Having a baby in Aalborg (part 1): pre-natal care

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Having a baby is a life-altering experience. This is an indisputable fact. However, having a baby in a place where the practices and norms are unfamiliar to you – or where you do not comfortably speak the language – can make pregnancy, labor and delivery, and post-partum care that much more nerve wracking. I know. I had two babies in Lausanne, Switzerland and while I had lived there nearly two years before the first was born, I was far from fluent in French and I knew nothing about the health care system as it pertained to me as a pregnant woman. The purpose of this post, therefore, is to provide information to those women who are considering having a baby in Aalborg but know little about what to expect here. Since I have not given birth in Denmark myself, I spoke with three women who had babies between January and March of this year and asked them about their experiences. This post is a synthesis of the information they gave me. It is the first of a 2-part series; I will cover labor & delivery and post-partum care next week. bigstock-Positive-Pregnancy-Test-693446

Pre-natal care in Denmark begins after you get a positive home pregnancy test. Those two lines may induce feelings of surprise, excitement, or anxiety (or, quite likely, all three!) but no matter what your reaction, here – as in most countries – the next step is standard: make an appointment with your doctor. In Denmark, that is your general practitioner (GP), or the doctor you are assigned to when you get your health card. The first appointment will entail confirming the pregnancy, estimating the due date, and providing you with some of the information you will need during the next 9-10 months. You will also be given a ‘vandrejournal’, which is a very important piece of paper used by all concerned with your care to keep track of your appointments and the progress of your pregnancy. Here is what it looks like. It is your responsibility to hold on to the vandrejournal and bring it to all relevant pre-natal appointments – as well as to the hospital when it is time to give birth.

In Aalborg, your pre-natal care will take place in three separate places after the first ‘confirmation’ appointment with your primary care physician. 12w UltrasoundBesides your doctor, whom you will see a total of three times prior to the birth if the pregnancy progresses normally, you will also visit the midwife center and Sygehus Nord (“Hospital North” – all labor & deliveries take place at Sygehus Nord). Ultrasounds are conducted at the hospital (although you can also have scans done at a private clinic, paid out of pocket; see, for example, here), while the midwife to whom you are assigned will become the person you see most frequently as your belly expands. Midwives work in midwife centers, called Jordemodercenter. (‘Jordemor’ literally translates to ‘earth mother’.) Aalborg Jordemodercenter covers the city of Aalborg, while women in Aalborg East visit their midwife at Aalborg Øst Jordmoderkonsultation. (If you live in one of the surrounding areas, you can find your midwife center here.) Here is a chart of the visits scheduled with each of the three care providers during pregnancy:

First pregnancy

Subsequent pregnancies

Week

General practitioner

Midwife

Ultrasound (hospital)

General Practitioner

Midwife

Ultrasound (hospital)

6-10

X

X

11-13

X[1]

X[1]

15-17

X

X

19-22

X[2]

X[2]

21

X

X

25

X

X

29

X

X

32

X

X

34

X

36

X

X

38

X

40

X

X

Post-delivery

X

X

8 weeks after delivery

X

X

As you can see from the chart, there are two fewer visits with the midwife when pregnant with a second, third, etc. child. Your GP will monitor your general health condition during pregnancy. If you need to take sick leave at all while you’re pregnant, only your doctor can provide official permission to take time off work. The doctor will also ask you about risk factors for gestational diabetes in order to determine whether you should be tested for the disease. If so, the test is done between weeks 18 and 20 or 28 and 30. However, as GPs are not obstetric specialists, it is generally acknowledged that the purpose of pre-natal care by GPs is more about cementing a good relationship between mother-to-be and the doctor, who provides family health care; complications during pregnancy, i.e. non-routine health issues on the part of the mother or fetus, will entail a referral to an obstetrician at the hospital.[3] Women interested in genetic screenings can also ask their doctor about their options. Here is a brochure on the topic that was published in 2010 (in Danish) and its 2005 equivalent in English (I could not find a more recent version).

Your midwife, whom you meet in the weeks after the first ultrasound, will be the person who follows your pregnancy most closely until you give birth. Danish midwives undertake a professional education of 3.5 years to become certified; they complete their degree with the title Professional Bachelor of Midwifery.[4] You will have the same midwife taking care of you throughout the pregnancy but she will not necessarily be the midwife who delivers your baby unless you choose a homebirth, in which case she will. Your midwife’s role is to carry out routine urine and blood pressure tests, advise about healthy habits during pregnancy (click here for an English brochure on this topic by the Ministry of Health), determine whether you should see the doctor (outside the routine three visits) or an obstetrician, have an extra ultrasound, answer any questions you might have, and prepare you for delivery by asking questions about your vision and concerns about the birth, i.e. would you like to labor in a warm bath; how worried are you about pain; would you like to have a C-section. Read more details about visits to the midwife here (in Danish). It is also the midwife’s job to assess whether you and/or the baby will need any special attention or monitoring after the birth.

While birthing classes used to be offered as part of pre-natal care through the health system, they are no longer due to the cost. If you would like to take private classes, for example, pre-natal yoga, you may do so but you must pay out of pocket. However, as expectant parents you are invited by the midwife center to attend a class on breastfeeding; a session on hospital orientation; and a seminar about labor & delivery and pain management. You may also participate in a guided group tour of the hospital to see the rooms, learn about what will happen when you arrive to deliver the baby, whom you will meet, what you should bring, etc. For women who do not speak Danish, accommodations are made to communicate with the mother or parents in English and other languages, if need be. However, one of the women with whom I spoke warned that the sessions on as breastfeeding, hospital orientation, and labor, pain and delivery offered in English are infrequent. She recommended that women who would prefer to attend these English sessions over sessions in Danish (offered more often) should make it a point to ask about them at their first midwife appointment. She also observed that while there is some printed information available in English at the midwife center, the vast majority is in Danish so if there is anything you do not understand or would like more information about, ask your midwife.

So what happens when the baby’s delivery is near? Find out next week when I cover labor & delivery and post-partum care. If you are a mom who has given birth in Aalborg and have additional information and/or advice for expectant parents, please comment below! A big thanks to Ditte, Kylene and Rachita & Parul for their contributions to this post!

[1] Nuchal fold scan [2] Anomaly scan [3] McKay, Susan, “Models of Midwifery Care: Denmark, Sweden and the Netherlands,” in Midwifery and the Medicalization of Childbirth: Comparative Perspectives, ed. George W. Lowis et al., 1 edition (New York: Nova Science Publishers Inc, 2004), 156. [4] See http://www.jordemoderforeningen.dk/english/

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One thought on “Having a baby in Aalborg (part 1): pre-natal care

    […] week I covered the subject of pre-natal care in Aalborg. Today’s post concerns the end of pregnancy and beyond: labor & delivery and the care you […]

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