From: friedan@raunvis.hi.is (Daniel Friedan)
Newsgroups: misc.kids
Subject: birth experience in Iceland
Date: 28 Sep 92 14:33:18 GMT
Distribution: misc

During my wife's pregnancy, I read this newsgroup and found the
information and personal anecdotes interesting and helpful.

My wife gave birth a couple of weeks ago in the maternity ward of the main
hospital in Reykjavik, Iceland.

Perhaps some here would be interested in a short description of the
process, especially for the sake of comparison with practices in the
United States.

Essentially all births in Reykjavik take place in this maternity ward, so
this is a description of establishment medical practice in Iceland.

Pre-natal care was paid by the state (like all basic medical care). The
pre-natal care consisted of medical examinations at a clinic in the
hospital, monthly through most of the pregnancy and weekly in the last
month or so. The examinations were carried out by midwives, with a doctor
appearing at the end of the examination to look at the results.

Normally, one sonogram is taken in the middle period of the pregnancy.
In our case, two extra sonograms were performed in order to time and
aim an amniocentesis (my wife and I are somewhat older than the average
parents).

We went to the hospital after about two hours of contractions, at about
2:30am. My wife and I were shown to an admitting room where she was
examined by a midwife. Then she was given a bed in a ward. The midwife
dragged an easy chair into the ward next to my wife's bed for me to sit
(and sleep) in.

The birth took place at 4:30pm the next day, so about 16 hours elapsed from
the beginning of contractions until the birth. During this period my wife
was attended by the midwives who happened to be on duty in the maternity
ward at the time. The labor lasted through two changes of shift, so three
midwives were involved. In addition, a student widwife assisted during the
last shift.

No doctors were involved until after the birth, when a doctor appeared to
check the baby's reflexes and clear his throat. Doctors were of course
always nearby in case of need.

The midwives all seemed to enjoy the process of birth. They were warm and
encouraging. The prevailing attitude seemed to be that birth is a normal
process. There was a strong preference for natural childbirth. On the other
hand, a fair amount of technology was used.

A fetal heart monitor was hooked up about every 4 hours.

At about the 6th hour, the midwife suggested to my wife a mild tranquilizer
(phenergan) to relax her, assuring her that it would not affect the baby,
and my wife accepted.

About 3 hours before the birth, my wife and I were taken to a birthing
room. The fetal heart monitor began to be used more frequently. In the last
half hour, it was used continuously.

The midwives offered my wife to breath a nitrous oxide/oxygen mixture
through a mask, at her own discretion. My wife found that breathing through
the mask helped her concentrate on her breathing and she used the nitrous
oxide during all the contractions.

I was clearly expected to help my wife with the labor, though there had
been no prior discussions of this with the midwives. Two midwives, one a
student, were present during the last part of the labor.

At some point, the midwives noticed something in the output from the fetal
heart monitor and began preparing for the birth. Their timing was perfect Q
about half an hour later the baby was born. Just before the baby's head
emerged, one of the midwives made a small incision which I understand was
designed to avoid tearing in the direction of the anus.

I was offered a scissors to cut the umbilical cord.

While one of the midwives did some repair work on my wife, the other
offered me the baby to bathe.

An obstetrician arrived and quickly checked the baby.

My wife and the baby were kept in the maternity ward for four days. This is
the normal period after a natural birth. After a caesarean, the mother and
baby are kept for seven days. These periods used to be seven and ten days.
The midwives in the post-birth wards feel that the current stay after birth
is much too short. They are extremely protective of the mothers and babies.
They are quite strict about visiting hours, explaining to the visitors that
the mothers are very tired and need rest.

Month by month statistics for the ward were posted in the central hall of
the maternity ward. Here is a summary of some of the data (for the first
six months of 1992):
                        births      1362
                        caesareans   207    15%
                        epidurals    374    27%
                        deadfetus      6   1/227.

My impression of the Reykjavik maternity ward and its midwives was
extremely positive. This was my first baby, so I have no prior experience
to compare with. And I don't have the technical knowledge to say whether
their practices are the best possible. But their attitudes induced in me a
great deal of confidence.

              Daniel Friedan    <friedan@raunvis.hi.is>
Newsgroups: misc.kids