A COVID-19 homebirth in Gothenburg, Sweden

It’s been awhile since I wrote anything – apart from this story comparing Sweden and Australia which ended up on the front page of TWO(!) Aussie newspapers – but, last Monday, I did something worth typing up.

When we learned that partners wouldn’t be allowed at ultrasounds, midwife appointments, or even aftercare stays in the hospital hotel, Felix and I were floored.

In a country where aged care workers aren’t even forced to wear masks or gloves, where pubs and clubs are still open for business, and where people who live with confirmed COVID-19 cases are still forced to go to work, even if it’s within health or aged care, it seemed that pregnant women and new mothers were being disproportionately punished.

As a second timer with a low risk pregnancy, it was always unlikely that I would need to stay in the hotel after birth, but going home early would have its own set of issues and force us to wait six hours in the delivery room before being allowed to leave.

On top of that, a hospital is a bad place to be in a pandemic if it’s not necessary.

Having been born at home myself, I thought about the option of a homebirth and asked my public midwife about the process.

“I have no idea, but it’s not really done here, and you’ll have to pay for it yourself. We don’t really support it through the state and I don’t have any information to give you,” was the approximate response.

Okay.

So I Googled around and found www.födahemma.se, which had a list of homebirth midwives in the Gothenburg region. I called around and decided to go with BarnmorskeTeamet, a group of midwives who work on the side of their day jobs to provide in-home midwifery, and campaign for the rights of women in Sweden to choose where, how and with whom they birth their babies.

After a phone call with Johanna, I was sold on the group and felt excited about our upcoming birth for the first time since COVID-19 entered the scene. 

I had briefly considered a homebirth with Elsie but, being quite new in Sweden and a first-timer, it didn’t feel quite right. She was born in a hospital after an induction due to a long latent phase and at least partially to extreme lack of patience.

While there’s no research that suggests homebirths are actually dangerous for first time mums, there’s a lot that says they’re very safe for subsequent births, and even safer than hospital births in these cases, provided the pregnancy is low-risk. “Safer” often meaning fewer interventions, though hospitals seem to usually define “safer” with fetal rather than maternal outcomes in mind.

Having made the decision to birth at home, it came as an unwelcome surprise to learn that little Boyo was still upside down at 37 weeks.

I tried some spinning babies and visited the chiropractor, but Boyo was stubborn. I ended up having an ECV (external cephalic version) where I was given medication to relax my womb and the doctor turned him right-side-up from the outside. Pretty incredible and incredibly painful.

One of the wonderful benefits of having a homebirth is continuity of care, which is otherwise missing in Swedish maternity care. While pregnant women are often able to meet the same midwife for checkups and appointments (though I met three different midwives in the public system due to the pandemic), it’s luck of the draw when you enter the hospital and midwives often change shifts multiple times during a labour. During Elsie’s birth, there were three shift changes, and my midwives were in and out, tending to multiple labouring mothers at the same time. Not always an issue, but obviously not the best-case scenario.

I kept my midwives  updated via sms, and got quick replies every time. I had extra visits and cervical checks from one of the midwives who happened to live a couple of minutes away, so the care and attention I received from Barnmorsketeamet compared to the public system was apples and oranges. For the record, I’m well aware that budget cuts and systematic limitations are responsible for this, and that the public midwives would, in many cases, very much like to be able to offer more.

Regardless, having someone I could text about various concerns I had toward the end of the pregnancy – and even after the birth – has been fantastic.

I was pretty late trying to hire a birthing pool, and they were all rented out by the time I got around to it. I’d resigned myself to the idea of labouring on dry land, but the day before I went into labour, a pool was returned early to The Birth Suite, and we had just enough time to pick it up.

In said pool, before the contractions got really bad. And before the sun went down.

On Monday, the contractions were more painful, but not so close together that they counted as “the real deal” according to the birthing ward or the internet. When I rested, they became further apart, leading me to believe they were signs of false labour. 

By the afternoon, however, they were getting hard to walk and talk through, and we called Felix’s mum to see if she’d rather take Elsie just in case, or be called up in the middle of the night to come and collect her. Needless to say, she opted for the first. Felix had time to inflate the birthing pool and cycle Elsie to his mum’s while my mum stayed awake on the other side of the world, texting me until he got home.

“It’s the real thing,” she kept telling me.

We managed to finish dinner right before the pain really got going and I rang Johanna, who arrived about an hour later.

I was already enjoying the amazing pain relief provided by the birthing pool when she turned up, and got out for a quick cervical check that showed I was in active labour, and not – as my doubtful mind kept taunting me – making a big deal out of nothing.

 

Really incredibly great pain relief.

The labour was surprisingly painful, which might sound like a funny thing to say regarding childbirth, but the truth was that after terrible back labour with Elsie I’d been hoping for a ‘regular’ one this time around.

But it was not to be, and the back labour was, once again, intense and horrible.

One of the wonderful things about continuity of care in a maternity setting is the after-birth debrief. During a lovely home visit a few days after the birth, Johanna and Nina were able to walk me through the labour and explain a lot of the things I’d been confused about at the time.

He had gotten a little caught up sideways with a shoulder stuck on my pubic bone and wasn’t descending as he should, puzzling everyone and causing the labour to be longer and more painful than it maybe should have been.

But they were amazingly calm and professional, and though I wondered why things were taking longer than I’d expected, I was otherwise unconcerned. It was wonderful to fully trust the midwives and know I was in safe hands. To be able to let go of all thinking and decision making and just focus on working through the contractions.

In the end, when I was begging for it to end, and threatening to just die instead, Johanna got me out of the pool, told me to lean all of my weight back onto her and lifted the baby right up, pulled him back toward me, and out he popped in two big pushes.

“He would have come out eventually,” she told me afterwards, “but it might have taken a couple more hours.”

I will be forever grateful for that maneuver.

And then he was there, on my chest, and the pain was all gone. Flooded with love, joy, disbelief, exhaustion and relief, I stared at the tiny, squished up face that had just come out of my body. I still find it completely impossible to wrap my head around. How can something so completely incredible be so normal?

Moment of disbelief.
Felix cuts the cord.

And here we are, nine days later, soaking up the baby bubble which – this time – is pure joy and much less anxiety. This time it’s summer, it’s baby number two, and I had a wonderful, natural, unmedicated, empowering homebirth. 

My family couldn’t be with me, we’re in the middle of a pandemic, and we’re pretty isolated, but we’re happy and healthy and life is good. 

Proud and happy.

Otto eats well, sleeps well and is the cutest little newborn I’ve seen since 2018.

Sleepiest
Baby

Two months of two-under-two is looking to be easier and more lovely than I ever could have hoped. Welcome and thank you, Otto, for joining our little family.

Bliss
She's adjusting amazingly well.
And so is he.
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Lily Ray
Lily Ray

Journalist, photographer, traveller and knitter. Mother to a small but demanding infant, Lily's life is messy but generally lovely. She has a lot of thoughts. Here is where she puts them.

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