Having A Baby In Sweden – The Midwife Experience

swedish pregnancy test

One of the points of my blogging is to give information for people looking for it. Like, say, if you’re moving to Sweden from somewhere else and you have no idea where to begin…I hope I can be of some service to someone out there, if needed.

I’d forget how big of a deal it seemed to ship the dogs over, or to register for our personnummers if I didn’t have it all written down. (Oh, yeah, and I still don’t have it all written down…so feel free to email me if I’ve left something out and you’re wondering 🙂 )

So, having a baby in Sweden! That’s what’s going on for us these days, and the care a woman receives is quite different (I think) from the United States. Plus, it’s my first baby! This is the kind of stuff I want written down to remember.

23 weeks belly

So, settle in with a cup of coffee if you want to read about the Swedish midwife experience (or mine so far), because this is a doozy…

Some background info: When you become a resident in Sweden, the lady-doctor (Kvinnohälsan) office sets you up with an appointment for cell testing (HPV). You don’t have to go (you can ignore the letters), but they’ll keep sending you appointments every six months until you do. I guess some could think of this as weird, but I think it’s great – coming from the USA where women’s health care seems unreasonably fought about and somewhat neglected/shame-based. I like that they take the initiative to keep lady-bits healthy here (and to spread further infection). Also, as far as I know…it’s free.

Health care here comes at a minimal cost (comparatively) for tax-paying residents. Sometimes the care you get might not be what you want/need (Matt had to go around to a few doctor’s for a shoulder problem when we first got here) but overall, it’s worked out well for us (we’ve been for flu shots, tick bites – then antibiotics, etc.).

Buying a pregnancy test, the only thing you need to know is what the word “Gravid” means: Pregnant! “Inte Gravid” means you’re not.

probablytmi

Once you get the positive news, you call Kvinnohälsan (Women’s Health) or Mödravårdscentraler (Maternity Services/Midwives) in your area. You can find the contact information on the county’s health care websites (Linköping’s is lio.se, for example).

When I called, I ran into my first hurdle: an answering message service in Swedish. Luckily, I can understand enough Swedish to figure out what to press and when to put in my personnummer and phone number. After I did that though, I didn’t understand what the message told me. All I understood was the word, “elva”, which means eleven. I assumed this meant they might call back at 11? But to be sure, I walked to the health clinic and asked. I had done it and understood it correctly! Whew!

Now…if you’ve been pregnant lately, you might know that some people don’t want to share the news right away – for fear of something going wrong early on. I didn’t want to share it until I had some more information, so when a midwife called me at 11am, and I was on a walk with my neighbor, it made for a semi-awkward, semi-rude moment when I held back to privately talk on the phone. Ugh, I felt bad! And I also felt bad for asking the midwife to speak English. But it worked out well, and I got my first appointment scheduled…

…for 6 weeks later (I was at about week 5 then). What?! I actually said to the midwife after she gave me the date, “So far from now?!” and she replied with a nice but curt, “What?”. I suppressed my naïve worry that that was too late to have my first prenatal appointment and just agreed to the allotted time. I found out later that outside the USA, many women don’t go see their midwife until weeks 8-11, if everything feels good.

The weeks leading up to the first appointment were a good lesson in patience, but also nerve-wracking for a first time pregnancy. What about what I’m supposed to eat (is all Swedish food OK to eat)? Am I healthy enough to have this baby? Don’t they always stress the importance of early prenatal care?!?! Turns out, there’s not much anyone can do in those first few weeks, and those standard rules – don’t drink, don’t smoke, don’t do drugs – those are your guidelines in a normal pregnancy. My Mom reminded me that when she had my older sister, she went to the doctor later in her first trimester, and that maybe the only reason Americans go so much now is either for the convenience of peace of mind and/or for doctors to cover their asses in case of whatever may go wrong can’t be blamed on them.

The month-plus leading up to the first appointment, I immersed myself in all the pregnancy websites devouring as much info as I could. We also went to Germany for Oktoberfest…which, well, isn’t that ironic? It was no problem for me to abstain from beer, but Germans smoke a lot more than I’d have thought, so hanging out in the Oktoberfest tents was short-lived…poor Matt. During that last week before the first appointment I became a grouchier version of myself. I was sick of waiting, and wanted some confirmation of this pregnancy (I had very little morning sickness or anything).

"i swear i can see a belly matt! don't make fun of me!"
“i swear i can see a belly matt! don’t make fun of me!”

Well, that first appointment came, and while all the women on the message boards were getting early ultrasounds to confirm a growing bean shape inside them, or blood tests to measure HCG levels, I met with my midwife and got a blood test (for iron levels and mandatory STD testing). Matt asked (probably more for my sake) if the midwife was going to “confirm” the pregnancy somehow, and she basically said the pregnancy test was it. A total bummer for my sake – it’d be convenient for me if they confirmed it somehow, but I knew it wasn’t necessary. They did, however, give me an alcohol quiz (to make sure I wasn’t an abuser or currently drinking) and another quiz to measure any feelings of depression. I’ll be taking another one after birth, as well, which I think is great. I’d like to combat any postpartum depression if it comes up.

I did great on the alcohol test. Despite my wino tendencies I don’t have any drinking problems. But after the depression test, I got the head-tilt and sympathy look from the midwives, “Awww. You’re a little depressed.” I’m not, really, but I did answer that I felt bad about myself if I didn’t accomplish my daily tasks – which probably meant responsibility-related (career-related) tasks, not the dishes. Oops. Oh well. I’m married to a former Marine, we run a tight ship, dishes included. Whatever! I’m happy they even care.

I did have to ask about diet guidelines, if there was anything off-limits in Sweden (like certain cheeses/meats/coffee/”-must” drinks/etc.) and the midwives told me to look online. There you go! After copious reading on pregnancy-safe foods, I just use my best judgement here.

Anyway, the first visit was pretty uneventful, but we did go for a Thai lunch on the way home, so that was nice 🙂

One of my options was to set up the KUB test (nuchal translucency testing, in the States), which I happily agreed to mainly for the chance to finally have an ultrasound. So, the longest two and a half weeks later (at 14 weeks), we made our way to the hospital early one morning for some real confirmation.

ultrasound appointment. does he look nervous?
ultrasound appointment. does he look nervous?

 

Side note: Linköping is a University town, with the main industries being health, technology, and aviation. The hospital seems like it might employ the entire town because it was all abuzz at 8am, and I’ve never seen anything in Sweden abuzz before 10am at the earliest. There were even doctors running around like on Grey’s Anatomy…….raise your hand if you can tell I don’t make it into hospitals very often…

Anyway, I was wondering whether or not we’d get to watch the ultrasound, if we’d get any information there or have to wait for the midwife to look at it, and – god forbid – I worried we’d get bad news, too. Luckily, the ultrasounds are super high quality and we got to watch along while the midwife conducting it told us what she was doing.

bignews

Do you know how it feels to see a little baby-form on the screen the second she swipes the wand over the belly?! AMAZING. IT FEELS AMAZING. Surprisingly, I didn’t cry, one tear let loose, but that was it. Matt jumped out of his seat and grabbed my hand right away, and we watched, mesmerized, for the next 15 minutes or so. All measurements looked great, and we were able to buy two pictures for 50:- ($7). Those first pictures about kill me, little face, little legs. Somehow, a 7cm human was developing perfectly inside me all along, despite the lack of feeling or showing. GLORIOUS DAY. So thankful.

I had another appointment with my midwife at 16 weeks, or so, where she reported that my blood tests, blood sugar levels, and urine tests were good, and confirmed the findings from the ultrasound were good, too. She weighed me, this is two days after our Thanksgiving dinner, and gave me a look for being a smidge higher than average. I hung my head in shame because I knew explaining that it was due to our gluttonous American holiday wouldn’t really be understood. I mean, Jesus, pumpkin pie doesn’t even exist here…how could they understand?

That was my last appointment until week 24. That’s right folks, I went over two months without seeing the midwife. If you ask if this is OK on a babycenter message board, the resounding answer is NO. However, there are only so many blood and urine tests to tell you what you need to know, and I can watch my weight at home (by that I mean, watch it go up). I felt good, I had numbers to call in case of emergency, and I actually did have the anatomy ultrasound in the middle of those appointments.

ultraljud

Another ultrasound! We managed to fight off incessant questions from family on whether we’d find out the gender; we didn’t know if we could  find out because some places in Sweden they don’t tell you. Why? Because it’s not important to the health of the fetus, alright, and that’s the mission here. We had conflicting reports from friends around town with kids, some had found out, some were allowed to guess, and some weren’t told at all. Matt asked right away if we could find out, and the midwife tech measured us up, but agreed to look.

For the record, I’ve NEVER wanted to find out the gender. I’ve always liked the idea of a surprise. But the pressure to find out made me annoyed, and Matt wanted to know too, so I didn’t want to deny him of that.

Another spin around the uterus showed a healthy baby and healthy Mamma, so that was the best Christmas gift I could ever ask for.  We shelled out another 50:- for two more shots, including one BEAUTIFUL profile of our little boy.

babyface

This week saw the 24 week check up. Overall, it went really quick. Another couple of blood tests, a measure of the fundus (uterus height), and the first use of the heart beat doppler (baby kept kicking it, feisty kid!). All looked great and we’ve got more frequent appointments with the midwife from now on.

The next appointments will explain more about labor and birth, and then also what happens after baby is born. From what we know of other people who’ve given birth here, they first say it’s the best experience ever (holla!), but also that you get to go home usually within a day, and a midwife comes to your house regularly to check up/help, and parents get a little money from the government for their children.

If I understand things correctly (I’ll confirm this as we go along), the midwives here tend to be far more woman-centered than OB/GYN’s – which naturally midwives are anyway. In my opinion, this is a beautiful thing. I’ve been reading up on all the Ina May Gaskin literature that I can, to prepare myself for the midwife style of pregnancy and delivery and I’m totally on board.

our reading pile
our reading pile

 

I couldn’t be happier to have the care of midwives who specifically mention that they care for the woman’s experience and let the body do it’s thing as naturally as possible. Just, you know, in a hospital… so there’s still the emergency medical care should it be needed.

I’ll go on record now to say that I am aiming for a natural delivery, because I’m not as afraid of natural pain as I am of intervention, seriously! Ina May is basically a woman goddess sent from Heaven, and she makes me WANT to give birth. As an American, this is rare – that anyone would speak so highly of birth, not to mention natural childbirth. Swedish maternity care and midwives seem (in my limited knowledge at this point) to encourage a more interference-free delivery, if you want. Again, I’ll report more as I go along.

So, there you go. 24 weeks into an American expat’s first pregnancy in Sweden. On the medical side of things, it’s far more relaxed than what I know about how things go in the States. Have some patience, ask questions when you meet with your midwife, and enjoy your pregnancy.

I’ll be touching on more baby topics, like looking for baby-gear, setting up the nursery, and of course, more about midwife care as I go along.

This totally went from a random ex-pat blog to a full on BABY IN YOUR FACE blog, didn’t it? Maybe. Hopefully not. Does anyone want to read about this stuff anyway? Gold star if you got through this beast of a post 🙂

does this picture make up for the baby talk? she's still our #1 girl!
does this picture make up for the baby talk? she’s still our #1 girl!

    7 Comment

    1. I read it all. Useful. Where should I put the gold star? 🙂

    2. […] I later celebrated my birthday, then we celebrated our 5th anniversary of meeting, and (despite how uneventful it was) our first midwife appointment. […]

    3. Thanks for your story. This is great stuff. As an American, I am looking for a lot of info on a cheaper/less invasive maternity system. I hope you’ll continue writing on this.

    4. […] last left off at the week 24 appointment, where the midwife measured fundal height and listened to the heart beat […]

    5. I am also an American living in Sweden, this is very helpful to me!

    6. hi, thanks for sharing. do you have suggestions also on how renting a breastpump from a swedish hospital?

      1. Hi Silvia! I’m sorry I won’t be of too much help, as I never rented a breast pump. I would suggest talking to the baby nurse that you will see often after your child is born. I am sure she can help! Or get in touch with your midwife after delivery to talk to her about obtaining one. It looks like this website may be really helpful, http://www.amningshjalpen.se. Good luck!

    Leave me a comment!