this procedure affects the complication risk is not known. The aims of this study were, first, to examine the association between female genital mutilation/cutting and the risk of cesarean section in Norway, and, second, whether the timing of deinfibulation affected the cesarean section risk. Material and methods This was a historical cohort study of nulliparous Somali-born women who gave birth in Norway between 1990 and 2014. The Medical Birth Registry of Norway identified the women. Data were collected from medical records at 11 participating birth units. The exposures were female genital mutilation/cutting status and deinfibulation before pregnancy, during pregnancy, or no deinfibulation before labor onset. The main outcome was odds ratio (OR) of cesarean section. Type of cesarean section, primary indications, and neonatal outcomes were secondary outcomes. Results Women with female genital mutilation/cutting type 3 had lower risk of cesarean section compared with women with no female genital mutilation/cutting (OR 0.54, 95% CI 0.33-0.89 P = .02). Among the 1504 included women, the cesarean section rate was 28.0% and the proportion of emergency operations was 92.9%. Fetal distress was the primary indication in approximately 50% of cases, across the groups with different female genital mutilation/cutting status. Women who had no deinfibulation before labor onset had lower risk of cesarean section compared with those who underwent deinfibulation before or during pregnancy (OR 0.64, 95% CI 0.46-0.88 P = .01). Conclusions High risk of cesarean section in Somali nulliparous women was not related to the type of female genital mutilation/cutting in the present study. Deinfibulation before labor did not protect against cesarean section. Our findings indicate that nulliparous Somali women are at high risk of intrapartum complications. Future research should focus on measures to reduce maternal morbidity and on how timing of deinfibulation affects the outcomes of vaginal births.

• Waldum, Åsa; Jacobsen, Anne Flem; Lukasse, Mirjam; Staff, Anne Cathrine; Falk, Ragnhild Sørum & Vangen, Siri [Show all 7 contributors for this article] (2020). The provision of epidural analgesia during labor according to maternal birthplace: a Norwegian register study. BMC Pregnancy and Childbirth. 20(321). doi: 10.1186/s12884-020-03021-8. Full text in Research Archive Show summary

  Background: The provision of epidural analgesia during labor is ideally a shared decision between the woman and her health care provider. However, immigrant characteristics such as maternal birthplace could affect decision-making and thus access to pain relief. We aimed to assess disparities in the provision of epidural analgesia in planned vaginal birth according to maternal region of birth. Methods: We performed a nation-wide register study of 842,496 live-born singleton deliveries in Norway between 2000 and 2015. Maternal birthplace was categorized according to the Global Burden of Disease framework. The provision of epidural analgesia was compared in regression models stratified by parity and mode of delivery. Results: Compared to native-born women, primiparous women from Latin America/Caribbean countries with an instrumental vaginal delivery were most likely to be provided epidural analgesia (OR 2.12, 95%CI 1.69–2.66), whilst multiparous women from Sub-Saharan Africa with a spontaneous vaginal delivery were least likely to be provided epidural analgesia (OR 0.42, 95% C 0.39–0.44). Longer residence time was associated with a higher likelihood of being provided analgesia, whereas effects of maternal education varied by Global Burden of Disease group. Conclusions: Disparities in the likelihood of being provided epidural analgesia were observed by maternal birthplace. Further studies are needed to consider whether the identified disparities represent women’s own preferences or if they are the result of heterogeneous access to analgesia during labor.

• Sørbye, Ingvil; Oppegaard, Kevin Sunde; Weeks, Andrew; Marsdal, Kjersti Engen & Jacobsen, Anne Flem (2020). Induction of labor and nulliparity: A nationwide clinical practice pilot evaluation. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 99(12), p. 1700–1709. doi: 10.1111/aogs.13948. Full text in Research Archive Show summary

  Introduction Induction of labor has become an increasingly common obstetric procedure, but in nulliparous women or women with a previous cesarean section, it can pose a clinical challenge. Despite an overall expansion of medical indications for labor induction, there is little international consensus regarding the criteria for induction, or for the recommended methods among nulliparous women. In this light, we assessed variations in the practice of induction of labor among 21 birth units in a nationwide cohort of women with no prior vaginal birth. Material and methods We carried out a prospective observational pilot study of women with induced labor and no prior vaginal birth, across 21 Norwegian birth units. We registered induction indications, methods and outcomes from 1 September to 31 December 2018 using a web‐based case record form. Women were grouped into “Nulliparous term cephalic”, “Previous cesarean section” and “Other Robson” (Robson groups 6, 7, 8 or 10). Results More than 98% of eligible women (n=1818) were included and a wide variety of methods was used for induction of labor. In nulliparous term cephalic pregnancies, cesarean section rates ranged from 11.1% to 40.6% between birth units, whereas in the previous cesarean section group, rates ranged from 22.7% to 67.5%. The indications “large fetus” and “other fetal” indications were associated with the highest cesarean rates. Failed inductions and failure to progress in labor contributed most to the cesarean rates. Uterine rupture occurred in two women (0.11%), both in the previous cesarean section group. In neonates, 1.6% had Apgar <7 at 5 minutes, and 0.4% had an umbilical artery pH <7.00. Conclusions Cesarean rates and applied methods for induction of labor varied widely in this nationwide cohort of women without a prior vaginal birth. Neonatal outcomes were similar to those of normal birth populations. Results could indicate the need to move towards more standardized induction protocols associated with optimal outcomes for mother and baby.

• Sørbye, Ingvil; Vangen, Siri; Juárez, Sol P; Bolumar, Francisco; Morisaki, Naho & Gissler, Mika [Show all 11 contributors for this article] (2019). Birthweight of babies born to migrant mothers - What role do integration policies play? SSM - Population Health. ISSN 2352-8273. 9. doi: 10.1016/j.ssmph.2019.100503. Full text in Research Archive
• Marsdal, Kjersti Engen; Sørbye, Ingvil; Gaudernack, Lise Christine & Lukasse, Mirjam (2018). A comparison of misoprostol vaginal insert and misoprostol vaginal tablets for induction of labor in nulliparous women: a retrospective cohort study. BMC Pregnancy and Childbirth. 18(1). doi: 10.1186/s12884-017-1647-3. Full text in Research Archive Show summary

  Background: Since Misoprostol Vaginal Insert (MVI - Misodel ®) was approved for labor induction in Europe in 2013, to date, no study has been published comparing MVI to Misoprostol vaginal tablets (MVT). The aim of this study, performed as part of a quality improvement project, was to compare the efficacy and safety of 200 μg MVI versus 25 μg MVT for labor induction in nulliparous women. Methods: This retrospective cohort study included 171 nulliparous singleton term deliveries induced with MVI (n=85) versus MVT (n=86) at Oslo University Hospital Rikshospitalet, Norway, from November 2014 to December 2015. Primary outcomes were time from drug administration to delivery in hours and minutes and the rate of cesarean section (CS). Results were adjusted for Bishop Score and pre-induction with balloon catheter. Results: Median time from drug administration to delivery was shorter in the MVI group compared to the MVT group (15 h 43 min versus 19 h 37 min, p=0.011). Adjusted for confounding factors, mean difference was 6 h 3 min (p=0.002). The risk of CS was 67% lower in the MVI group compared to the MVT group (11.8% versus 23.3%, OR=0.33; adjusted 95% CI 0.13–0.81). Adverse neonatal outcomes did not differ between the groups. Conclusions: In a setting of routine obstetric care, MVI seems to be a more efficient labor induction agent than MVT, and with a lower CS rate and no increase in adverse infant outcomes.

• Berg, Rigmor; Taraldsen, Sølvi; Said, Maryan; Sørbye, Ingvil & Vangen, Siri (2017). Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review. Journal of Sexual Medicine. ISSN 1743-6095. 14(8), p. 977–990. doi: 10.1016/j.jsxm.2017.05.016. Full text in Research Archive Show summary

  Background: Because female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality, women are increasingly seeking surgical interventions for their FGM/C-related concerns. <br>Aim: To conduct a systematic review of empirical quantitative and qualitative research on interventions for women with FGM/C-related complications. <br>Methods: We conducted systematic searches up to May 2016 in 16 databases to obtain references from different disciplines. We accepted all study designs consisting of girls and women who had been subjected to FGM/C and that examined a reparative intervention for a FGM/C-related concern. We screened the titles, abstracts, and full texts of retrieved records for relevance. Then, we assessed the methodologic quality of the included studies and extracted and synthesized the study data. <br>Outcomes: All outcomes were included. <br>Results: Of 3,726 retrieved references, 71 studies including 7,291 women were eligible for inclusion.We identified three different types of surgical intervention: defibulation or surgical separation of fused labia, excision of a cyst with or without some form of reconstruction, and clitoral or clitoral-labial reconstruction. Reasons for seeking surgical interventions consisted of functional complaints, sexual aspirations, esthetic aspirations, and identity recovery. The most common reasons for defibulation were a desire for improved sexual pleasure, vaginal appearance, and functioning. For cyst excision, cystic swelling was the main reason for seeking excision; for reconstruction, the main reason was to recover identity. Data on women’s experiences with a surgical intervention are sparse, but we found that women reported easier births after defibulation. Our findings also suggested that most women were satisfied with defibulation (overall satisfaction ¼ 50e100%), typically because of improvements in their sexual lives. <br>Conversely, the results suggested that defibulation had low social acceptance and that the procedure created distress in some women who disliked the new appearance of their genitalia. Most women were satisfied with clitoral reconstruction, but approximately one third were dissatisfied with or perceived a worsening in the esthetic look. <br>Clinical Translation: The information health care professionals give to women who seek surgical interventions for FGM/C should detail the intervention options available and what women can realistically expect from such interventions <br>Strengths and Limitations: The systematic review was conducted in accordance with guidelines, but there is a slight possibility that studies were missed. <br>Conclusion: There are some data on women’s motivations for surgery for FGM/C-related concerns, but little is known about whether women are satisfied with the surgery, and experiences appear mixed.

• Berg, Rigmor; Taraldsen, Sølvi; Said, Maryan; Sørbye, Ingvil & Vangen, Siri (2017). The effectiveness of surgical interventions for women with FGM/C: a systematic review. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. 125(3), p. 278–287. doi: 10.1111/1471-0528.14839. Full text in Research Archive Show summary

  <p><i>Background</i><br> Female genital mutilation/cutting (FGM/C) changes normal genital functionality and can cause complications. There is an increasing demand for treatment of FGM/C‐related complications.</p> <p><i>Objectives</i><br> We conducted a systematic review of empirical quantitative research on the outcomes of interventions for women with FGM/C‐related complications.</p> <p><i>Search strategy</i><br> A search specialist searched 16 electronic databases.</p> <p><i>Selection criteria</i><br> Selection was performed independently by two researchers. We accepted quantitative studies that examined the outcome of an intervention for an FGM/C‐related concern.</p> <p><i>Data collection and analysis</i><br> We extracted data into a pre‐designed form, calculated effect estimates, and performed meta‐analyses.</p> <p><i>Main results</i><br> We included 62 studies (5829 women), which investigated the effect of defibulation, excision of cysts, and clitoral reconstruction. Meta‐analyses of defibulation versus no defibulation showed a significantly lower risk of caesarean section (relative risk, RR: 0.33; 95% confidence interval, 95% CI: 0.25–0.45) and perineal tears with defibulation: second‐degree tear (RR: 0.44, 95% CI: 0.24–0.79), third‐degree tear (RR: 0.21, 95% CI: 0.05–0.94), fourth‐degree tear (RR: 0.06, 95% CI: 0.01–0.41). The meta‐analyses detected no significant differences in obstetric outcomes of antenatal versus intrapartum defibulation. Except for one study, none of the studies on the excision of cysts indicated any complications, and the results were deemed favourable. Reconstructive surgery resulted in a visible clitoris in about 77% of women. Most women self‐reported improvements in their sexual life, but up to 22% experienced a worsening in sexuality‐related outcomes after reconstruction.</p> <p><i>Conclusions</i><br> Women with FGM/C who seek therapeutic surgery should be informed about the scarcity of evidence for benefits and the potential harms of the available procedures.

• Sørbye, Ingvil; Wanigaratne, Susitha & Urquia, Marcelo L. (2016). Variations in gestational length and preterm delivery by race, ethnicity and migration. Best Practice & Research: Clinical Obstetrics & Gynaecology. ISSN 1521-6934. 32, p. 60–68. doi: 10.1016/j.bpobgyn.2015.08.017. Full text in Research Archive
• Urquia, Marcelo L.; Sørbye, Ingvil & Wanigaratne, Susitha (2016). Birth-weight charts and immigrant populations: A critical review. Best Practice & Research: Clinical Obstetrics & Gynaecology. ISSN 1521-6934. 32, p. 69–76. doi: 10.1016/j.bpobgyn.2015.09.001. Full text in Research Archive
• Sørbye, Ingvil; Daltveit, Anne Kjersti; Sundby, Johanne; Stoltenberg, Camilla & Vangen, Siri (2015). Caesarean section by immigrants' length of residence in Norway: a population-based study. European Journal of Public Health. ISSN 1101-1262. 25(1), p. 78–84. doi: 10.1093/eurpub/cku135. Full text in Research Archive
• Sørbye, Ingvil; Daltveit, Anne Kjersti; Sundby, Johanne & Vangen, Siri (2014). Preterm subtypes by immigrants' length of residence in Norway: A population-based study. BMC Pregnancy and Childbirth. 14. doi: 10.1186/1471-2393-14-239. Full text in Research Archive Show summary

  Background: The reduction of the preterm delivery (PTD) rate is a maternal and child health target. Elevated rates have been found among several immigrant groups, but few studies have distinguished between PTD according to the mode of birth start. In addition, migrants’ birth outcomes have further been shown to be affected by the time in residence; however, the association to PTD subtypes has not previously been assessed. In this study we examined if the risk of spontaneous and non-spontaneous, or iatrogenic, PTD among immigrants in Norway varied according to the length of residence and the country of birth, and compared with the risks among the majority population. Methods: We linked population-based birth and immigration data for 40 709 singletons born to immigrant women from Iraq, Pakistan, the Philippines, Somalia, Sri Lanka and Vietnam and 868 832 singletons born to non-immigrant women from 1990–2009. Associations between the length of residence and subtypes of PTD were estimated as relative risks (RRs) with 95% confidence intervals (CIs) from multivariable models. Results: In total, 48 191 preterm births occurred. Both spontaneous and non-spontaneous PTD rates were higher among immigrants (4.8% and 2.0%) than among non-immigrants (3.6% and 1.6%). Only non-spontaneous PTD was associated with longer lengths of residence (p trend <0.001). Recent immigrants (<5 years of residence) and non-immigrants had a similar risk of non-spontaneous PTD, whereas immigrants with lengths of residence of 5–9 years, 10–14 years and ≥15 years had adjusted RRs of 1.18 [95% CI 1.03,1.35], 1.43 [95% CI 1.20,1.71] and 1.66 [95% CI 1.41,1.96]. The association was reduced after further adjustments for maternal and infant morbidity. Conversely, the risk of spontaneous PTD among immigrants was not mitigated by length of residence, but varied with country of birth according to the duration of pregnancy in term births. Conclusions: Non-spontaneous PTD increased with the length of residence whereas spontaneous PTD remained elevated regardless of the length of residence. Policies to improve birth outcomes in ethnically mixed populations should address the modifiable causes of PTD rather than aiming to reduce absolute PTD rates.

• Sørbye, Ingvil; Stoltenberg, Camilla; Sundby, Johanne; Daltveit, Anne Kjersti & Vangen, Siri (2014). Stillbirth and infant death among generations of Pakistani immigrant descent: a population-based study. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 93(2), p. 168–174. doi: 10.1111/aogs.12303. Full text in Research Archive
• Sørbye, Ingvil; Vangen, Siri; Oneko, Olola; Sundby, Johanne & Bergsjø, Per (2011). Caesarean section among referred and self-referred birthing women: a cohort study from a tertiary hospital, northeastern Tanzania. BMC Pregnancy and Childbirth. 11. doi: 10.1186/1471-2393-11-55. Full text in Research Archive Show summary

  Background The inequity in emergency obstetric care access in Tanzania is unsatisfactory. Despite an existing national obstetric referral system, many birthing women bypass referring facilities and go directly to higher-level care centres. We wanted to compare Caesarean section (CS) rates among women formally referred to a tertiary care centre versus self-referred women, and to assess the effect of referral status on adverse outcomes after CS. Methods We used data from 21,011 deliveries, drawn from the birth registry of a tertiary hospital in northeastern Tanzania, during 2000-07. Referral status was categorized as self-referred if the woman had bypassed or not accessed referral, or formally-referred if referred by a health worker. Because CS indications were insufficiently registered, we applied the Ten-Group Classification System to determine the CS rate by obstetric group and referral status. Associations between referral status and adverse outcomes after CS delivery were analysed using multiple regression models. Outcome measures were CS, maternal death, obstetric haemorrhage ≥ 750 mL, postpartum stay > 9 days, neonatal death, Apgar score < 7 at 5 min and neonatal ward transfer. Results Referral status contributed substantially to the CS rate, which was 55.0% in formally-referred and 26.9% in self-referred birthing women. In both groups, term nulliparous singleton cephalic pregnancies and women with previous scar(s) constituted two thirds of CS deliveries. Low Apgar score (adjusted OR 1.42, 95% CI 1.09-1.86) and neonatal ward transfer (adjusted OR 1.18, 95% CI 1.04-1.35) were significantly associated with formal referral. Early neonatal death rates after CS were 1.6% in babies of formally-referred versus 1.2% in babies of self-referred birthing women, a non-significant difference after adjusting for confounding factors (adjusted OR 1.37, 95% CI 0.87-2.16). Absolute neonatal death rates were > 2% after CS in breech, multiple gestation and preterm deliveries in both referral groups. Conclusions Women referred for delivery had higher CS rates and poorer neonatal outcomes, suggesting that the formal referral system successfully identifies high-risk birth, although low volume suggests underutilization. High absolute rates of post-CS adverse outcomes among breech, multiple gestation and preterm deliveries suggest the need to target self-referred birthing women for earlier professional intrapartum care.

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• Misje, Ragnhild; Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi E; Sørbye, Ingvil Krarup & Dahl, Cecilie (2025). 578 Increased risk of adverse maternal pregnancy outcomes among undocumented migrants in Norway. European Journal of Public Health. ISSN 1101-1262. 35(Supplement_6). doi: 10.1093/eurpub/ckaf180.186. Full text in Research Archive Show summary

  Abstract OP 29: Health Status 4, B302 (FCSH), September 4, 2025, 16:00 - 17:00 Aim Migrants are known to have an increased risk of adverse complications during delivery. However, it is not known whether undocumented migrants have a different risk profile compared to documented migrants and non-migrants. This study aimed to gain better knowledge about undocumented migrants’ reproductive outcomes, which is crucial to enable targeted preventive interventions. Method We performed a historical register-based population study based on numbers from the Medical Birth Registry of Norway (MBRN) from 1999 to 2020. Women aged 18–49 years with singleton births were included, in total 1,247,537 births. Legal status, i.e., undocumented migrants (without a Norwegian identity number), documented migrants (with a Norwegian identity number and born abroad) and non-migrants (with a Norwegian identity number and born in Norway), was used as the exposure. We used logistic regression to estimate the association between legal status and adverse maternal birth outcomes. Results In total, 5856 undocumented migrant women gave birth during the study period, representing 0.5 % of all births in Norway. Undocumented migrants had an odds ratio (OR) of 1.39 (95 % Confidence Interval (CI) 1.28–1.51) for an acute CS and OR = 0.86 (95 % CI 0.76–0.98) for a planned CS, both compared to non-migrants. Similarly, the OR for severe postpartum haemorrhage (PPH) was 1.22 (95 % CI 1.03–1.43) and OR 0.70 (95 % CI 0.57–0.87) for anal sphincter injury. None of the results were significantly different when documented migrants were used as the reference group. Conclusion Undocumented migrants have an increased risk of adverse maternal birth complications compared to non-migrants, but not different from documented migrants. This indicates that for maternal birth complications, factors concerning migration may affect the risk profile to a larger degree than legal status.

• Misje, Ragnhild; Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi E; Sørbye, Ingvil Krarup & Dahl, Cecilie (2025). Increased risk of adverse maternal pregnancy outcomes among undocumented migrants in Norway. Full text in Research Archive
• Taraldsen, Sølvi & Sørbye, Ingvil Krarup (2025). Andregenerasjons innvandrere og kvinnehelse. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(3). doi: 10.4045/tidsskr.25.0041. Full text in Research Archive
• Sørbye, Ingvil Krarup; Gunnes, Nina; Solhoff, Aslak Vimme; Haavaldsen, Camilla; Kessler, Jørg & Kjøllesdal, Anne M [Show all 14 contributors for this article] (2025). Multicentre double-blind randomised placebo-controlled four-arm trial to assess the effect of oral sodium bicarbonate and intravenous hyoscine butylbromide on spontaneous delivery after induction of labour in nulliparous women: Protocol for the Safe Induction of Labour Trial (SAINT). doi: 10.1136/bmjopen-2024-093992. Full text in Research Archive
• Sørbye, Ingvil Krarup; Hagemann, Cecilie Therese & Vangen, Siri (2024). Senfølger etter omskjæring og helsehjelp i Norge. In Johansen, R. Elise B (Eds.), Kvinnelig omskjæring/kjønnslemlestelse i Norge; Kunnskap og praksis. Universitetsforlaget. ISSN 9788215069494. p. 237–249. doi: 10.18261/9788215069487-24-13. Full text in Research Archive Show summary

  I dette kapittelet presenterer vi funn fra studier i Norge om langtidsefekter etter kvinnelig omskjæring. Resultatene viser høy forekomst av underlivsplager og svangerskapskomplikasjoner som hastekeisersnitt og alvorlige fødselsrifter. Spesialisert helsehjelp finnes, men kun som tilbud om undersøkelse og åpningskirurgi. Det synes imidlertid å være behov også for smertekartlegging og behandling samt psykoseksuell rådgiving.

• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil Krarup & Dahl, Cecilie (2024). The use of maternity care and perinatal outcomes among undocumented migrants in Norway. Full text in Research Archive
• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil; Ruud, Sven Eirik & Dahl, Cecilie (2023). Use of emergency health care services by pregnant undocumented migrants over a ten-year period in Oslo, Norway. Full text in Research Archive
• Miltenburg, Andrea Solnes; Bains, Sukhjeet Kaur; Strøm-Roum, Ellen Marie; Vartdal, Vegard Weyergang; Sørbye, Ingvil Krarup & Alnæs-Katjavivi, Patji [Show all 8 contributors for this article] (2023). Svangerskap, fødsel og barseltid – mer enn bare overlevelse. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(15), p. 1–3. doi: 10.4045/tidsskr.23.0500. Full text in Research Archive
• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil Krarup; Valberg, Morten & Dahl, Cecilie (2023). Perinatal mortality among pregnant undocumented migrants in Norway 1999-2020: a register-based population study. Full text in Research Archive
• Sørbye, Ingvil; Bains, Sukhjeet & Owe, Katrine Mari (2022). Authors' reply re: Obstetric anal sphincter injury by maternal origin and length of residence. BJOG: An International Journal of Obstetrics and Gynaecology. ISSN 1470-0328. doi: 10.1111/1471-0528.17079. Full text in Research Archive
• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil; Ruud, Sven Eirik & Dahl, Cecilie (2022). Utilization of an emergency primary care clinic in Oslo by pregnant undocumented migrants compared to pregnant residents of Norway. Full text in Research Archive
• Eick, Frode; Vallersnes, Odd Martin; Sørbye, Ingvil; Ebbing, Cathrine; Storkås, Guro & Ekrem, Marthe [Show all 11 contributors for this article] (2022). Pregnant undocumented women’s use of two humanitarian clinics between 2009-2020 and their maternal outcomes in Norway: A cohort study. Full text in Research Archive
• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil; Storkås, Guro & Ekrem, Marthe [Show all 11 contributors for this article] (2022). Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway. Full text in Research Archive Show summary

  In 2011, Norway granted pregnant undocumented women the right to antenatal care and to give birth at a hospital, but did not include them in the general practitioner and reimbursement schemes. In addition, Non-Governmental Organizations (NGO) have been running health clinics for undocumented migrants. There is a need to investigate how pregnant undocumented women use NGO clinics and how this affects their maternal health. We therefore investigated the care received, occurrence of pregnancy-related complications and maternal and perinatal outcomes in women receiving care at these clinics. In this historic cohort study we included pregnant women aged 18-49 who attended urban NGO clinics between 2009-2020 and retrieved their medical records from the hospitals in the uptake area. We compared women based on region of origin using log-binominal regression to estimate relative risk of adverse outcomes. We identified 582 pregnancies in 500 women during the study period. About half (46.5%) the women sought antenatal care after the first trimester. The women had median 1 (IQR 1-3) antenatal visit at the NGO clinics which referred 77.7% of the women to public health care. In 205 retrieved deliveries, there was a 45.9% risk for any adverse outcome. The overall risk of stillbirth was 1.0%, pre-term birth 10.3%, and emergency caesarean section 19.3%. Pregnant undocumented women who use NGO clinics receive substandard antenatal care and have a high risk of adverse maternal and perinatal outcomes. This study suggests that increased attention should be given to ensure the accessibility of adequate antenatal care to undocumented women.

• Eick, Frode; Vallersnes, Odd Martin; Fjeld, Heidi; Sørbye, Ingvil; Ruud, Sven Eirik & Dahl, Cecilie (2022). Use of an emergency primary clinic in Oslo by pregnant undocumented migrants compared to pregnant residents of Norway. Full text in Research Archive
• Sørbye, Ingvil; Gaudernack, Lise Christine; Einarsen, Angeline Elisabeth Styve; Rosseland, Leiv Arne; Lukasse, Mirjam & Gunnes, Nina [Show all 7 contributors for this article] (2022). Study protocol for the BUSCopan in LABor (BUSCLAB) study: A randomized placebocontrolled trial investigating the effect of butylscopolamine bromide to prevent prolonged labor. PLOS ONE. 17(11). doi: 10.1371/journal.pone.0276613. Full text in Research Archive Show summary

  Background First-time mothers are prone to prolonged labor, defined as the crossing of partograph alert or action lines. Prolonged labor may occur among as many as one out of five women, and is associated with a range of adverse birth outcomes. Oxytocin is the standard treatment for prolonged labor, but has a narrow therapeutic window, several adverse effects and limited efficacy. Despite poor evidence, labor wards often use antispasmodic agents to treat prolonged labor. The antispasmodic drug butylscopolamine bromide (Buscopan®) may shorten duration of labor, but studies on prevention of prolonged labor are lacking. In this randomized double-blind placebo-controlled clinical trial, we aim to evaluate the effect of butylscopolamine bromide on duration of labor in first-time mothers showing first signs of slow labor progress by crossing the World Health Organization partograph alert line. Methods and analysis The study is a single center study at Oslo University Hospital, Oslo, Norway. We will recruit 250 primiparous women with spontaneous labor start at term. Women are included in the first stage of labor if they show signs of slow labor progress, defined as the crossing of the partograph alert line with a cervical dilation between 3–9 cm. Participants are randomized 1:1 to either 20 mg intravenous butylscopolamine bromide or intravenous placebo (1 mL sodium chlorine 9 mg/mL). We considered a mean difference of 60 minutes in labor duration clinically relevant. The primary outcome is duration of labor from the provision of the investigational medicinal product to vaginal delivery. The secondary outcomes include change in labor pain, use of oxytocin augmentation, delivery mode, and maternal birth experience. The primary data for the statistical analysis will be the full analysis set and will occur on completion of the study as per the prespecified statistical analysis plan. The primary outcome will be analyzed using Weibull regression, and we will treat cesarean delivery as a censoring event.

• Sørbye, Ingvil; Andersen, Hilde B.; Melin, Erik & Nordøy, Ingvild (2018). En høygravid kvinne med hodepine og feber. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 138(4). doi: 10.4045/tidsskr.17.0383. Full text in Research Archive
• Sørbye, Ingvil; Vangen, Siri; Daltveit, Anne Kjersti & Sundby, Johanne (2012). Perinatal mortality among generations of Pakistani immigrants to Norway: a linked registry based study. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. 91, p. 128–129. doi: 10.1111/j.1600-0412.2012.01435_2.x. Full text in Research Archive

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