Pregnant in Sweden

Introducing the newest Ferland at 18 weeks

The long periods in between blog posts are partially due to the fact that we weren't publicly announcing our pregnancy until the half way point.  That meant that I couldn't really divulge all that was going on in our lives which meant some posts were on the boring side.  Now that the cat is out of the bag, I can talk about all of the things I've been dying to talk about!

I'm not sure how much Calvin understands of what is going on, but he points to my belly whenever we mention "baby" and he repeats baby names after us whenever we are brain storming.  Now that we know we are having a girl, I'm sure a small part of him is relieved he won't be needing to share his cars with a brother.  She could surprise us though and be a total tomboy.  She'll be wearing his hand me downs for sure, because why not?  Gender equality is the rage here in Sweden so girls wearing trucks is nothing shocking.

Here is a rundown of how this pregnancy has been COMPLETELY DIFFERENT than my first pregnancy.  Of course, every woman experiences pregnancy differently but this time, I'm in a new country learning about a new health care system.  It keeps things interesting, that's for sure.

Positive pregnancy test: January 20, 2013
Estimated due date: October 10, 2013 -- this date keeps moving around so we'll just keep 10/10 to make things easy.

First trip to Swedish midwife: Barnmorcentral -- February 2013

• More of a "meet and greet" type scenario -- discussed medical background, exercise, diet, smoking/alcohol consumption, etc
• Blood pressure test: 113/76
• Urine test for protein
• Finger stick for blood sugar test and iron
• Everything came out in the normal range
• Next appointment: May 27, 2013

Differences between Swedish and US prenatal care:

• This first visit didn't even confirm that I was pregnant -- no blood test, urine test, etc.
• First (and only) ultrasound will be conducted at 18 weeks at the ultrasound center
• Quite different from the three ultrasounds of Calvin before 18 weeks (@8, 12, then 16 weeks)
• There they check for growth, abnormalities, twins (eek!)
• If you are over 35, you have the option for an amniocentesis to check for genetic disorders and defects
• Blood glucose blood test is only done if medically necessary
• They take 5 finger pricks throughout the pregnancy and if you show high blood sugar levels, they may make you take the glucose challenge for gestational diabetes.  Thank goodness I am not subjected to that needless, vomit-inducing and stressful test!
• At 20 weeks, you attend a group discussion of diet, exercise, and general things that women experience halfway through pregnancy.  Since it's all in Swedish, my midwife suggested I meet with her to discuss any concerns we may have.
• The midwives you see for office visits are NOT the midwives who will deliver your baby.  There are office midwives and hospital midwives.  Hospital midwives do delivery and office midwives handle the well-visits.  Definitely a departure from the US system where you agonize and stress over building a relationship with your midwife or OB because you want them to honor your birth plan.
• You won't know where you are going to deliver until you are in labor.  You have your list of preferred hospitals, who have your information and due date, but when you are in labor, you have to call the hospital to see if they have room for you.  If not, you have to go to the next hospital and so on.  It's a stressful situation but there is a limitation on the number of beds each hospital has and Stockholm has a lot of pregnant ladies.
• Birth plans are real things here -- since you won't know where you are delivering and you won't have a personal relationship with whoever delivers your baby, you hand over your birth plan, cross your fingers, and hope that they honor your wishes the best they can. 
• I've heard stories of some midwives being "old school" and not giving epidurals because they deemed them unnecessary.  These women are of viking blood and are as tough as nails.  I need to make sure I put on my big girl panties and get prepared to do this the natural way. Calvin was a piece of cake because I had a cozy epidural but that may not be an option this time.  Time to practice rhythmic breathing!

I have no willpower when it comes to cravings

Impressions:

• Sweden's approach to prenatal care is pretty holistic.  They don't schedule appointments every 4 weeks for healthy pregnancies and expensive procedures are limited only to those who need them.  Let's face it -- pregnancy isn't a complicated event for 90% of women.  In a socialized medical world, you need to limit expenses everywhere you can and anything that is unnecessary is not done.
• It is kind of disconcerting to go through the first half of your pregnancy without any medical appointments, but that's how they do things here.  They take your information and then say, "See ya at 20 weeks! Call us if things get weird."
• We asked my midwife about prenatal vitamins and she looked at me like I was crazy.  Why would you need vitamins?  It almost seems like prenatal vitamins are a pre-requisite in the US and women freak out if they miss a pill.  Missing a prenatal vitamin will surely result in a deformed child, for sure, right? Isn't that what my US midwife pounded into my head??  She shook her head and said, "folic acid is necessary in the first 8 weeks but fine afterwards and you won't need additional iron until week 20." -- Everything else is just business as usual I guess.  Maybe Americans are a little more uptight than I had thought.
• Iron -- my blood test came back very deficient in iron. I'm anemic and nearly pass out on a regular basis and this pregnancy has really sapped whatever iron was remaining in my blood.  When we were in Rome, I had to sit down frequently after walking around because I was dizzy. Around 13 weeks,  I was reading to Calvin on the couch and nearly passed out sitting up -- the tunnel vision,  loss of hearing, everything.  I called to Jon and he ran to the apoteket to get the high dosage of iron supplements my midwife had recommended.  I'm now on 2 pills a day - the maximum dosage and am feeling much better.
• Emergency care during pregnancy -- around week 12, we had a scare with cramping and some bleeding.  I called my midwife and she sent me to the emergency gyn clinic.  Calvin was a model child and played with his cars in the waiting room for 4 hours.  Aside from waiting for forever even though there was NOBODY THERE, they did an ultrasound to confirm everything was ok.  Fortunately it was and they couldn't explain my symptoms so I was scheduled for another ultrasound.  Two weeks later, we had a follow up ultrasound and once again, they confirmed everything was fine.  
• Even though the socialized prenatal care here is very "laid back" in comparison to US practices, they do take you seriously if you have an emergency.  This was very comforting and it bolstered my confidence in their approach.  If everything is normal, no need to come in.  If things are not normal, come in immediately and we'll take care of you.  Makes sense to me.

Turns out it's easy to hide a pregnancy when you live half a world away

How I'm feeling:

• Before we knew we were having a girl, I was convinced I was having a girl.  Everything was different than last time. I was super sick for 2 weeks and had food aversions for another few weeks after that.  I couldn't drink coffee for 15 weeks and still don't really care for it.  I started eating everything in sight... and I mean everything.  I did the stereotypical pregnant lady move and ate an entire jar of pickles -- only breaking down in tears when I struggled to open the jar, followed by real tears once I did pry the jar open. Tears of joy! Over pickles?!? Who am I? What is this baby doing to me?  I was/am a hormonal wreck...
• Now that I'm taking iron supplements regularly, I'm feeling much much better. I have more energy and haven't felt like I was going to pass out in a long time.  Just those two things have been a lifesaver.
• Having experienced the US approach to prenatal care, I cannot say that I was overwhelmed with my positive experience. I probably would've had a good experience regardless of where I delivered.  I had a low/no-risk pregnancy, epidural with pitocin and Calvin was born after 3 pushes.  Everything went fine for me so I can't credit the US-medical system with doing anything remarkable.  Reading up on Sweden's positive birth-related outcomes, this country is, without a doubt, the much safer place to have a child.  Sweden's approach to birthing babies respects the process and allows the woman's body to do its own thing.  
• I'm slightly nervous about the figure-out-where-you-are-going-to-deliver-once-you-are-in-labor deal.  1) Labors after the first baby often come much quicker, 2) We don't own a car, so will I be laboring in a taxi? On the T-bana tram? 3) The nearest hospital is about a 40 minute drive..., 4) Who will watch Calvin?
• We are moving a few months before the baby is due, so it is my mission to make good friends with our neighbors very quickly.  We may need a last minute lift to the hospital or someone to watch Calvin on short notice, so I'm hoping they are amenable...
• Worst case scenario - give birth on the side of the road and call an ambulance.  THIS HAS HAPPENED TO WOMEN HERE.  It is a story I have heard from other women.  The last minute scrambling has resulted in some chaos and the baby comes when the baby comes.  Eeek!