Sweden's maternity wards have issues with midwife shortages all year round, with the situation worsening over the summer period as the staff are all entitled to four consecutive weeks of holiday during the summer under Swedish law.
More babies are usually born during summer, too, meaning that the busiest period on Swedish maternity wards is often the period where they have the least staff.
So, how is the situation in maternity wards across Sweden this summer? Newswire TT asked each of Sweden's healthcare regions to fill in a questionnaire between May 10th and May 23rd, asking for information on the state of maternity care in the run-up to the summer months. Here are the results.
Blekinge
Situation: Same as last summer
Blekinge region described the situation this year as strained, adding that many shifts have still not been filled.
Staff on parental leave, one hired-in independent midwife, temporary staff on hourly contracts and managers are taking shifts to fill the gaps, and midwives are being offered 7,000 kronor to move a week of holiday.
The region added that there is a small risk that patients will have to give birth in another region, although this is uncommon, and that the biggest challenge is covering midwife shifts and possible absences.
Dalarna
Situation: Worse than last summer
In Dalarna, the region described the situation as "fragile" due to a very small number of staff and no stand-ins for sick cover.
Their greatest concern is that staff won't be able to cope if they have to cover for each other, according to the survey.
However, it reports that there's also a low number of births expected, so pressure is not that high. There are around four midwife positions left unfilled, and staffing issues are being resolved by hiring retirees and giving bonuses for extra shifts.
Gotland
Situation: Better than last summer
Gotland has enough midwives to cover maternity wards over the summer, and some temporary staff have been hired to cover the summer months. The region has not had to hire in any independent midwives and is not offering bonuses for staff to move their holidays.
Gävleborg
Situation: Worse in Hudiksvall hospital, same as last year in Gävle.
In Hudiksvall, the region is 3-4 midwives short of the level needed for summer cover. It is trying to cover this with overtime shifts and by offering bonuses of 20,000 kronor a week (up from 15,000) for moving weeks of holiday.
It has had difficulties in finding enough independent midwives to bring in for holiday cover in Hudiksvall, and in Gävle, some wards are running at a reduced capacity.
Halland
Situation: Worse than last year
In Halland, capacity has been reduced to around 75 percent of normal capacity, with around 15 midwife positions unfilled. The region is hiring in independent midwives, retirees, and offering bonuses for moving holidays and working overtime. The region says that this is the third year in a row with staffing issues and describes staff as "tired".
It says that the biggest challenge is in Halmstad, where the neonatal ward is located.
Jämtland Härjedalen
Situation: Better than last summer
Jämtland Härjedalen's main challenge is ensuring there are enough senior midwives working when pressure on hospitals is at its highest. It has hired in three independent midwives in part-time positions, is hiring retirees and offering bonuses for moving holidays and extra shifts.
It adds that some staff have moved their holidays and received bonuses which are offered as a certain percent of their salary.
Jönköping
Situation: Differs depending on maternity clinic
Jönköping has 14 empty midwife positions, and is struggling to have enough experienced staff working over the summer. It has hired independent midwives and retired staff, is offering bonuses for moved holiday weeks, but adds that there is still a risk that some patients will have to give birth in a different region.
Kalmar
Situation: Same as last summer
Västervik hospital has a few empty midwife positions and the biggest challenges are staff needing to take sick leave and peaks in workload. Independent midwives and retired staff have been hired, as well as bonuses offered for moving holidays and taking extra shifts. Midwives in other areas (gynaecology, postnatal care) have been moved to maternity wards over summer.
Kronoberg
Situation: Same as last summer
Tight situation, if any staff get sick there will be more pressure on others. Two rooms on Växjö maternity ward closed. Independent midwives have been hired in and bonus offered for moving holiday. There's a risk some patients will have to give birth in other regions.
Norrbotten
Situation: Same as last summer
No expected staff shortages on maternity wards. Gaps in staffing have been covered by hourly workers, some new hires and staff hired through a summer recruitment initiative where the region offers to pay for travel and housing. Some staff have moved holiday weeks with a bonus of 25,000 kronor per week moved. Some staff are taking extra shifts, and independent midwives and retirees have been brought in for the summer.
Skåne
Situation: Same as last summer
Difficult to get enough staff on the maternity ward at Skåne University Hospital as well as neo-natal ward as Helsingborg hospital. In Kristianstad, there are 5 empty midwife positions and they will need to scale down services over summer.
Independent midwives have been hired for the summer as well as retirees. Skåne is also offering bonuses for moving holiday weeks and taking extra shifts, and Kristianstad have brought in assistant nurses and service workers to help lessen the load.
Stockholm
Situation: Better than last summer
Around 50 empty midwife positions, although the region says the situation better than previous years. Two hospitals might need help with referrals. A new maternity ward at S:t Görans hospital as well as fewer expected births means the region believes it has planned well.
Stockholm has also hired in independent midwives and retirees, offering bonuses for moved holidays and for taking extra shifts. It is offering 15,000 kronor for moving one week of holiday or 25,000 kronor for moving two weeks, and adds that there is a risk that patients will have to give birth in other regions.
Sörmland
Situation: Same as last summer
Sörmland doesn't have enough midwives to cover all of the region's maternity wards, stating that it's not possible to say how many midwives it's missing. Like many other regions, the region has hired in independent midwives and retirees and is offering bonuses for moved holidays and for taking extra shifts.
Uppsala
Situation: Same as last summer
Uppsala also said it had a midwife shortage, but also a shortage of experienced assistance nurses. Around 10 midwife positions are empty this summer, and it is offering 12,000 kronor to midwives for each moved week of holiday. It adds that there is a risk of women giving birth in other regions and is combatting this by hiring in independent midwives and pensioners. It has cut the number of hospital spots available for patients just after giving birth, is offering extra pay for senior midwives during summer and is prioritising treatment that can't wait.
Värmland
Situation: Same as last summer
Värmland region said that its biggest problem is not enough experienced staff, as well as the logistics of making sure that there is a good balance of experienced staff working on each shift. It has hired independent midwives and retirees, and offering 20,000 kronor bonuses for moving holiday weeks, as well as bonuses for taking extra shifts. It is also working at minimum capacity.
Västmanland
Situation: Better than last summer
Despite the situation being better this year than last year, Västmanland region said that the situation was still fragile, as it has assistant nurses and midwives working during the summer who don't work all year round.
Some midwives have been moved from other clinics to handle births, and independent midwives and retired midwives have been brought as extra cover over the summer. Midwives have been offered 15,000 kronor to move a week of holiday.
Västerbotten
Situation: Better than last summer
Västerbotten described its biggest challenge as providing safe maternity care with extremely low staff. It has hired independent midwives, midwives working hourly rates, is offering bonuses for moving holidays and taking extra shifts and has also hired midwives from Finland.
Västernorrland
Situation: Same as last summer
The region said that it had a shortage of around 12 midwives, which it is covering by hiring independent midwives and by asking employees to work overtime. It has also hired retired midwives, and is offering bonuses for moving holidays and taking extra shifts.
Västra Götaland
Situation: Better than last summer
Midwives, nurses and assistant nurses need to work extra shifts and move holiday weeks. Retired staff have been hired in, as well as staff working on hourly contracts. Midwives are being offered 10,000 kronor per moved week of holiday and bonuses for working overtime.
Örebro
Situation: Better than last summer
Around 30 midwife positions will be unfilled over the summer, and midwives have been offered 20,000 kronor per moved week of holiday, as well as bonuses for working overtime. The biggest issue is staffing extra shifts. It writes that there is a risk of patients having to give birth in other regions.
Östergötland
Situation: Better than last summer
Östergötland's biggest issue is covering sick leave or other absences. It has hired independent midwives and retired midwives and is offering bonuses for moving holidays and taking extra shifts. It adds that there is a risk of patients having to give birth in another region.
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