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Pregnant mothers in for a long wait: report

Karen Holst · 20 Aug 2011, 11:39

Published: 20 Aug 2011 11:39 GMT+02:00

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Due to the continued baby boom and the limited number of midwives, many primary care clinics in the Malmö area have quickly had to absorb responsibility for maternity care patients.

“Now we stand exactly where we feared. We are completely overloaded,” Laila Mårtensson, a midwife at the maternity care clinic Famlijens Hus in Malmö, told Sydsvenskan.

Familjens Hus, or The Family House, is one of the busiest maternity clinics in the nation, with midwives often booking appointments during their lunch period.

“We are doing everything in our power to receive the women. We schedule them in, and we use all our administrative time to tend to them, but it is not enough,” Mårtensson added.

In accordance with national health recommendations, a pregnant woman should be offered enrollment into a maternal care program between weeks 8 and 10, which should include all the routine health screens and tests.

However, a pregnant woman who calls a maternal care clinic in Malmö can expect to have only a short conversation regarding her health during week 12, and her actual full enrollment six weeks later. At the latest, it could be week 24 that a woman finally has her first actual appointment.

During the brief health conversations a midwife will ask about the woman’s health, her lifestyle, whether she smokes, drinks alcohol, exercises or is subject to any hereditary risks.

It is only during the actual enrollment, or "inskrivning", that the routine tests are taken, the actual journal is written and the medical history is reviewed more thoroughly.

Women who receive an enrollment time late in their pregnancy must monitor themselves when it is time for the fetus diagnostic tests and make an appointment on their own for the ultrasound.

“If we have a health conversation in week 13, it’s already too late for the KUB test,” explained Mårtensson about the time sensitivity regarding certain critical screens.

KUB is a combination ultrasound and biochemical test that screens for amongst others chromosome defects such as Downs Syndrome and must be done prior to 13 weeks gestation.

Story continues below…

Some politicians have attempted to persuade their local party colleagues in the region not to transfer maternity care to primary care clinics.

“They do not understand what they have done. The idea is good but you cannot make such a big change in such a short time. The primary clinics have not had time to build their organizations for this,” Mårtensson told Sydsvenskan.

The outlook for the autumn remains uncertain and there is still confusion amongst midwives as to which doctors they should refer patients to, where cell tests should be sent and who will lead parenting classes.

Karen Holst (kholstmedia@gmail.com)

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Your comments about this article

16:20 August 20, 2011 by texaslass
Perhaps in an emergency situation like this, priorities should be put in place. Money should not be spent on parenting classes, but rather used to hire more prenatal care professionals. Realizing that the health care system does not have the funds to support all activities, then focus should be on the ones that are most important. Seems like common sense.
19:11 August 20, 2011 by jacquelinee
I am unfamiliar with what kind of medical education or medical "Betyg" a midwife has to receive before practicing medicine in Sweden? I have only before now, heard of Obstetricians who have gone to medical school for 13 years of training dealing with pregnancy and childbirth, with extensive training in surgery, in order to get a diploma, and extra education to specialize in prenatal care. The last time I heard of a "midwife, outside of Sweden that is, was in the remote rural areas in the 1800's where it was often very difficult and nearly impossible to get to a doctor. Those "midwives" were basically older women who had many children themselves so, it was assumed thy knew about birthing babies.

Is a midwife hear another term for an intern training to be an obstetrician? Sometimes the meaning of certain terms can get lost in translation from Swedish to English. How much university education does a person need in order to become a midwife. It must be reasonably substantial if they are dealing with the complexities of pregnancy?

I am just curious because, the article is speaking about midwives in the south, Skäne/Malmö region and not far north in remoter areas where getting to a doctor would be more difficult.
01:14 August 21, 2011 by zircon
I don't like to brag but I am a good midwife. Well, as good as Dr Kosevich (Nine months movie).
12:17 August 21, 2011 by Gretchen
Maternity care in Sweden (through which I am going through now for the second time) is so limited and basic anyway when compared to other European Countries - I am not surprised about this article at all.

Care is so old fashioned with no real gynocological examination scheduled (none whatsoever, at least not in the Stockholm area - and I have been to 2 different centres). No check for infections, no check if you are prematurely opening. Instead measuring of the belly with an taylors tape measure (at which my doctor at home just had to laught). Both times here in Sweden the calculated birth date has been well off the mark and in the end I have been so scared to give birth here, I travelled home twice for that reason. You do not even know if you can go to the clinic of your preference here, you cannot bring your own midwife (as it is the custom in my country) and are kicked out of hospital as soon as possible due to overload. I am so disillusioned when it comes to the Swedish health system!
13:37 August 21, 2011 by jacquelinee
@ #2

I too am cocerned with healthcare in Sweden. I am still hoping someone will answer the question from post #2

What level of education/university can a person expect to need as a prerequsite for becoming a midwife? It has to pretty high if they are performing the duties that are normally given to highly trained and skilled doctors, in most present day countries. Not do disrespect or question midwives' obvious care for pregnant women in Sweden. It must be good. It just seems strange to continue with such an archaic medical practice in the 21st century unless the midwives actually have trained in medicine at a qualified university had have a least a partial medical degree.

I am just curious because I really don't know much about it.
20:37 August 21, 2011 by wxman
"Pregnant mothers in for a long wait." Yeah, typically 9 months. Give or take a week or two.
21:18 August 21, 2011 by voiceofreason
I work in an establishment with about 1500 employees and it seems all the women have gone on parental in the past 2 years.

It is indeed a baby boom.
08:03 August 22, 2011 by Bender B Rodriquez
@jacquelinee: A midwife has a 3 year university degree in nursing (licensed nurse) + 12 months work practice + 1.5 years of specialist training.
11:15 August 22, 2011 by jacquelinee
@ Bender B Rodriquez

Thanks. That is actually very reassuring. It just goes to show you how perceptions of the same word can be so different from culture to culture.
11:20 August 22, 2011 by Bender B Rodriquez
@jacquelinee: Also, midwifes only handle uncomplicated births; it is a natural process after all. Any sign or history of complication means that an obstretician will take over.
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