Thursday, June 16, 2005

Highly satisfied with the Finnish Maternity Clinics (Neuvolat)

In the June 15th Helsingin Sanomat newspaper there was an article reporting that according to a survey done by Vauva ("Baby") magazine, Finnish parents are satisfied with the local maternity clinics (neuvola).

In particular, parents are satisfied with the location of the clinics, the frequency of visits and the ability to get appointments. Areas receiving the most criticism were the lack of breastfeeding guidance (moms are too easily moved to bottle feeding) and the difficulty in discussing tough topics such as substance abuse and depression after delivery. It was also noted that in 60% of cases, mothers are the ones taking children to the health clinic. Fathers' participation in the visits diminishes after the birth of the child.

The knowledge and skill of the health workers was the most important factor in determining satisfaction.

My pre-natal care experience

I was also for the most part satisfied with the pre-natal care and neuvola visits I had at the Kallio clinic. Fortunately, my pregnancy with very easy so I never had any major concerns or needed any special medical assistance or advice.

> in general, I met (and my husband) met with our midwife once a month in the beginning of the pregnancy and then every other week around the 7th/8th month and then weekly during the last month. The visits usually lasted about 1/2 hr.
> at every visit my blood pressure, weight, sugar levels and size of the uterus were monitored. About every third visit, my hemoglobin levels were also tested. Since I am Rh negative, I had three separate blood tests to make sure that I wasn't producing antibodies which could be harmful to the baby. After the fourth month, the baby's heartbeat was monitored with a Doppler device.
> while the midwife usually answered any questions I had, she did not often offer any unsolicited advice. I felt her knowledge and experience were sufficient.
> I met with the doctor twice. She performed the internal exams. Kallio's clinic was unique in that it had its own ultrasound machine so I also had ultrasounds taken when we saw the doctor. She used the ultrasounds to check the baby's heart, growth and development of the organs. Towards the end of the pregnancy, this information also gave us a better estimate of the birth weight.
> Like the midwife, the doctor answered questions we had, but did not offer any additional advice or information.
> All the information was recorded on my Neuvola Card -- this was the method it would transferred to the maternity hospital!
> There was no cost for any of the midwife or doctor's visits or for any lab work.

The areas I would like to see improved are:
> more information, especially for first-time mothers since I felt I did not always know all the questions I should be asking
> better phone access to the midwife. Currently, they have an hour a day when they answer the phone.
> better birth preparation classes - there weren't any in English. We found one at a local evening school, but I found very weak.
> electronic links between the health clinics and the maternity hospital so we don't have to depend on deciphering handwritten notes on a card.

Move to a new Neuvola

Following the birth of Peanut, we moved to the suburb of Espoo and are now part of the Otaniemi health center. This clinic is very small compared to the one in Kallio. There are only 2 midwives and the doctor visits twice a week.

We've been to the clinic on two occasions. Once for Peanut's 1 month visit and for my post-partum check-up.

The childcare professional who examined Peanut obviously adores babies and children, which is also important, but I wasn't as confident about the depth of her knowledge and experience. She had trouble answering our questions about what could be causing occasional droplets of blood in Peanut's diaper or even about finding a gentle baby wash. Peanut now also has her own Health card with handwritten observations about her reflexes, disposition and nutrition as well as her weight and height.

The doctor I met with was also charmed by Peanut, but seemed a bit flighty to me. When I asked about taking allergy medications while breastfeeding she had to turn to her medical reference book. I also had to remind her about discussing birth control options with me and then in the end, after again checking her reference book, she wrote out a prescription for birth control pills - but in Peanut's name! In the end, she recommended I make an appt with my new ob/gyn for a check-up in a month.

This makes me a bit concerned. What if we have a more serious medical issue? Will I feel confident that the local clinic can handle it?

See upcoming post on the case for private health insurance for baby!

No comments: