Pregnant? You Might Want to Move to Sweden
Where the (midwife-led!) maternal care is free, and the outcomes are awesome
Approaching pregnancy as a normal condition, and birth as a natural process, is considered somewhat radical here in the United States, where we treat pregnancy essentially as an illness and birth as a process requiring much intervention. But the fact is that our approach isn’t exactly doing mamas and babies proud. We have the world’s most expensive birthing system, complete with extensive testing and monitoring, yet our maternal mortality rates have doubled over the past 25 years—placing us 50 spots from the top, worldwide, in terms of safety in that respect—and our infant mortality rates are similarly dismal.
In Sweden, however, a very different status quo prevails.
Sweden’s maternal care system is—as it has been for centuries—run by midwives, with doctors, medical tests and hospitals on standby only in the event of complications. Barring any indication of a health risk, Swedish moms receive only one ultrasound, and exactly zero doctor’s appointments, from conception to baby. Not only is the system super cost effective, but its outcomes are awesome: Sweden’s infant mortality rate is the second lowest in Europe, just behind Iceland, and its maternal mortality rate is also extremely low—3.1 deaths out of every 100,000 births. America’s is greater than four times that figure. Only 17 percent of Swedish moms have c-sections, compared to about 33 percent of American moms, and only 10% receive episiotomies.
Wowza, right? Here’s the kicker: Swedish moms receive their maternal care free of charge, since it’s a part of the state health care system.
While the number of American women who venture beyond the standard medical maternal care model is still relatively low—less than 10 percent of the overall population of moms—midwives, in hospitals, birthing centers and homes, are making a definite comeback here. Home births are up by a whopping 50 percent! I am a part of that growing number; having had a hospital birth already, I opted for midwife-led care, and a home birth, for my second pregnancy. (My sweet new baby Otto arrived last month.) My level of care, and my overall experience, were far superior in my second pregnancy and birth, and I found myself wondering why all women—or at least most women, those without major risk factors—aren’t having their babies this way.
I was also surprised, though, by how many people still believe the hospital system to be a safer option, even for low-risk births, and even in light of the above-mentioned statistics, and of recent research that’s shown midwife care outcomes to be quantifiably better than medical care. Another mom at a breastfeeding support meeting even tried to talk me out of my home birth, citing safety as her hang-up… She meant well, and there are certainly more militant voices on the ‘anti’ side of the home birth debate, but her feelings are shared by many; in our culture, we’ve become accustomed to fearing pregnancy and birth.
Sweden has shown that low-intervention, midwife-led maternal care is in fact viable on the larger scale, and the results are better for moms and babies alike. Our own birthing system could surely benefit from adopting some of its practices. But changing the system begins with changing how we think of, and therefore approach, pregnancy and birth themselves, and that begins with each pregnant mama. Whether in the care of midwives or doctors, we might consider that approaching pregnancy as normal, and birth as natural, is perhaps simply rational after all.
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