• 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
Motorists in sticky drama after jam spill

Motorists in sticky drama after jam spill

Drivers in western Sweden were forced to jam on the brakes after a van shed its load of preserves and juices which led to major traffic problems. READ  

Property of the Week
In Pictures: The Local's Property of the Week
Photo: Fastighetsbyrån

In Pictures: The Local's Property of the Week

Why settle for owning a house when you can own part of the island it is located on? This week's property allows you to get your money's worth of solitude while spending some time with your closest neighbour - the sea. READ  

Saab buys Swedish submarine shipyard
File photo: TT

Saab buys Swedish submarine shipyard

Swedish defence and aeronautics group Saab said Tuesday it had completed the acquisition of German heavy industry giant ThyssenKrupp's submarine shipyard in southern Sweden. READ  

Opinion
'The Danish narrative on Sweden is based on a lie'
File photo: Shutterstock

'The Danish narrative on Sweden is based on a lie'

There is a popular narrative that in Sweden people bite their tongues while in Denmark they speak their minds; political commentator Brian Esbensen debunks this, arguing that Danes simply find it easier to criticize others. READ  

Swedish cops elect not to shoot 'angry elks'

Swedish cops elect not to shoot 'angry elks'

After reports that wandering elks were scaring the public, police on the island of Frösön have decided not to open fire on the animals, but have urged locals to exercise caution instead. READ  

Swedish funds to tackle female genital mutilation
Sweden's Minister of International Development Cooperation Hillevi Engström with Foreign Minister Carl Bildt. File photo: TT

Swedish funds to tackle female genital mutilation

Sweden has earmarked 48 million kronor ($7 million) of its development aid budget to a United Nations programme to tackle female genital mutilation. READ  

Swedish leaders speak out on Gaza crisis
Photo: TT

Swedish leaders speak out on Gaza crisis

Swedish foreign minister Carl Bildt believes Israel is interested in negotiating a ceasefire with Hamas while Social Democrat leader Stefan Löfven has stood by his comment about the Israelis having a right to defend itself. READ  

New alcohol retail rules threaten micro-breweries
File photo: Systembolaget

New alcohol retail rules threaten micro-breweries

Swedish micro-breweries have reacted with concern to new distribution regulations being imposed by the state controlled alcohol monopoly Systembolaget, which they fear may put them out of business. READ  

ABB and Volvo in electric buses tie-up
Volvo hybrid bus. Photo: Volvo Buses

ABB and Volvo in electric buses tie-up

Swiss-Swedish engineering group ABB and Volvo Buses of Sweden have announced a joint project to develop a system for electric buses to recharge their batteries fast when at bus stops. READ  

'First ever' heat warning issued for Sweden
Photo: TT

'First ever' heat warning issued for Sweden

Swedish weather agency SMHI has issued its first ever warning for high temperatures with the many areas set to bask in plus 30C heat. READ  

RECEIVE OUR NEWSLETTER AND ALERTS
Gallery
People-watching Båstad
Business & Money
Sweden falls to third in global innovation index
Society
Swedish ornithologists keep webcam watch
Photo: Andreas Nordström/Image Bank Sweden
Gallery
Top ten Swedish beach hot spots
Tech
Swedish Wiki vet sets new content record
Blog updates

22 July

PROTECTING GIRLS FROM ABUSE OF THEIR RIGHTS (The Diplomatic Dispatch) »

"Today (22 July) my Prime Minister, David Cameron, and UNICEF, are hosting the world’s first #GirlSummit in London. The Summit’s aim is to mobilise domestic and international efforts to end the appalling practices of Female Genital Mutilation (FGM) and Child Early Forced Marriage (CEFM). This is a high priority for the UK government and the Prime..." READ »

 

18 July

Starting over (Around Sweden in a kayak) »

" I’ve now been off the water for almost 14 days. At first I was totally gutted being forced into a rest period, I had Stockholm in my sights and apart from the pain and discomfort in my shoulder, spirits were high and I was starting to gain some momentum. The news hit me fairly hard and..." READ »

 
 
 
Photo: Fastighetsbyrån
Lifestyle
In Pictures: The Local's Property of the Week
Photo: Finest.se
Gallery
People-watching July 15-16
Photo: Ola Ericson/Image Bank Sweden
Society
What's On in Sweden
Photo: Lisa Mikulski
National
Hope springs eternal for expat pet shop owner
Gallery
Princess Estelle steals limelight at mum's birthday
National
Swedes risk infants' lives by covering up prams
National
Swede runs for office just using Bitcoin funds
Gallery
People-watching July 11-13
National
Malmö mayor slams Danish beggar ban
National
Swedish anti-abortion midwife sues county
National
Swede's salary chopped for Facebook use
National
Northern Sweden warmest in 90 years
Gallery
'Victoria Day': Crown Princess Victoria turns 37
Politics
Mona Sahlin to fight extremism in Sweden
National
EU tells Sweden to cover up snus flavours
Society
Swede snags assassin role in Tom Cruise film
Lifestyle
Top ten ways to spend a few days in Malmö
Gallery
Swedish summer tourism highlights
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

699
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
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
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