The Swedish Midwife Experience – Part 2
We last left off at the week 24 appointment, where the midwife measured fundal height and listened to the heart beat with a doppler for the first time in the pregnancy.
After week 24, I started seeing my midwife more often: once a month for the next two months, then a visit three weeks later, then visits every 2 weeks until delivery. About 8 times, or so, in the second half of pregnancy. In comparing that to the USA, it’s still not nearly as often as people see their OB/GYN’s. At each of these visits the midwife checked blood pressure, fundal height, and heart beat, and then usually some combination of weight, urine, and blood sugar (but rarely each one each visit). I was encouraged to ask any and all questions that I had, and nothing was a bad question (I even asked about where Swedes put the infant car seat – turns out, it’s in the front passenger seat as long as the airbag is turned off!).
At one visit, my midwife talked to us (Matt came to every single appointment) about breastfeeding. They obviously really encourage breastfeeding here, and she gave me basic tips and suggestions. At the next visit, we talked about what to expect when it was time to go to the hospital. They don’t do pre-labor hospital tours here, like they tend to do in the States, and instead they have (had?) a video on the healthcare website (förlossningen) that was basically an idea of where you should go, what you should do, and what to expect when you need to deliver your baby.
Fun fact: Google Chrome (which will automatically translate websites for losers like us who still don’t speak Swedish) translates förlossningen (essentially: “labor and delivery”) to “Pain”. HA HA GOOGLE.
Anyway, there used to be a video that walked you through the process from driving up to the förlossningen entrance, being greeted by a midwife, and being taken up to the delivery area. It showed you their pain relief options (gas, a bath tub), a general delivery room, and a recovery room, etc. At the moment, the hospital is under construction, so I think the video has been taken down, but in any case there’s a special entrance just for pregnant folks, kind of like an emergency entrance (and in our hospital they are next to each other).
Our midwife also explained what we would need to do when I go into labor and walked us through the same things the video showed. A big take away: they tell you to try to labor at home for a while. So, once you feel contractions you can call förlossningen and the midwife at the hospital who answers your phone call will assess where you’re at, they’ll be ready for you to come in eventually, and they suggest not coming in until the pain gets to be too much (assuming there’s no other need to come in sooner). It’s also first suggested that you pop a couple Panodil (Tylenol) too, which is hilarious to me because labor pains are totally not the same as a headache (but I kind of love that they are treated as normal as that). Now, they are totally on board with you coming in when you feel it’s time to come in, though, so if that’s sooner – it’s OK. I left each prenatal appointment feeling so confident and excited (honestly!) about giving birth.
The midwives would also feel the baby at each visit to check it’s position. A deep breath in, and when you release it they would feel for the head down in the pelvis area, to make sure baby was staying head down. If he wasn’t head down, they would manually turn him at the hospital. During one visit, a midwife student couldn’t confirm the head was down, so an ancient ultrasound machine was wheeled into the room. We got, literally, a 3 second shot of the top of the head. Poor Matt asked to see the rest of the baby, but I think his request was lost in translation, and the machine was wheeled out as fast as it came in.
Here’s what I didn’t have at any visit: Strep B testing, Gestational Diabetes testing, and no internal checks at all. From reading Ina May Gaskin’s books, I wasn’t worried that I didn’t receive any of these “mandatory” tests, because she pointed out that they were essentially unnecessary. To clarify, however, I was not at risk for gestational diabetes (which I would not have guessed…I’m a sugar monster), and my blood sugar was monitored with a finger prick a couple different times. Had that finger prick indicated a high blood sugar, or I had any symptoms of GD, then they would test and monitor for that.
At quite a few visits there were midwife students, or new midwives to the office, shadowing the midwife I was seeing. They would usually take over most of the visit, asking me questions and doing the check ups, and I will say that each woman who I met was calm, nice, happy, and professional. I know that sometimes when people see a midwife, or doctor for that matter, that it’s important that same person be there throughout the entire pregnancy and birth. My main midwife doesn’t work at the hospital, so she wasn’t going to be there. She was also out for a couple of my scheduled appointments, so I had to see another midwife. At no point did I feel uncomfortable with this, or that my care was in any way compromised. In fact, I think that coming into contact with different midwives and midwifery students made me more comfortable with just showing up at the hospital when it was time and trusting the midwife whose care I would be in.
Now, I had one appointment scheduled for 2 days after my due date. I hoped I wouldn’t need to go in for that one, for sure the baby would be here before it, right?! Well, baby was stubborn. At my first post-due-date appointment, my midwife then scheduled me for an induction date at 42 weeks 0 days (or, 42 weeks 1 day in American-speak). Aaaaand, between the appointment 2 days after the due date, and the induction date at 42+ weeks…there was nothing else scheduled. Nothing monitored, no one seen, call the hospital when you feel contractions or your water breaks and good luck…
…I’m ALL about going for as natural a delivery as possible, but it did make me nervous to not have any of those tests they run every other day for women who are past, what…38 weeks (?) in the States. Amniotic levels? No checking. Healthy placenta checks? Nope. Whatever else that I can’t remember now because I’m not freaking out about it….nope. No checks, no ultrasounds, nothing. They let the body do it’s thing here.
I did actually come back in really quickly one more time to have my semi-high blood pressure checked, to make sure it wasn’t going up and there was no risk for pre-eclampsia, but that was it – literally 5 minutes. And I did end up calling förlossningen a couple of times between weeks 40 and 41 because I had vision disturbances (they call them “flimmers” here) that are actually a sign of pre-e (though I had no other symptoms). So, I went into the hospital twice to be monitored (CTG) and have my blood pressure and urine checked again. Each time it was found that baby and I were healthy as could be, and it was just suggested that I relax. Easier said then done, but it was nice to know where I would be delivering now! The first time I went in for monitoring they actually did offer to do a membrane sweep, since I was almost a week past my due date. I was excited to have that done, but it really didn’t do anything for me.
A week later, at 41 weeks 4 days into my pregnancy, a Saturday, I about lost it. I was a worried, giant, pregnant mess. Scared of everything that could go wrong or that might statistically go wrong (stillbirth, “overdue” baby, autistic child (?!?!?!), etc.), and sick of being hugely pregnant (and swollen), and really not wanting an induction. Luckily, that’s the day (well, evening) I went into spontaneous labor and experienced a birth that…well…people dream about.
Like I’ve mentioned before, every woman we’ve talked to has expressed that they had a fantastic delivery at the hospital here. I’m just so relieved (grateful, thankful) that was also the case for me.