Pregnancy care in Sweden (MVC/BMM)
What is MVC/BMM, what do they do, what does it cost
MVC (mödravårdscentral) or BM-mottagning (barnmorskemottagning) is a place you go to for pregnancy check-ups (as well as consultations on birth control, but that's out of scope for this post). It is mostly barnmorskor (midwives) who work there and oversee the development of the pregnancy. If needed, they put the women in touch with doctors or psychologists. They also can give some lectures for parents-to-be.
All these services are free and voluntary for the future parents. You can contact them as soon as you got a positive result on a pregnancy test.
The exact number of visits and the checks performed depends on the region/län and on the pregnant woman’s health background. For example, in Skåne everyone is screened for gestational diabetes, while in some other regions there has to be something in the family history or similar to kick off this check. In Or you might need to pay if you want to do a trisomy test but you're younger than 35. There might be fewer visits if it's not your first child.
To find out how it works in your particular region, go to 1177.se, select your region at the top, and then click on Barn och Gravid (children and pregnant). Somewhere in there you'll find something like Besök under graviditeten, Besöksprogram för gravida or Undersökningar under graviditeten, which is a page with a list of all the visits and all the tests relevant for a normal pregnancy. Here's one from Gävleborg as an example:
You meet the same barnmorska every time (unless she goes on a prolonged vacation of course) and ask whichever questions you have. Most of the times it’s followed by measuring your blood pressure and doing a blood test. Around week 12 there are also tests for some infections, including sexually transmitted ones, and for the blood group. If there is a potential for Rh disease, they give the mother a shot against that (followed by another one after the birth).
In the second half of the pregnancy they also start checking the size of the belly and the heartbeat of the child. In the last few weeks of pregnancy the visits happen more often.
If the pregnancy is normal, there will be not more than two ultrasound appointments.
The barnmorska you meet during the pregnancy will not participate in the birth at all, but will provide the key information about you to the hospital staff beforehand. In particular, you'll discuss the options for pain relief, but it's not like that's set in stone and you can't change your mind when you're in labor.
Different regions also have slightly different approaches for what to do when the pregnancy is getting too long. Most seem to have a discussion between the parents and the doctors to potentially offer igångsättning av förlossningen (induction of labor) if the baby is not out by week 41+0.
How to choose an MVC, and how to change to another one
People often recommend to pick an MVC which has its own ultrasound equipment, because otherwise you’ll need to go to another place for the ultrasound appointments. It might be wise to at least check where that other place is.
It’s important to have good communication with your barnmorska, and if it’s not good, you can always go to another one. There’s no unified system to which all MVC:s would be connected though, so what you do in this case is just ask them to print out whatever information they have (logs of your visits, results of your tests) and bring it to the new barnmorska. This is also what you'll have to do if you move to another län during the pregnancy, like I did.
Your experience can vary quite a bit. For example, some MVC:s give you access to an app or an email address where you can contact your barnmorska directly, while others will just give a phone number where you get to talk to whoever happens to be on that shift. If you’re doing glukosbelastning for gestational diabetes, you can spend the two hours between the two blood tests in a relaxing room with soft armchairs and plentiful magazines, or in a waiting area in the hallway. You can get a brochure or a book about expecting children, or just be advised to use 1177.se whenever you’re wondering about something.
Other choices
In my experience, the staff of an MVC is not pushy about anything. Want to find out the sex of the baby? Great. Don’t want to? Also great. Want to know the chances of trisomy 13, 18 or 21? Sure. Don’t want to know? Okay. And so on.
The general direction is to support the parents, no matter their situation or preferences.
Food
Swedish healthcare system is pretty permissive in its recommendations when it comes to pregnant women’s nutrition, at least compared to some other countries I know about. Livsmedelsverket has the up-to-date information (in English even). Here are some highlights:
- it’s okay to drink coffee, just not too much (under 300 mg of caffeine per day)
- salami should be frozen for three days before you eat it
- no gorgonzola or other unpasteurised milk and derivatives
- no ginger, the jury is currently still out
- no ginseng
- not too much cinnamon
- leverpastej is fine, since it does not contain much lever (liver)
- try not to eat more than 50 grams of licorice per day too many days in a row :)
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