• Sweden's news in English
 
app_header_v3

Swedish midwives cut health care costs

The Local · 2 Oct 2013, 07:32

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.

Story continues below…

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
More flight delays hit Swedish airport
For some flights, the problems have led to up to two hours of delays. Photo: TT

Travellers at Stockholm’s Arlanda airport were beset again with delays on Saturday afternoon after technical problems with flightplan management software.

Video
The top reactions to Swedish high heels handyman video
Andersson was in agony after a day of laying floors in high heels. Photo: Emil Andersson

What did The Local's readers think about this viral clip challenging sexist beauty ideals?

Transport authorities call for probe into tech glitch
SAS aircraft grounded at Arlanda airport last week. Photo: Johan Nilsson/TT

But officials say it was not sabotage that caused last week's network failure, which knocked out large parts of Swedish air traffic.

Why northern Swedes get the hots for sex toys
File photo of handcuffs. Photo: Gunnar Lundmark/SvD/TT

Where in Sweden do people buy the most sex toys? Kiruna in the far north, apparently.

Royal baptism day for Sweden's Prince Oscar
Prince Oscar with Archbishop Antje Jackelén. Photo: Jonas Ekströmer/TT

UPDATED: Royalty, dignitaries and other esteemed figures took to Stockholm's Royal Chapel for the ceremony.

Giant replica of Swedish 18th century ship up for sale
The Götheborg setting sail from Stockholm in 2008. Photo: Claudio Bresciani / TT

A replica of a doomed Swedish merchant vessel that sank in 1745 within sight of its home port of Gothenburg has been put up for sale.

Border checks
First migrants make it from Denmark to Sweden on foot
The Öresund bridge between Sweden and Denmark. Photo: Erland Vinberg/TT

Dozens of attempts have been made, but this is the first successful crossing since Sweden introduced ID and border checks.

Brexit
Poll: Swedes are worried about Brexit consequences
The possibility of Brexit has Swedes worried about the EU's future. Photo: Lars Pehrson/SvD/TT

Swedes are worried about what may happen both at home and abroad if Britain votes to leave the EU in June.

The Local Recipes
Fend off the bad weather with a Swedish beetroot salad
Beetroot salad with cumin and feta. Photo: John Duxbury/Swedish Food

Rain, rain, go away.

How a Swedish rocker saved the life of this cute baby elk
Erik Brodén's daughters Tyra and Brita with the elk baby. Photo: Private

Probably the sweetest story you'll read today.

Sponsored Article
How to find student housing in Malmö: 5 tips
Gallery
The best, cutest and funniest snaps from Prince Oscar's christening
Sponsored Article
Can you afford to live in Stockholm? (Hint: yes)
Travel
Is this town the best place in Sweden?
Gallery
People-watching: May 25th
Blog updates

27 May

Editor’s blog, May 27th (The Local Sweden) »

"Hej readers, Would you spend a day doing manual labour in high heels? That’s what Swedish…" READ »

 

17 May

What about “att”? (The Swedish Teacher) »

"Hej! It often seems like the small words are the ones that cause the most confusion.…" READ »

 
 
 
Sponsored Article
'Sweden gives artists the space to follow their dreams'
Society
WATCH: Why Swedish handyman wore pink high heels for feminism
Sponsored Article
Stockholm makes it easier for refugees to meet startups
Sport
LIST: Top-ten ridiculous things Zlatan has compared himself to
Business & Money
Why Swedes don't want the euro
Fastighetsbyrån
Gallery
Property of the week: Vika, Falun
Sponsored Article
Food, fun, and reliable sun: Summer in Dubrovnik
National
Is this the most Swedish tattoo ever?
Sponsored Article
How Stockholm startups help new employees feel at home
Gallery
People-watching: May 20th-22nd
National
How to really annoy a Swede abroad
Sponsored Article
'Only soft power can defeat radicalism'
National
How this war veteran is warming hearts in Sweden
Sponsored Article
Why Stockholm attracts so many successful researchers
Gallery
People-watching: May 18th
National
How this Swede's viral ad totally nailed Stockholm's housing crisis
Gallery
Property of the week: Vasastaden, Gothenburg
Sponsored Article
'Sweden gives artists the space to follow their dreams'
Lifestyle
The best Swedish cities for dating
Sponsored Article
Retiring abroad: ensuring your health is covered
Gallery
People-watching: May 13th-15th
Sponsored Article
Can you afford to live in Stockholm? (Hint: yes)
Culture
BLOG: Eurovision as it happened
National
Why a 116-year-old Swede isn't the world's oldest woman
National
Youth unemployment falls in Sweden
Gallery
People-watching: May 11th
Gallery
People-watching: May 6th-8th
Politics
Why Sweden's Greens are in free fall
National
Can these cartoon Swedes help foreigners blend in?
3,350
jobs available
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