When I was expecting Peanut in Helsinki, I was given a "Maternity Health Clinic" card. Really a small booklet where at each midwife and doctor's visit my vital stats were recorded. The midwife and doctor also made the same notes into their own file. All by hand. I remember being surprised that the Katiloopisto hospital where Peanut would be born had no access to the information electronically - they, too, would have to decipher the hand-written notes from my maternity card.
I was told I should keep my Finnish Maternity card with me at all times so in essence I'd have my pregnancy health record on hand if I ever had to go to a different clinic or hospital. But, I liked it so I could keep track of how things were developing: my weight, blood pressure, blood test results, protein, glucose and iron tests, height of the uterus, Peanut's heart rate and position. It was fun to pull it out every once in a while at home to see how far we had progressed.
Here in the US, the notes are made by the nurse and my doctor into the folder kept at his office. A few times, I've even had to ask if I gained weight or how my blood pressure was as the nurse silently made her notes. I try to recall the details and write them down for myself in my own notebook. I suppose the idea is that if I need care, I will go only to his office and my selected hospital where my doctor will be available and aware of my condition.
Showing posts with label neuvola. Show all posts
Showing posts with label neuvola. Show all posts
Friday, September 22, 2006
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!
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!
Wednesday, June 15, 2005
Thumb vs Pacifier!
Like most issues in raising a baby, this one has strong advocates for both sides of the debate.
Our little Peanut has recently discovered her own thumb and is surprisingly adept at getting it into her mouth. While a relief to her parents that she can now soothe herself wherever and whenever without our assistance, I admit images of her as a 6 year old sucking her thumb are disturbing. But, what to do? Should we let her suck her thumb ? Do we just pop it out? Do we replace it with a pacifier?
Most childcare resources agree that babies simply have a strong need to suck beyond what they have to do for feeding. Its soothing for them. How that need is satisfied is the question. It could be at mom's breast (though the idea of having her hang on to me for hours seems not only painful, but rather inconvenient), with a pacifier or with her own hand/fingers/thumb.
When I asked at the Neuvola what they thought was best I was told that pacifier rather than thumb. I feel as if I see more pacifiers in use here than in the US. Admittedly, we've used a pacifier since the early weeks to help her fall asleep or if we're in the car. The challenge at night has been when the pacifier falls out - mom or dad have to drag themselves out of bed to re-insert. But, there are also those that think that using a pacifier is 'lazy parenting' meaning parents should seek to soothe their babies in some other way.
But, now, Peanut clearly prefers her own thumb to the pacifier. I've also found several advocates of the thumb who claim its a habit that disappears well before school age. So, for the time being we're happy to let her suck her thumb since it only happens when she's tired and readying herself for sleep or when she's very hungry and that's a problem mom can easily solve!
www.babycenter.com under Ask the Experts has some advice as well.
Also at www.askdrsears.com
Our little Peanut has recently discovered her own thumb and is surprisingly adept at getting it into her mouth. While a relief to her parents that she can now soothe herself wherever and whenever without our assistance, I admit images of her as a 6 year old sucking her thumb are disturbing. But, what to do? Should we let her suck her thumb ? Do we just pop it out? Do we replace it with a pacifier?
Most childcare resources agree that babies simply have a strong need to suck beyond what they have to do for feeding. Its soothing for them. How that need is satisfied is the question. It could be at mom's breast (though the idea of having her hang on to me for hours seems not only painful, but rather inconvenient), with a pacifier or with her own hand/fingers/thumb.
When I asked at the Neuvola what they thought was best I was told that pacifier rather than thumb. I feel as if I see more pacifiers in use here than in the US. Admittedly, we've used a pacifier since the early weeks to help her fall asleep or if we're in the car. The challenge at night has been when the pacifier falls out - mom or dad have to drag themselves out of bed to re-insert. But, there are also those that think that using a pacifier is 'lazy parenting' meaning parents should seek to soothe their babies in some other way.
But, now, Peanut clearly prefers her own thumb to the pacifier. I've also found several advocates of the thumb who claim its a habit that disappears well before school age. So, for the time being we're happy to let her suck her thumb since it only happens when she's tired and readying herself for sleep or when she's very hungry and that's a problem mom can easily solve!
www.babycenter.com under Ask the Experts has some advice as well.
Also at www.askdrsears.com
Monday, June 13, 2005
Midwife visited us at home following the delivery
After the delivery of our baby, the first visit with the midwife took place in our own home. A few days after we came home, I called my midwife at the Neuvola and set up a time/date about two weeks after Peanut's birth. It was very nice that we didn't have to go anywhere because at the point, its still a large production to get everyone out the door and mom is still in her early recovery period. Though it created some anxiety as we tidied up a bit and wanted to make sure we had all the baby equipment in order.
On that day, she came to our home with a small bag of supplies to give both me and Peanut a check-up. My medical information is basically all in the 'Maternity Card' I've carried with me since my first visit. I also had a printed out report from the maternity hospital describing the birth, my recovery and Peanut's first doctor's visit at the hospital. The information is not shared electronically among the health centers and hospitals even though they are both public services.
The midwife asked us some questions about general well being, nursing, sleeping and my mental health (occasionally weepy!,but to be expected, she said). She then undressed Peanut and checked her skin condition, eyes, mouth and reflexes. The midwife then produced fish weighing scales from her bag and wrapped Peanut in a diaper cloth before lifting her up by the scales to weigh her. She then took a look at my breasts to see how the nipples were and if the breasts were still engorged. Then, I undressed the lower half and she did a quick visual exam to see how everything was healing.
I had a long list of questions to review with her before she left. Our next appointment will be a childcare nurse at the Neuvola.
On that day, she came to our home with a small bag of supplies to give both me and Peanut a check-up. My medical information is basically all in the 'Maternity Card' I've carried with me since my first visit. I also had a printed out report from the maternity hospital describing the birth, my recovery and Peanut's first doctor's visit at the hospital. The information is not shared electronically among the health centers and hospitals even though they are both public services.
The midwife asked us some questions about general well being, nursing, sleeping and my mental health (occasionally weepy!,but to be expected, she said). She then undressed Peanut and checked her skin condition, eyes, mouth and reflexes. The midwife then produced fish weighing scales from her bag and wrapped Peanut in a diaper cloth before lifting her up by the scales to weigh her. She then took a look at my breasts to see how the nipples were and if the breasts were still engorged. Then, I undressed the lower half and she did a quick visual exam to see how everything was healing.
I had a long list of questions to review with her before she left. Our next appointment will be a childcare nurse at the Neuvola.
Monday, June 06, 2005
ouch! Vaccinations start at age two DAYS
First Injection
Even before we left the hospital, at two days old our Peanut got her first injection; the tuberculosis vaccination (BCG).
Its not mandatory, but highly recommended to protect babies born in Finland against possible cases of TB carried across the border from Russia or from across the gulf from Estonia and the other Baltics. There are many workers from the areas working in Finland as well as brisk travel for pleasure and business by Finns to the countries.
Peanut got the shot in her left thigh as part of her 'exit check-up' with the doctor. The shot often leaves a tell-tale round mark that remains for the rest of a baby's life. She did not have any adverse side effects from the shot ; only a short cry in the doctors office and now, 7 weeks later, a slightly raised scab and reddish circle at the injection site.
The American Academy of Pediatrics in their Recommended Childhood and Adolescent Immunization Schedule for the US (Jan - June 2004) did not recommend the TB vaccine.
Schedule of Immunizations in Finland
According to the information sheet I recieved from my local health center (Neuvola), the following is the schedule of immunizations given in Finland:
AGE: less than one week
IMMUNIZATION: Tuberculosis (BCG)
AMERICAN ACADEMY OF PEDIACTRICS (AAP): no recommendation
AGE: 3 months
IMM: DTaP (diphtheria, tetanus, pertussis - whooping cough), IPV (Polio vaccine - inactive), Hib (Haemophilus influenza TypeB)
AAP: recommends first DTaP at 2 months - then 4 mos, 6 mos, 6 - 12 mos, 18 mos and 4 - 6 yrs
AAP: recommends first IPV at 2 months -then 4 mos, 6 to 18 mos and 4 - 6 yrs
AAP: recommends Hib beginning at 2 months of age
AGE: 5 months
IMM: DTaP, IPV, Hib
AAP: see above
AGE: 12 months
IMM: DTaP, IPV, Hib
AGE: 14 - 18 months
IMM: MPR (Measles - morbilli, mumps - parotitis, rubella)
AAP: MMR (measles, mumps, rubella) at 12 - 15 mos and before 12 yrs
AGE: 4 yrs
IMM: DTaP, IPV
AGE: 6 yrs
IMM: MPR
AGE: 14 - 15 yrs
IMM: DTaP
Additionally, the American Academy of Pediatrics recommends the following vaccinations not rountinely given in Finland. More specifics are available at their website www.aap.org.
Hepatitis B (HepB) - soon after birth and before hospital discharge
Varicella (chicken pox) - at any drs visit or after age 12 months for susceptible children (those without reliable history of chicken pox)
Pneumococcal (PVC) - age 2 to 23 months
Hepatitis A - recommended for children in selected states and regions and for certain high-risk groups. Those in above regions can get first shot at any visit and booster in following 6 mos.
Influenza - annually for children above 6 mos of age with certain risk factors. Healthy children age 6 - 23 mos are encouraged to get the vaccine.
Even before we left the hospital, at two days old our Peanut got her first injection; the tuberculosis vaccination (BCG).
Its not mandatory, but highly recommended to protect babies born in Finland against possible cases of TB carried across the border from Russia or from across the gulf from Estonia and the other Baltics. There are many workers from the areas working in Finland as well as brisk travel for pleasure and business by Finns to the countries.
Peanut got the shot in her left thigh as part of her 'exit check-up' with the doctor. The shot often leaves a tell-tale round mark that remains for the rest of a baby's life. She did not have any adverse side effects from the shot ; only a short cry in the doctors office and now, 7 weeks later, a slightly raised scab and reddish circle at the injection site.
The American Academy of Pediatrics in their Recommended Childhood and Adolescent Immunization Schedule for the US (Jan - June 2004) did not recommend the TB vaccine.
Schedule of Immunizations in Finland
According to the information sheet I recieved from my local health center (Neuvola), the following is the schedule of immunizations given in Finland:
AGE: less than one week
IMMUNIZATION: Tuberculosis (BCG)
AMERICAN ACADEMY OF PEDIACTRICS (AAP): no recommendation
AGE: 3 months
IMM: DTaP (diphtheria, tetanus, pertussis - whooping cough), IPV (Polio vaccine - inactive), Hib (Haemophilus influenza TypeB)
AAP: recommends first DTaP at 2 months - then 4 mos, 6 mos, 6 - 12 mos, 18 mos and 4 - 6 yrs
AAP: recommends first IPV at 2 months -then 4 mos, 6 to 18 mos and 4 - 6 yrs
AAP: recommends Hib beginning at 2 months of age
AGE: 5 months
IMM: DTaP, IPV, Hib
AAP: see above
AGE: 12 months
IMM: DTaP, IPV, Hib
AGE: 14 - 18 months
IMM: MPR (Measles - morbilli, mumps - parotitis, rubella)
AAP: MMR (measles, mumps, rubella) at 12 - 15 mos and before 12 yrs
AGE: 4 yrs
IMM: DTaP, IPV
AGE: 6 yrs
IMM: MPR
AGE: 14 - 15 yrs
IMM: DTaP
Additionally, the American Academy of Pediatrics recommends the following vaccinations not rountinely given in Finland. More specifics are available at their website www.aap.org.
Hepatitis B (HepB) - soon after birth and before hospital discharge
Varicella (chicken pox) - at any drs visit or after age 12 months for susceptible children (those without reliable history of chicken pox)
Pneumococcal (PVC) - age 2 to 23 months
Hepatitis A - recommended for children in selected states and regions and for certain high-risk groups. Those in above regions can get first shot at any visit and booster in following 6 mos.
Influenza - annually for children above 6 mos of age with certain risk factors. Healthy children age 6 - 23 mos are encouraged to get the vaccine.
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