• Sweden edition
 
Swedish midwives cut health care costs

Swedish midwives cut health care costs

Published: 02 Oct 2013 07:32 GMT+02:00
Updated: 02 Oct 2013 07:32 GMT+02:00

Only one ultrasound in nine months and no need to see the doctor or obstetrician: at first glance, Sweden's pregnancy care appears rather simplistic.

But while it may be far from the medical approach to pregnancy seen in most Western countries, where mothers-to-be have a series of doctor's appointments and tests, the Swedish system, where midwives reign supreme, has proven its merits.

According to the organization Save the Children (Rädda barnen), Sweden is the second-best country in the world to become a mother, behind Finland.

Neonatal mortality is low, at 1.5 deaths per 1,000, the second lowest in Europe behind Iceland, as is maternal death in childbirth, at 3.1 per 100,000 births, according to the European Perinatal Health Report from 2010.

In Sweden, midwives are entrusted with caring for the health of the expectant mother and the foetus. It is the only pregnancy care available to women, and is free for the patient, falling under state health care benefits.

"A doctor can be called in at the midwife's initiative as soon as she notices that something is not right," says Sofie Låftman, a midwife in central Stockholm.

For those accustomed to intensive medical care during pregnancy, the Swedish way may seem rudimentary: a few blood and urine tests are done to detect vitamin deficiencies or anomalies, the mother's blood pressure and the heartbeat of the foetus are checked, and a little nutritional advice is doled out.

During a normal pregnancy without complications, just one ultrasound will be done over the whole nine months, and not a single gynaecological exam.

Meanwhile, in France for example, a 2011 report from the health ministry showed 20 percent of expectant mothers had more than six ultrasounds and four percent had more than ten -- without any obvious benefit.

"Pregnancy is a normal condition" and not an illness, says Marie Berg, professor in health and care sciences at Sahlgrenska Academy at Sweden's University of Gothenburg.

Låftman echoed that notion, saying most women under 40 did not need more medicalized care since their bodies were healthy and capable of giving birth, which is after all a natural process.

A scientific study published in August by the Cochrane Collaboration, an organization of health practitioners, concluded that "most women", those who have no complications in pregnancy, would benefit from seeing a midwife during pregnancy rather than a doctor.

Care by a midwife can actually reduce the number of premature births, the study's authors say. In Sweden, only five percent of babies are born prematurely. But the lack of contact during pregnancy can be tough for some expectant mothers.

Christina Singelman, a 31-year-old expecting her second child, recalls the sense of loneliness she felt during her first pregnancy: from the time she registered at the clinic until her first ultrasound, some 10 weeks went by without a single appointment.

But if the woman is under the age of 40, has no prior medical conditions and has fallen pregnant by natural methods "there's no reason to have more frequent checks in the beginning", insists Laaftman, the Stockholm midwife, who cares for about 100 pregnant women at a time.

Adina Trunk, 33, saw two different midwives for her two pregnancies.

"They were both very competent but the system puts them in a very passive position. It's always up to the expectant mother to take the initiative, to ask questions and possibly ask to see a specialist," she says.

"And since this is a culture where people don't like to make a fuss, it keeps costs down," she adds.

Midwives also take care of the delivery, although that is with an entirely different team than the one that has followed the mother throughout her pregnancy.

A doctor will only intervene if there are complications during the delivery, or if the woman in labour asks for an epidural, which is the case in about half of all deliveries.

Entrusting pregnancy and delivery care to midwives to such an extent is unique in the world. Midwives in Sweden have been in charge of pregnancy care since the 18th century.

While the rise of the modern medical profession meant midwives in much of Europe were forced to yield at least part of their responsibilities to doctors, Sweden's midwives held onto their traditional role thanks to doctors' consent and, in recent times, a strong union.

The system has never been called into question, owing primarily to its strong track record. The number of Caesarian sections is relatively low in Sweden, at around 17 percent of births in 2011, and only 10 percent of women undergo episiotomy, an incision to widen the opening for delivery.

"It's an efficient system in terms of cost management," says University of Gothenburg professor Berg.

In countries where doctors care for pregnant women, she says, the number of "tests and ultrasounds often multiply, which opens the way to easy money".

AFP/The Local/at

Follow The Local on Twitter

The Local (news@thelocal.se)

Don't miss...X
Left Right

Your comments about this article

Today's headlines
Boy receives cancer vaccine by mistake
Photo: Hasse Holmberg/TT

Boy receives cancer vaccine by mistake

A boy scheduled to be vaccinated against mumps, measles, and rubella instead received a vaccine against cervical cancer. His family has now reported the blunder for inspection. READ  

Sweden grants additional funds to jobs agency
Photo: Bertil Enevåg Ericson/TT

Sweden grants additional funds to jobs agency

The Swedish government has announced that it will increase funding to the jobs agency (Arbetsförmedlingen) in 2015, primarily to cover personnel costs but also to prevent long-term unemployment. READ  

Police 'powerless' against street racers
Police on E4 highway. Photo: Johan Nilsson/TT

Police 'powerless' against street racers

Stockholm police said they were powerless to react when streetracers took over at "insane speeds" on a large highway on Friday night. READ  

Saab carmaker wins receivership
Photo: Björn Larsson Rosvall/TT

Saab carmaker wins receivership

After initial rejection, a Chinese-owned company set up to take over Saab's assets after the troubled Swedish carmaker's bankruptcy said on Friday it had succeeded in being placed in receivership. READ  

Woman suffers cardiac arrest while giving birth
Photo: Tomas Oneborg/TT

Woman suffers cardiac arrest while giving birth

A 30-year-old woman went into cardiac arrest while giving birth at a Stockholm clinic - without hospital staff noticing that anything was wrong. She remains in a critical condition on Friday. READ  

Champions League
History repeats for Malmö fifty years later
Striker Magnus Eriksson during Malmö's 3-0 win over Salzburg in a Champions League qualifier. Photo: Björn Lindgren/TT

History repeats for Malmö fifty years later

Malmö's entry into the Champions League serves as a reminder of times gone by in European football. With Spain's champions bound for Sweden things just couldn't be better, writes contributor Lee Roden. READ  

Elections 2014
Löfven promises jobs to 50,000 young Swedes
Social Democrat leader Stefan Löfven. Photo: Fredrik Sandberg/TT

Löfven promises jobs to 50,000 young Swedes

Social Democrat party leader Stefan Löfven announced on Friday his "most important election promise", a 90-day job guarantee programme for young Swedes. READ  

 Sweden to buy fighter jets despite Swiss pullout
The Jas Gripen fighter aircraft. File photo: Wikimedia

Sweden to buy fighter jets despite Swiss pullout

Sweden said Friday it would go ahead with the purchase of a new generation of Saab Gripen fighter jets, despite Switzerland pulling out of a major co-financing deal. READ  

Three hurt after northern knife attack

Three hurt after northern knife attack

Three people are in hospital after they were stabbed during what police suspect was a gang-related attack in Umeå. READ  

Stockholm 'thief' turns out to be trainee ninja

Stockholm 'thief' turns out to be trainee ninja

Stockholm police rushed to the scene when a worried Swede reported that their neighbours were the victim of a break-in - but when officers arrived, they found nothing but a ninja in the middle of practice. READ  

RECEIVE OUR NEWSLETTER AND ALERTS
Gallery
People-watching August 27
Gallery
Top ten false friends in Swedish
National
Roma advocate scoops Wallenberg prize
Society
Meet the man who made a Swedish store recall its high heels for kids
Business & Money
'How I came to run my own business in Sweden'
Blog updates

25 August

Hit och dit, här och där (The Swedish Teacher) »

" Hej igen! A common challenge for Swedish language students are the location adverbs hit/här, dit/där, hem/hemma etc. Some of the location adverbs come in two versions. We should use one type of location adverb when we use a verb describes where we are, and we should use the other type of location adverb when we the verb..." READ »

 

25 August

The Dollar Store (Blogweiser) »

"A dollar store in Sweden. Blog post: http://t.co/tNuuvcP1q0 #USD #greenbacks #sweden #sverige pic.twitter.com/RHFAYf7U1k — Joel Sherwood (@joeldsherwood) August 23, 2014 There’s a chain here in Sweden called The DollarStore. This name always stood out to me in a country where they don’t use dollars. I went there for the first time this weekend. They actually accepted greenbacks..." READ »

 
 
 
Politics
Expert explains why Sweden's election oozes uncertainty
National
City plays Schindler's List theme at Nazi rally
Society
For Stockholm Fashion Week, here's the A-Z of Swedish fashion
National
'Amnesiac' man avoids deportation for ten years
Gallery
Princess Estelle through the years
Business & Money
Swedish city all set for six-hour workday trial
Business & Money
Five golden rules for the Swedish job hunt
Sponsored Article
Graduates: Insure your income in Sweden with AEA
Gallery
People-watching August 22-24
National
Armed royal guards caught (very) drunk on the job
National
Sweden orders textbook on Roma discrimination
Gallery
Violent anti-Nazi demonstrations in Malmö
Society
A closer look at Sweden's five official minority languages
Gallery
See the destruction from the southern Sweden floods
Politics
'Sweden Democrats hold the key to elections'
Society
Swedes celebrate first day of smelly fish season
Politics
Sweden elections: How do they work?
Finest.se
Gallery
People-watching August 20th
Society
Did you know the Bronx in NYC was named after a Swede?
Sponsored Article
Find out what gives this Swedish school executive appeal
Sponsored Article
Introducing...Your finances in Stockholm
Sponsored Article
Introducing...Housing in Stockholm
Latest news from The Local in Austria

More news from Austria at thelocal.at

Latest news from The Local in Switzerland

More news from Switzerland at thelocal.ch

Latest news from The Local in Germany

More news from Germany at thelocal.de

Latest news from The Local in Denmark

More news from Denmark at thelocal.dk

Latest news from The Local in Spain

More news from Spain at thelocal.es

Latest news from The Local in France

More news from France at thelocal.fr

Latest news from The Local in Italy

More news from Italy at thelocal.it

Latest news from The Local in Norway

More news from Norway at thelocal.no

771
jobs available
Swedish Down Town Consulting & Productions
Swedish Down Town Consulting & Productions is an innovative business company which provides valuable assistance with the Swedish Authorities, Swedish language practice and general communications. Call 073-100 47 81 or visit:
www.swedishdowntown.com
PSD Media
PSD Media is marketing company that offers innovative solutions for online retailers. We provide modern solutions that help increase traffic and raise conversion. Visit our site at:
http://psdmedia.se