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What’s the state of Sweden’s maternity wards this summer?

A difficult summer is on the cards for maternity wards across Sweden once again this year. Here's a rundown of the situation in each region in Sweden.

What's the state of Sweden's maternity wards this summer?
The maternity ward at Karolinska hospital in Stockholm. Photo: Henrik Montgomery/TT

Sweden’s maternity wards have issues with midwife shortages all year round, with the situation worsening over the summer period as the staff are all entitled to four consecutive weeks of holiday during the summer under Swedish law.

More babies are usually born during summer, too, meaning that the busiest period on Swedish maternity wards is often the period where they have the least staff.

So, how is the situation in maternity wards across Sweden this summer? Newswire TT asked each of Sweden’s healthcare regions to fill in a questionnaire between May 10th and May 23rd, asking for information on the state of maternity care in the run-up to the summer months. Here are the results.


Situation: Same as last summer

Blekinge region described the situation this year as strained, adding that many shifts have still not been filled.

Staff on parental leave, one hired-in independent midwife, temporary staff on hourly contracts and managers are taking shifts to fill the gaps, and midwives are being offered 7,000 kronor to move a week of holiday.

The region added that there is a small risk that patients will have to give birth in another region, although this is uncommon, and that the biggest challenge is covering midwife shifts and possible absences.


Situation: Worse than last summer

In Dalarna, the region described the situation as “fragile” due to a very small number of staff and no stand-ins for sick cover.

Their greatest concern is that staff won’t be able to cope if they have to cover for each other, according to the survey.

However, it reports that there’s also a low number of births expected, so pressure is not that high. There are around four midwife positions left unfilled, and staffing issues are being resolved by hiring retirees and giving bonuses for extra shifts.


Situation: Better than last summer

Gotland has enough midwives to cover maternity wards over the summer, and some temporary staff have been hired to cover the summer months. The region has not had to hire in any independent midwives and is not offering bonuses for staff to move their holidays.


Situation: Worse in Hudiksvall hospital, same as last year in Gävle.

In Hudiksvall, the region is 3-4 midwives short of the level needed for summer cover. It is trying to cover this with overtime shifts and by offering bonuses of 20,000 kronor a week (up from 15,000) for moving weeks of holiday.

It has had difficulties in finding enough independent midwives to bring in for holiday cover in Hudiksvall, and in Gävle, some wards are running at a reduced capacity.


Situation: Worse than last year

In Halland, capacity has been reduced to around 75 percent of normal capacity, with around 15 midwife positions unfilled. The region is hiring in independent midwives, retirees, and offering bonuses for moving holidays and working overtime. The region says that this is the third year in a row with staffing issues and describes staff as “tired”. 

It says that the biggest challenge is in Halmstad, where the neonatal ward is located.

Jämtland Härjedalen

Situation: Better than last summer

Jämtland Härjedalen’s main challenge is ensuring there are enough senior midwives working when pressure on hospitals is at its highest. It has hired in three independent midwives in part-time positions, is hiring retirees and offering bonuses for moving holidays and extra shifts.

It adds that some staff have moved their holidays and received bonuses which are offered as a certain percent of their salary.


Situation: Differs depending on maternity clinic

Jönköping has 14 empty midwife positions, and is struggling to have enough experienced staff working over the summer. It has hired independent midwives and retired staff, is offering bonuses for moved holiday weeks, but adds that there is still a risk that some patients will have to give birth in a different region.


Situation: Same as last summer

Västervik hospital has a few empty midwife positions and the biggest challenges are staff needing to take sick leave and peaks in workload. Independent midwives and retired staff have been hired, as well as bonuses offered for moving holidays and taking extra shifts. Midwives in other areas (gynaecology, postnatal care) have been moved to maternity wards over summer.


Situation: Same as last summer

Tight situation, if any staff get sick there will be more pressure on others. Two rooms on Växjö maternity ward closed. Independent midwives have been hired in and bonus offered for moving holiday. There’s a risk some patients will have to give birth in other regions.


Situation: Same as last summer

No expected staff shortages on maternity wards. Gaps in staffing have been covered by hourly workers, some new hires and staff hired through a summer recruitment initiative where the region offers to pay for travel and housing. Some staff have moved holiday weeks with a bonus of 25,000 kronor per week moved. Some staff are taking extra shifts, and independent midwives and retirees have been brought in for the summer.


Situation: Same as last summer

Difficult to get enough staff on the maternity ward at Skåne University Hospital as well as neo-natal ward as Helsingborg hospital. In Kristianstad, there are 5 empty midwife positions and they will need to scale down services over summer.

Independent midwives have been hired for the summer as well as retirees. Skåne is also offering bonuses for moving holiday weeks and taking extra shifts, and Kristianstad have brought in assistant nurses and service workers to help lessen the load.


Situation: Better than last summer

Around 50 empty midwife positions, although the region says the situation better than previous years. Two hospitals might need help with referrals. A new maternity ward at S:t Görans hospital as well as fewer expected births means the region believes it has planned well.

Stockholm has also hired in independent midwives and retirees, offering bonuses for moved holidays and for taking extra shifts. It is offering 15,000 kronor for moving one week of holiday or 25,000 kronor for moving two weeks, and adds that there is a risk that patients will have to give birth in other regions.


Situation: Same as last summer

Sörmland doesn’t have enough midwives to cover all of the region’s maternity wards, stating that it’s not possible to say how many midwives it’s missing. Like many other regions, the region has hired in independent midwives and retirees and is offering bonuses for moved holidays and for taking extra shifts.


Situation: Same as last summer

Uppsala also said it had a midwife shortage, but also a shortage of experienced assistance nurses. Around 10 midwife positions are empty this summer, and it is offering 12,000 kronor to midwives for each moved week of holiday. It adds that there is a risk of women giving birth in other regions and is combatting this by hiring in independent midwives and pensioners. It has cut the number of hospital spots available for patients just after giving birth, is offering extra pay for senior midwives during summer and is prioritising treatment that can’t wait.


Situation: Same as last summer

Värmland region said that its biggest problem is not enough experienced staff, as well as the logistics of making sure that there is a good balance of experienced staff working on each shift. It has hired independent midwives and retirees, and offering 20,000 kronor bonuses for moving holiday weeks, as well as bonuses for taking extra shifts. It is also working at minimum capacity.


Situation: Better than last summer

Despite the situation being better this year than last year, Västmanland region said that the situation was still fragile, as it has assistant nurses and midwives working during the summer who don’t work all year round.

Some midwives have been moved from other clinics to handle births, and independent midwives and retired midwives have been brought as extra cover over the summer. Midwives have been offered 15,000 kronor to move a week of holiday.


Situation: Better than last summer

Västerbotten described its biggest challenge as providing safe maternity care with extremely low staff. It has hired independent midwives, midwives working hourly rates, is offering bonuses for moving holidays and taking extra shifts and has also hired midwives from Finland.


Situation: Same as last summer

The region said that it had a shortage of around 12 midwives, which it is covering by hiring independent midwives and by asking employees to work overtime. It has also hired retired midwives, and is offering bonuses for moving holidays and taking extra shifts.

Västra Götaland

Situation: Better than last summer

Midwives, nurses and assistant nurses need to work extra shifts and move holiday weeks. Retired staff have been hired in, as well as staff working on hourly contracts. Midwives are being offered 10,000 kronor per moved week of holiday and bonuses for working overtime.


Situation: Better than last summer

Around 30 midwife positions will be unfilled over the summer, and midwives have been offered 20,000 kronor per moved week of holiday, as well as bonuses for working overtime. The biggest issue is staffing extra shifts. It writes that there is a risk of patients having to give birth in other regions.


Situation: Better than last summer

Östergötland’s biggest issue is covering sick leave or other absences. It has hired independent midwives and retired midwives and is offering bonuses for moving holidays and taking extra shifts. It adds that there is a risk of patients having to give birth in another region.

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Pair behind Covid vaccine discovery win Nobel Prize

Katalin Karikó of Hungary and Drew Weissman of the United States won the Nobel Medicine Prize on Monday for work on messenger RNA (mRNA) technology that paved the way for Covid-19 vaccines.

Pair behind Covid vaccine discovery win Nobel Prize

The pair, who had been tipped as favourites, “contributed to the unprecedented rate of vaccine development during one of the greatest threats to human health in modern times”, the jury said.

The World Health Organization declared Covid a pandemic in March 2020 and the mRNA vaccines were approved for use in December that year. Billions of doses have been injected around the world since then.

Together with other Covid vaccines, they “have saved millions of lives and prevented severe disease in many more”, the jury said.

Karikó, 68, and Weissman, 64, longstanding colleagues at the University of Pennsylvania in the United States, have won a slew of awards for their research.

They include the prestigious Lasker Award in 2021, often seen as a precursor to the Nobel.

In honouring the duo this year, the Nobel committee in Stockholm broke with its usual practice of honouring decades-old research, after ensuring it has stood the test of time.

While the prizewinning research dates back to 2005, the first vaccines to use the mRNA technology were those made by Pfizer/BioNTech and Moderna against Covid-19.

Unlike traditional vaccines which use weakened virus or a key piece of the virus’ protein, mRNA vaccines provide the genetic molecules that tell cells what proteins to make, which simulates an infection and trains the immune system for when it encounters the real virus.

Sweet comeback

The idea was first demonstrated in 1990 but it wasn’t until the mid-2000s that Weissman and Karikó developed a technique to control a dangerous inflammatory response seen in animals exposed to these molecules, opening the way to develop safe human vaccines.

The honour is particularly sweet for Karikó, the 13th woman to win the Medicine Prize, who toiled in obscurity for years and struggled to convince her superiors of the need for research on “messenger ribonucleic acid”.

Speaking to Swedish Radio (SR), she said her late mother always had faith in her, listening to the Nobel prize announcements “year after year” in the hopes of hearing her daughter’s name called out.

“Unfortunately, five years ago she passed at the age of 89. She might be listening from above,” Karikó said.

Thomas Perlmann, the secretary general of the Nobel Assembly, called Karikó “an extraordinary and unusual scientist” who “resisted any temptation” to do “something easier”.

Weissman told SR he heard the news from Karikó, who received the call from the jury first.

“We weren’t sure if somebody was playing a prank on us,” he said, adding that he would “probably go out with my family and have a nice dinner” to celebrate.

In the 1990s, Karikó believed mRNA held the key to treating diseases where having more of the right kind of protein can help — like repairing the brain after a stroke.

But the University of Pennsylvania, where Karikó was on track for a professorship, decided to pull the plug after the grant rejections piled up.


Much of the scientific community was at the time focused on using DNA to deliver gene therapy but Karikó believed that mRNA was also promising since most diseases are not hereditary and don’t need solutions that permanently alter our genetics.

First though, she had to overcome the problem of the massive inflammatory response in animal experiments, as the immune system sensed an invader and rushed to fight it.

Karikó and Weissman discovered that one of the four building blocks of the synthetic mRNA was at fault — and they could overcome the problem by swapping it for a modified version.

They published a paper on the breakthrough in 2005. Then, in 2015, they found a new way to deliver mRNA into mice, using a fatty coating called “lipid nanoparticles” that prevent the mRNA from degrading and help place it inside the right part of cells.

Both these innovations were key to the Covid-19 vaccines developed by Pfizer/BioNTech and Moderna.

Their mRNA technology is now being used to develop other treatments for diseases and illnesses such as cancer, influenza and heart failure.

The pair will receive their Nobel prize, consisting of a diploma, a gold medal and a 11 million kronor cheque (around one million dollars), in Stockholm on December 10.

The Nobel will however not be the first gold medal in Karikó’s family. Her daughter Susan Francia is a two-time Olympic gold medallist rower.