Monday, November 23, 2015

Giving birth in Sweden: The parent preparation course

Flickorna Helin & Voltaire cafe on Djurgården, Stockholm  |  Giving birth in Sweden: The parent preparation course on afeathery*nest  |

When I'd registered us for the information night at the birthing center we'd chosen, I also signed us up for the 6-hour (!) "parent preparation" course, which covered a litany of topics related to the actual labor and delivery, as well as the days and weeks after. As we've both gone into this adventure with our eyes wide open but without our brains jammed full of information from every possible source, the relatively brief, but comprehensive, afternoon course was the perfect choice for us.

And what I mean by sans information overload is that we've purposely chosen a "light" form of preparation for this little one's arrival next month. We've got the big, necessary stuff ready, a few purchased onesies and clothing sets in varying newborn sizes (the plan is to get more once we actually know how big or small the baby is on arrival), and a few each of some of the smaller things, like swaddling blankets. But that's it. We have a minimalist, simple approach to purchasing things for our home and while it's a little hard to hold strong to that when a baby is on the way, we're doing our best.

We took the same approach when it came to "mental" preparation, in that we've talked a lot about the kind of parents we want to be, how we'll handle diapering and breastfeeding and food choices and the like, but apart from figuring out what I should and should not eat during pregnancy, we didn't get too bogged down in loads of information about each week of the pregnancy. Similarly, I've decided not to watch any live birth footage on YouTube and we didn't do a Lamaze course.

There's a chance I'm about to have the shock of a lifetime in a few weeks, but also the chance that practicing yoga for many years and going into this without all the potential what-if's flashing before my eyes will mean a calmer, saner birthing experience (during which I'll already know how to breathe through the pain, theoretically).

So—the one-shot overview of what to expect and how to prepare worked well for our style and we arrived at the auditorium to find it completely jammed with expectant parents. And while the schedule said it was a 6-hour situation, once we'd had a break for lunch and a fika, it was just four-and-a-half hours (whew).

But of course, all in Swedish.

Here's the thing with me and Swedish: if someone asked me to explain to them in Swedish or write down in Swedish what we'd learned, I wouldn't be able to, but given how I process languages (using lots of context clues and educated guessing), following along wasn't too much of an ordeal, as long as I didn't let me my mind wander. And since the lecturing midwife was a great speaker (lots of jokes and a personable style), that was easy to do and I ended up understanding about 80%.

(Even so, when we filed our birth plan we asked that the attending midwives speak English during key moments, because I'm pretty sure I won't be able to handle Swedish right then.)

As for what the course actually covered, she talked about:
  • How our lives will change as parents:
    She reminded us to make sure we do a lot of solo things now, like dinners out and spontaneous plans, etc., telling us to be as selfish as we can, because once that baby comes "every moment of our lives until we take our final breath will be consumed with wondering how our child is". (Her poetic phrasing naturally made me tear up).

  • How our relationship will change once we're parents:
    Then she spoke about how we're about to have a sweet, charming little baby in our midst...who's also a master manipulator. She talked about the importance of working together as a team and warned us not fall into the trap of becoming roommates or transforming our relationship into that of siblings.

    I was impressed that these kinds of reminders were included, and in general, that the course wasn't solely about the women and the physical changes and obstacles we're going through to bring our babies into the world, but also about the mental and emotional changes we'd both go through as equal partners in this. (Yay, Sweden!).

  • The psychology and physiology of birthing:
    The hormones that are released and how they instigate contractions, help move labor along, and signal to the body to begin producing milk. And how the baby actually descends and is pushed out (also the different ways that it can come out).

  • The phases of birth:
    Latent contractions—manageable contractions (you can sleep during these).
    Active contractions—when your body is dilating to 10 cm (i.e., painful).
    Transitional contractions—when the baby comes out (i.e., super painful).

  • When to call the birth center and when to go in:
    We were advised to stay at home as long as possible before coming in, as it's easier and more relaxing to be in your own cozy home than a hospital (assuming you're not the type to panic).

    And, that there's no need to call the hospital if your mucous plug comes out, but as soon as your water breaks we must call as the baby must be delivered sometime within 48 hours from that point (so as not to get an infection).

    What's great is that the midwives who answer your call listen to how you're breathing and talking and use that to recommend when you should come in (speaking on the phone during a latent contraction is fairly normal, whereas it's very difficult to speak through an active contraction).

  • Pain relief methods and options:
    Sweden offers lots of options and don't push any of them, which is another one of the reasons I wanted to and looked forward to giving birth here. The main choices are taking a shower/bath in your private birthing room's attached bathroom, massage, acupuncture, laughing gas, and an epidural.

  • The last moments before birth:
    This is where I learned one of the most amazing things. The midwife was telling us that when asked what they fear most about giving birth, women's #1 response is that they'd have an "accident" on the table (it happens, the midwives expect it), and #2 was that they'd tear or require an episiotomy.

    Not only would the latter be painful during the birth, but recovery from it (with stitches) means a very painful first few weeks at home (with problems going to the bathroom, walking, sitting, and laying down), when you're already dealing with everything else that comes with being a new parent. Then there are also the effects that the French tend to worry about (I'll let you Google that), but the midwife didn't mention that part of it at all.

    In an attempt to avoid this very uncomfortable ordeal, midwives take monthly refresher courses on how to coach a birthing woman through each contraction so that she's not pushing when she shouldn't be (which can also cause a tear), but in addition, there are always two midwives present during the final moments of birth: one to guide the baby out and one to apply warm oil and warm washcloths to make the skin more flexible while she uses her own hands to, essentially, hold the woman together. (Amazing.)

  • The first moments after birth:
    We were told there's no reason to include in our birth plans that we want to be sure the baby's cord stops pulsing before it's cut (something that happens quite often in the rest of the world), as standard practice is to place the naked baby on the mother's chest immediately. Cleanup and cutting of the cord comes later—another difference with some parts of the world that cut the cord and clean the baby before it's placed (wrapped) on the mother's chest.

    She told the partners present that they'd have to wait their turn to hold the baby as in the first hours after birth it's essential that mothers have the babies with them not only for the emotional bond and contact, but the smell of the baby and the hormones it releases also help get the flow of milk going.

  • What to bring with you to the hospital
  • Complicated births
  • Breastfeeding
  • Going to the "hotel"
  • Taking the baby home

Once again we left feeling very, very glad to be here in Sweden for this part of our lives. And while the fear of giving birth hasn't quite descended on me yet, going through how it's all going to play out and learning so much about the care the midwives provide, I'm fairly certain that when those feelings of panic set in, I'll have something to remember that will calm me down.

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More on Swedish healthcare, prenatal care and giving birth in Sweden:

One year ago: A taste of the familiar
Three years ago: Some tweaks & (Out of the) ordinary

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