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HEALTH

Swedish midwives launch course on giving birth in cars

Two Swedish midwives have launched a course teaching expectant parents how to act if they have to go through the process of giving birth in a car, as the impending closure of a maternity ward means the journey to the nearest maternity unit will soon become far greater.

Published: 16 January 2017 11:39 CET
Updated: 16 January 2017 17:36 CET
Swedish midwives launch course on giving birth in cars
Sparsely populated, the distance between towns in northern Sweden can be significant. Photo: Fredrik Sandberg/TT

The closure of the maternity ward in Sollefteå, northern Sweden, at the end of January means that expectant mothers in the area will soon have to travel to Örnsköldsvik or Sundsvall, both of which are around a hundred kilometres away.

In order to try and help pregnant women feel more secure, two midwives at the ward which is closing have launched a course on what to do if the process of childbirth begins during a long car journey.

“If you think that it will be something between 120 and 200 kilometres to the nearest maternity ward, and it’s winter, it’s dark, there’s a bad mobile signal, anything can happen on the way. Car accidents, the car could break down, you maybe drive off the road. You have to be ready, and the worst could happen even if it is very, very uncommon,” course leader and midwife Stina Näslund told The Local.

The course will cover the practicalities of making a long journey with someone who is close to giving birth, and even what to do if labour begins.

“Keep in mind that a quick delivery may be needed for a first time mother. That’s a challenge. Our municipality is huge,” Näslund explained.

The midwife said that the reaction has been surprisingly large since the course was announced on Friday afternoon, with people contacting via e-mail and telephone, and both domestic and international media asking about it.

“We have always had a maternity ward in Sollefteå, so this it will be new for the area when the ward closes in two weeks. It’s an economic question: they think they will save millions of kronor by closing the ward. For me, personally, it feels like they are cutting the lifeblood of a society,” Näslund noted.

Sweden’s stretched natal care has been a high-profile subject in recent years following stories related to the scarcity of beds at hospitals and women being turned away due to a lack of space.

In December, a pregnant woman died in the emergency room of a hospital after spending the night there because there were no free beds in the neurology ward.

And in July, a baby died after a clinic in southern Sweden sent a heavily pregnant woman home despite showing signs of pre-eclampsia, due to a lack of space.

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HEALTH

Who should get vaccinated against TBE in Sweden?

Tick-borne encephalitis (TBE) has more than doubled in Sweden in the past decade. Who should get vaccinated against it and how much does it cost?

Published: 13 March 2024 13:44 CET
Updated: 8 April 2024 07:53 CEST
Who should get vaccinated against TBE in Sweden?

TBE, or Tick-borne encephalitis, is one of the two main tick-borne diseases in Sweden (Lyme disease is the other one).

It is a viral brain infection, which can cause a range of symptoms, usually starting with typical flu-like symptoms and then developing to include nausea, dizziness, and in around a third of cases, severe problems.

Symptoms usually appear around a week after the bite, but can take longer. There is no cure, but it can be treated, and there is a vaccination too.

The tick season tends to last from March to November, peaking in April to mid-June. According to the Public Health Agency, most TBE cases however tend to be recorded during the summer, as that’s the period when people spend the most time outdoors.

TBE is relatively rare, but has been on a fairly steady increase in Sweden in the past decade, from 178 confirmed cases in 2014 (or an incidence rate of 1.83 per 100,000 people) to 595 cases in 2023 (incidence rate 5.64), according to the Public Health Agency’s statistics.

Who should get vaccinated?

Because the infection can in a few cases lead to serious consequences, anyone who lives in an area where there’s a high concentration of ticks carrying TBE is recommended to get vaccinated.

That includes people who live there permanently and who have temporary summer homes, as well as people who spend a lot of time outdoors in these areas, but there’s no strict cut-off point.

Not all ticks carry TBE, and they have historically been concentrated in southern parts of Sweden and the Stockholm archipelago, but have been spreading across the country in recent years.

The regions that recorded the most number of cases last year were Stockholm (160, or an incidence rate of 6.52 per 100,000 people), Västra Götaland (121, or 6.85), Södermanland (55, or 18.22), Uppsala (52, or 12.85), Västmanland (33, or 11.75) and Värmland (31, or 10.93).

The only region that didn’t record a single case of TBE in 2023 was Gotland. Jämtland, Västerbotten and Västernorrland recorded one case each, and Norrbotten two cases.

You may want to contact your regional health services for specific information. Skåne, for example, only recorded 21 cases last year (an incidence rate of 1.48), but TBE is more common in certain parts of the region than others, and the region recommends that people living in these parts get vaccinated – there’s more information to be found on the region’s TBE vaccine page.

You can of course also get vaccinated even if you don’t live in a high-risk area, especially if you spend a lot of time in the forest or tall grass.

How can I get vaccinated?

You can search for healthcare centres near you through 1177.se or the website Fästing.nu (fästing is the Swedish word for tick – don’t confuse it with fästning, a fortress). To view regional information on 1177, go to the top of the page and click välj region (choose region).

The vaccine is not part of Sweden’s national vaccination programme, so you have to pay for it.

In Östergötland, the vaccine is subsidised by the region, so each dose of the initial three doses costs 200 kronor for adults. In a lot of other regions, including Stockholm, it costs around 400 kronor.

Only Sörmland, Uppsala, Västmanland, Östergötland and Jönköping offer the vaccine for free to children and teenagers, at least the basic vaccination schedule of the initial three doses.

How does the vaccine work?

You start with three doses (or four if you’re over 50), usually the first two within the space of one to three months and the third dose ahead of the next season, no more than a year after the second dose.

Each of these doses increases your level of protection, but because you need several to be fully protected, it’s recommended that you begin the vaccination programme well ahead of tick season.

You then get a fourth (or fifth if you’re over 50) top-up dose after three years, and will need top-ups every five years.

Children under the age of 15 are recommended to get the second dose one month after the first dose, then the third dose after 5-12 months. After that they follow the same schedule as adults, so a fourth dose after three years followed by top-ups every five years.

People with an impaired immune system due to underlying health issues are recommended to follow the same schedule as over-50s. They may not be able to reach a full level of defence against TBE, but the vaccine will offer enough protection that they are still recommended to get it.

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