• Sweden edition
 
Swedish midwives cut health care costs

Swedish midwives cut health care costs

Published: 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)

Your comments about this article

Today's headlines
Cash for Swedes who saw dying Dad on TV
Svea Court of Appeal in Stockholm. Photo: Leif R Jansson/TT

Cash for Swedes who saw dying Dad on TV

Relatives of a man whose final moments appeared in a television programme about a hospital in Sweden have each been awarded 20,000 kronor ($2,700) in compensation, after a court ruled that his privacy had been breached. READ  

Sweden rallies behind women in Ukraine
Sweden's foreign minister Margot Wallström in Kiev. Photo: Gustav Sjöholm/TT

Sweden rallies behind women in Ukraine

Sweden's Foreign Minister Margot Wallström is making her first visit to Ukraine, where she has urged leaders to press on with efforts to support women and cut corruption as tensions continue in the east of the country. READ  

The Local's Countdown to Christmas
Five magical Swedish winter markets
Kalmar Castle, Småland is hosting a Christmas market. Photo: Flickr/Simon Green

Five magical Swedish winter markets

Stockholm and Gothenburg may be the main tourist draws when it comes to winter markets in Sweden, but away from the big cities, Swedes do their Christmas shopping in barns, castles and farm shops. Here are The Local's top tips for 2014. READ  

Immigrant graduate jobs on the rise in Sweden
More foreign-born graduates are finding work in Sweden. Photo: Shutterstock

Immigrant graduate jobs on the rise in Sweden

It is getting easier for foreign-born graduates to find a job in Sweden, according to the country's Employment Service, which says it has seen a jump in the percentage of immigrants scoring roles that require a university degree or college education. READ  

Hospital in 'fairyland' tax haven claims
A model of the new Karolinska hospital being constructed in Stockholm. Photo: Bertil Enevåg Ericson/TT

Hospital in 'fairyland' tax haven claims

An estimated 1.3 billion kronor of taxpayers money set aside to build Sweden's most advanced hospital is alleged to have been channelled to a tax haven in Luxembourg by the companies behind the project. READ  

Sweden's Spotify turns up volume as losses fall
Spotify was created in 2008 in Sweden. Photo: Erik Mårtensson/TT

Sweden's Spotify turns up volume as losses fall

The world's biggest music streaming service, Spotify, has announced that its revenue grew by 74 percent in 2013 while net losses shrank by one third, in a year of spectacular expansion. READ  

The Local's Countdown to Christmas
Top ten Swedish Christmas presents
Presents photo: Shutterstock

Top ten Swedish Christmas presents

Christmas shopping is a challenge every year. If you're looking for something particularly Swedish with a special touch, it can be even harder. Here is The Local's own guide to top Christmas gifts of the year. READ  

Video: Fashion versus Weather
How to stay stylish in Sweden in November
Student Antonia Erlandsson laughs off the wet weather under a wide-brimmed hat. Photo: The Local

How to stay stylish in Sweden in November

It's hard to flaunt your favourite fashions when the November skies are unrelentingly bleak even by Swedish standards. But fashion doesn't have to be a victim of Scandinavia's chilly weather, as The Local discovers on the streets of Stockholm. READ  

Christmas sun sought by record numbers
Many Swedes are opting for warmer climes during Christmas. File photo: puroticorico/Flickr

Christmas sun sought by record numbers

A record number of Swedes are leaving the country to go away on holiday for Christmas, with sunny destinations like the Canary Islands and old favourite Thailand proving most popular. READ  

Man shot dead in Stockholm 'execution'
Police examine the shattered window of the Audi car after a man was shot dead in Sollentuna on November 25th 2014. Photo: Jonas Ekströmer /TT

Man shot dead in Stockholm 'execution'

A 32-year-old man has been shot dead in his car in Stockholm, with witnesses describing the attack as a brutal killing. READ  

RECEIVE OUR NEWSLETTER AND ALERTS
Sponsored Article
How to get your own office anywhere in the world
National
'I'm a Swedish 'expat' in my home country'
Imagebank Sweden
Society
Decorating your home for Swedish Christmas
Gallery
IN PICTURES: Sweden's 2015 Eurovision hopefuls
Gallery
Property of the week: Rosengården
Blog updates

26 November

Is Putin trying to buy up Europe’s nationalists? (Globally Local) »

" Photo: Alexey Druzhinin/AFP Political funding is a murky business at the best of times. If a party..." READ »

 

26 November

Not Pants (Blogweiser) »

" The woman who took the picture above was on her first visit to IKEA. She had just..." READ »

 
 
 
National
'Racist' Black Pete party scrapped in Sweden
Gallery
IN PICTURES: Sweden's Christmas gifts through the years
Sponsored Article
Introducing... Family life in Stockholm
Lifestyle
'I'm spreading Japan's 'cute' culture in Sweden'
National
Ebola: Sweden's leading expert speaks
National
Why this Swedish rabbi is facing death threats
National
Fears up to 300 Swedes fighting with Isis
Lifestyle
How to make Swedish mulled wine
Gallery
People-watching: November 22nd - 23rd
Society
What's on in Sweden: November 20th to 27th
National
How to boost your career in Skåne, Sweden's south
Lifestyle
How an Umeå museum is rewriting Swedish history
National
Timeline: Julian Assange sex allegations
Lifestyle
Five unique backpacker hostels in Stockholm
National
Bones show off Sweden's history
National
What new word are Swedes voting on?
National
Why African Swedes are angry about Santa's helper
National
Pine, tar, and tinder: flavours from the north
Gallery
Selfies, solidarity and Hillary Clinton: Stefan Löfven on tour
Gallery
People-watching: November 19th
Society
Why are international professionals leaving Sweden?
Business & Money
Meet the Swedes who made suits for The Hunger Games
Technology
'I'm among the first Swedes with a microchip'
National
What is Sweden doing about bird flu?
Gallery
Property of the week: Eriksberg
National
Vecka45: Sweden's most innovative week
Gallery
In Pictures: The clubs and loves of Sweden's Sven-Göran Eriksson
Society
What's On in Sweden: November 13th to 20th
Gallery
People-watching: November 16th
National
Driving (expats) home for Christmas?
Lifestyle
Make your own Swedish pea soup
Politics
"Totally unacceptable": Defence Minister on Stockholm submarine
Society
The A-Ö guide to making life in Sweden easier
National
How a Swedish party inspired a masterpiece
National
Seen the new Ace of Base yet?
National
Meet the Irish woman thundering into Swedish rock
Gallery
In Pictures: Ace of Base through the years
Society
Ten things you should never say to a Swede
Gallery
People-watching: November 12th
Business & Money
Get your own office in Gothenburg or Stockholm - free for a day
Sponsored Article
The best options for oversea transfers
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

782
jobs available
Swedish Down Town
Consulting & Productions

We are an innovative business company which provides valuable assistance with the Swedish authorities, Swedish language practice, and general communications.
Call 0731 004 781 or visit:
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:
psdmedia.se
If you want to drink, that’s your business. If you want to stop, we can help.
Learn more about English-language Alcoholics Anonymous in Sweden. No dues. No fees. Confidentiality assured.
aa-europe.org/sweden
The Local Spain is hiring!
The Local is seeking a new editor for our site in Spain to join our growing team of internationally-minded, driven, ambitious and clued-up journalists.
Details and how to apply