Towards optimal maternity care in Sweden

Yesterday we, the institute of Health and Care Sciences arranged a conference on maternity care in Sweden. We left the conference with new energy and challenges towards further improvements of maternity care. The conference was an activity within the EU COST network (ISO 907) aiming at identify and support optimal maternity care in Europe. Professor Soo Downe, the president of this Cost action, was a key speaker.

All participants made the conference so successful, and especially the speakers sharing their experiences: Ingela Lundgren, Ida Lyckestam, two mothers and one father, Eva-Marie Wassberg and Maria Hogenäs midwives at the `Birth House´, Ingegerd Hildingsson, and Ann Morris.

All you others participating in the conference, please share your impressions of it.

Ingela Lundgren presenting Optibirth

A mother shares her birth stories. The baby is seven weeks old.

Vivid activity in buzz groups.

Identifying threats, weaknesses, strengths and opportunities.


Ida Lyckestam

Key speaker professor Soo Downe



  1. Helen Elden
    Maj 24, 2012 @ 10:58:01

    The key speaker professor Soo Downe’s told us that at present, there are 15 COST countries, whereas 11 are situated in Europe. The other countries are North America, China, Africa and, Australia.

    The Aims of the Action are to advance scientific knowledge in maternity care provision and outcomes for mothers, babies and families across Europe by understanding what works, for who, in what circumstances and by identifying and learning from the best. The COST action wants to normalise birth without affecting neonatal mortality and morbidity; with the maximum capacity for optimum parenting; maximum wellbeing for parents and staff, and minimum use of resources.

    This is urgent!!!!

    The percentage of ‘Normal’ births decreases in Europe. Also, The rate of episiotomy is very high in some countries (82.3% in ES Valencia vs. 9.7% in Denmark). Caeserian section differs widely (f 17% in Sweden vs. 37% in Italy).

    Another important issue that was discussed by professor Soo was the use of Oxytocin in labor. The use of oxytocin in Sweden has increased. Nowadays about 6/10 of nulliparous women, and 3/10 multipauros women in Sweden get it. Soo meant that this intervention needs to be highligted as it has been shown that use of oxytocin significantly increases the risks low Apgar score < 7 at 5 min (OR 2.3); the need for neonatal intensive care (OR 1.6) and operative birth (OR 4.0).

    She spoke about on-going research of longer term risks of oxytocin, showing 2-3 fold higher cortisol levels in induced horse foals, which lead insulin resistance. E.g. it may affect the risk for diabetes. It has also been shown that oxytocin has dose-dependent developmental effects on pair-bonding and alloparental care (in animals).

    She also spoke about results from a study performed in Gotheburg (Ladfors et al. 2001) that showed that 4 % of women (n=2880) were interested in home birth. Thus, it seems to be a big gap between this interest and the number of women that actually give birth at home (about 10/year in Gothenburg).

    Soo shared a memorable qoute from Sheila Kitzinger:

    ‘…To anyone who thinks about it long enough, birth cannot simply be a matter of techniques for getting a baby out of one’s body. It involves our relationship to life as a whole, the part we play in the order of things…

    The session ended with the following words:

    If we all work together…
    If we get birth right, we get the world right…


    • Ingela Lundgren
      Maj 26, 2012 @ 19:50:12

      A very interesting day! By working together; midwives, doulas, parents and consumer groups a special atmosphere was created. To work in partnership is a goal for the EU-COST action. The main objective of the Action is to advance scientific knowledge about ways of improving maternity care provision and outcomes for mothers, babies and families across Europe. In order to do that we need the perspective from women and men. One question is why there are so few consumer groups in Sweden? We listened to birth stories from two women and one men during the conference and it was very powerful. More about the COST Action:


  2. Eva-Maria Wassberg
    Maj 28, 2012 @ 18:16:49

    This was an amazing conference where I learned a lot. Soo Downe is an impressive lady. I very much appreciate her attitude concerning ”Tea and cakes”. It’s important we can talk to each other whether we have different opinions or different professions, instead of making escalating conflicts. We all have something in common: healthy mother and healthy baby. But as prof. Downe puts it: best practice is also maximal capacity for a optimal parenthood, that maternity care gives a maximum of wellbeing for the family as well as the staff.
    Lot’s of improvements can be done. The birth stories told by parents during this day was a good illustration to how it can be when caregivers not are attentative/not are given the possibility to be attentative and what happens when the care is given on the parents/birthing womans conditions.
    Another question raised, but just touched, was the ”brain-drain” from maternity care. A lot of midwives (and obgyn’s) leave the profession as they cannot practice best care. This is sad, but interesting that we now can learn more from the research done.
    So – put the kettle on! More tea and cakes!

    If you have time you can read Födelsehusets Barnmorskors blog (in Swedish) on the following address:


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