‘Fantastic childcare, but disappointing maternal care’: How Covid-19 has stretched Sweden’s maternity wards

'Fantastic childcare, but disappointing maternal care': How Covid-19 has stretched Sweden's maternity wards
Staff shortages and limited hospital beds have changed the experience of childbirth in Sweden. Photo: Tomas Oneborg/SvD/TT
Women who gave birth in 2020 told The Local how they were affected by hospital staff shortages, as a new study shows that more than 900 women in Stockholm could not be offered a place on maternity wards when they gave birth.

It’s the first time the region has reviewed how many people were not given an appropriate hospital bed when they gave birth. A total of 28,362 births were recorded last year in Stockholm, but 80 women were directed to a different region for care and for a further 929 women there was no suitable hospital bed available.

Instead these women usually gave birth in rooms not intended for childbirth, SVT Nyheter reported, which in some cases had negative effects on patient safety, for example if the room did not have the right equipment.

In one case, a woman was sent home and gave birth in her own shower, and the report found that one child died because of the lack of hospital bed.

Sweden has faced issues in maternity care for several years, with rates of injury in childbirth above the OECD average. Between the years 2000 and 2017, nine maternity clinics were closed nationwide, with the sparsely populated northern regions particularly affected. After protests, recent years have seen regions invest in improving maternity care.

But during the pandemic, pressure on healthcare has only increased, with staffing problems reported in multiple regions last summer. 

One woman who gave birth in Gothenburg, Jessica, described her labour of over 40 hours, in which she suffered significant blood loss and had an emergency Caesarean.

During her time in the postnatal ward (BB in Swedish), she told The Local staff were “so busy that when I rang the bell for help it could take upwards of 20-30 minutes for someone to arrive. I wasn’t allowed to leave the room, either, due to Covid-19. It was like prison.”

“Furthermore, due to Covid-19 I never saw a midwife for a postpartum check-up,” she said. “They changed that meeting to a phone call, with a midwife I’d never met before. It was a pointless phone call in my opinion. I am highly dissatisfied with the post care, or lack thereof, that I received.”

As well as worries about their physical health, several women who gave birth in Sweden in 2020 have said their mental health concerns have not been addressed. While many had found support from fellow parents, through social media and WhatsApp groups, and some had been able to access support from healthcare clinics digitally, several felt neglected.

“I’m really disappointed with the maternal care in Sweden and I know that other women who have had babies in 2020 have felt the same. The childcare is fantastic and I feel my baby couldn’t be better taken care of, but I feel forgotten and not really sure where to turn to for questions about my own health,” said a Stockholmer who moved here in 2014.

Her concerns included a lack of follow-up after receiving a high score in a screening for depression, a lack of information about how the hospital had changed its procedures due to the pandemic, and the difficulty of not being able to be accompanied by her partner at emergency care visits for her young child.

Another woman, who gave birth in Stockholm in October, said that the shortage of staff due to Covid-19 had a direct impact on her birth.

“We went through so many different midwives, doctors and nurses that it was ridiculous. It was pretty common to hear from the nurses and midwives, ‘I don’t actually work at this hospital, so I am not sure how they do things here’. There was a huge communication problem where midwives were not passing on information to each other or not documenting it in the journal. [When] I finally went into active labour, I had a failed epidural and they were unable to get the anesthesiologist back to my room that evening due to short staff. I had no pain relief apart from gas and air for 15 hours,” she said.

The new parent also described the stress of going through regular check-ups alone, saying she was told her partner could not even join virtually. Throughout the pandemic, rules about whether a partner can accompany new parents to appointments and even during the birth have varied between regions and over time. In some cases when the partner cannot join in person, they can join digitally through apps like FaceTime, but this parent said she was not allowed to use this option and her husband missed out on the scans.

“I had a tricky pregnancy and required a scan every two to three weeks to make sure that baby was growing well,” she said. “There were a few times where the sonographer would go very quiet and this would then trigger worry and concern, this made me feel very alone and scared not having my partner with me. So I would just then dread each appointment through my whole pregnancy.”

“My husband could attend the birth but had to leave a few hours later when I went to BB [maternity ward]. I don’t have much knowledge with Swedish medical terms and I felt very bullied about breastfeeding while alone,” said another woman, who moved to Sweden three years ago.

According to figures from the umbrella organisation for Sweden’s municipalities and regions (SKR), nationwide the proportion of new parents receiving after-birth follow-up from a midwife rose from 79 percent in 2015 to 86 percent last year. And the gap between foreign-born women and native Swedes has reduced, with the figures changing from 69.6 and 82.1 percent respectively in 2015, to 81.8 and 88 percent in 2020.

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