An update on research issues in the assessment of birth settings.Washington (DC): National Academies Press; 2013

Bombak AE. Self-rated health and public health: a critical perspective. Front Public Health. 2013; 1:(15)1-4

Carlander A-KK, Andolf E, Edman G, Wiklund I. Health-related quality of life five years after birth of the first child. Sex Reprod Healthc. 2015; 6:(2)101-107

Chan Y. Biostatistics 202: logistic regression analysis. Singapore Med J. 2004; 45:(4)149-153

Cheng C-Y, Li Q. Integrative review of research on general health status and prevalence of common physical health conditions of women after childbirth. Womens Health Issues. 2008; 18:(4)267-280

Christian LM, Iams J, Porter K, Leblebicioglu B. Self-rated health among pregnant women: associations with objective health indicators, psychological functioning, and serum inflammatory markers. Ann Behav Med. 2013; 46:(3)295-309

Cooklin AR, Amir LH, Jarman J, Cullinane M, Donath SM, Team CS. Maternal physical health symptoms in the first 8 weeks postpartum among primiparous Australian women. Birth. 2015; 42:(3)254-260

Deeg DJ, Kriegsman DM. Concepts of self-rated health: specifying the gender difference in mortality risk. Gerontologist. 2003; 43:(3)376-386

Delpierre C, Lauwers-Cances V, Datta GD, Berkman L, Lang T. Impact of social position on the effect of cardiovascular risk factors on self-rated health. Am J Public Health. 2009; 99:(7)1278-1284

Essén B. Perinatal mortality among immigrants from Africa s Horn: the importance of experience, rationality, and tradition for risk assessment in pregnancy and childbirth.Lund, Sweden: Lund University; 2001

Eurenius E, Lindkvist M, Sundqvist M, Ivarsson A, Mogren I. Maternal and paternal self-rated health and BMI in relation to lifestyle in early pregnancy: the Salut Programme in Sweden. Scand J Public Health. 2011; 39:(7)730-741

Fabian H, Rådestad I, Rodriguez A, Waldenström U. Women with non-Swedish speaking background and their children: a longitudinal study of uptake of care and maternal and child health. Acta Paediatr. 2008; 97:(12)1721-1728

Fayers PM, Sprangers M. Understanding self-rated health. Lancet. 2002; 359:(9302)187-188

Feijen-de Jong EI, Jansen DE, Baarveld F Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study. Women Birth. 2015; 28:(2)87-94

Fisher J, Rowe H, Wynter K Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial. BMJ Open. 2016; 6:(3)1-18

Ghasemi A, Zahediasl S. Normality tests for statistical analysis: a guide for non-statisticians. Int J Endocrinol Metab. 2012; 10:(2)486-489

Graviditetsregistret. Annual report 2013. 2014. (accessed 8 August 2021)

Graviditetsregistret. Annual report 2016 - Theme: Psychiatric illhealth. 2017. (accessed 8 August 2021)

Henderson J, Redshaw M. Who is well after childbirth? Factors related to positive outcome. Birth. 2013; 40:(1)1-9

Henriksson P, Söderström E, Blomberg M Self-rated health in migrant and non-migrant women before, during and after pregnancy: a population-based study of 0.5 million pregnancies from the Swedish pregnancy register. J Clin Med. 2020; 9:(6)1764-1773

Iglesias E, Robertson E, Johansson S-E, Engfeldt P, Sundquist J. Women, international migration and self-reported health. A population-based study of women of reproductive age. Soc Sci Med. 2003; 56:(1)111-124

Lantz B. The large sample size fallacy. Scand J Caring Sci. 2013; 27:(2)487-492

Layes A, Asada Y, Kephart G. Whiners and deniers–what does self-rated health measure?. Soc Sci Med. 2012; 75:(1)1-9

McFadden E, Luben R, Bingham S, Wareham N, Kinmonth A-L, Khaw K-T. Does the association between self-rated health and mortality vary by social class?. Soc Sci Med. 2009; 68:(2)275-280

Mechakra-Tahiri S, Zunzunegui MV, Seguin L. Self-rated health and postnatal depressive symptoms among immigrant mothers in Quebec. Women Health. 2007; 45:(4)1-17

Molgora S, Fenaroli V, Saita E. Psychological distress profiles in expectant mothers: what is the association with pregnancy-related and relational variables?. J Affect Disord. 2020; 262:83-89

National Board for Health and Welfare. Socioekonomiska faktorers påverkan på kvinnors och barns hälsa efter förlossning. 2016. (accessed 8 August 2021)

Newbold KB. Self-rated health within the Canadian immigrant population: risk and the healthy immigrant effect. Soc Sci Med. 2005; 60:(6)1359-1370

Nilsson E, Orwelius L, Kristenson M. Patient-reported outcomes in the swedish national quality registers. J Int Med. 2016; 279:(2)141-153

Ny P, Dykes A-K, Molin J, Dejin-Karlsson E. Utilisation of antenatal care by country of birth in a multi-ethnic population: a four-year community-based study in Malmö, Sweden. Acta Obstet Gynecol Scand. 2007; 86:(7)805-813

Olsson P. Vårdande under graviditet. In: Berg M, Lundgren I (eds). Lund, Sweden: Studentlitteratur AB; 2010

Persson M, Winkvist A, Mogren I. Lifestyle and health status in a sample of Swedish women four years after pregnancy: a comparison of women with a history of normal pregnancy and women with a history of gestational diabetes mellitus. BMC Pregnancy Childbirth. 2015; 15:(1)57-72

Petersson K, Persson M, Lindkvist M Internal validity of the Swedish maternal health care register. BMC Health Serv Res. 2014; 14:(1)364-376

Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2016; 4:(4)

Schoevers M, Van den Muijsenbergh M, Lagro-Janssen A. Self-rated health and health problems of undocumented immigrant women in the Netherlands: a descriptive study. J Public Health Policy. 2009; 30:(4)409-422

Schytt E, Hildingsson I. Physical and emotional self-rated health among Swedish women and men during pregnancy and the first year of parenthood. Sex Reprod Healthc. 2011; 2:(2)57-64

Schytt E, Waldenström U. Risk factors for poor self-rated health in women at 2 months and 1 year after childbirth. J Womens Health. 2007; 16:(3)390-405

Sheldon T. Statistics for evidence-based nursing. Evidence-Based Nursing. 2000a; 3:(1)4-6

Sheldon T. Estimating treatment effects: real or the result of chance?. Evidence-Based Nursing. 2000b; 3:(2)36-39

Statens Offentliga Utredningar. Barnomsorgsgruppens slutbetänkande om föräldrautbildning. 1980. (accessed 8 August 2021)

Wasserstein RL, Lazar NA. The ASA statement on p-values: context, process, and purpose. Am Stat. 2016; 70:(2)129-133

Webb HJ. Maternal self-rated health and psychological distress predict early feeding difficulties: Results from the longitudinal study of Australian children. Int J Eat Disord. 2018; 51:(12)1312-1321

World Health Organization. Sexual and reproductive health. 2020. (accessed 8 August 2021)

Zielinski R, Ackerson K, Low LK. Planned home birth: benefits, risks, and opportunities. Int J Womens Health. 2015; 7:361-377

Self-rated health in Swedish pregnant women: a comprehensive population register study

02 June 2022
16 min read
Volume 30 · Issue 6



Sociodemographic factors are associated with perceived overall health status or ‘self-rated health’. However, research using data from the comprehensive population register in Sweden to examine self-rated health in pregnant women is limited. This study aimed to examine sociodemographic factors associated with self-rated health before, during and after pregnancy in low-risk pregnant women, based on comprehensive population register data in Sweden.


This was a retrospective analysis of the Swedish pregnancy register (Graviditets registret). Data from 167 523 women were tested with group comparisons and ordinal regression analyses.


Women between the ages of 25 and 29 years and primiparas were less likely to self-rate their health lower. Women born outside Scandinavia, those whose education did not reach university level, jobseekers, those on parental leave and students were more likely to report lower self-rated health. Women with risky behaviours, such as alcohol consumption and those who smoked and/or snuffed were more likely to report lower self-rated health.


The findings indicate that preventive and health promoting actions in the midwifery profession should build on awareness of possible associated sociodemographic factors.

The right to functional sexual and reproductive health includes the right to adequate perinatal care. The World Health Organization (WHO, 2020) has addressed reproductive health as the reproductive processes, functions, and system at all stages of life. Reproductive health rights mean women have the right to access healthcare centers that can facilitate safe pregnancy and childbirth.

Several studies have shown that self-rated health has a strong association with mortality, and this is not related to a known background disease (McFadden et al, 2009). These findings suggest that a self-rated health assessment is a valuable source of information regarding subjective health status.

Although there are many benefits to Swedish maternal healthcare, which influences the self-rated health of pregnant women, there are many factors that influence self-rated health, including physical and emotional symptoms of pregnancy (Schytt and Waldenström, 2007; Schytt and Hildingsson, 2011; Henderson and Redshaw, 2013). In general populations, factors known to be associated with self-rated health include gender, income, education, employment status, culture and health behaviors (Layes et al, 2012).

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