Conflicts over maternity care

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Four  hospital maternity wards and two local birthing units in northern, central and western Norway are either scheduled to close or have been slated for closure. Regional health authorities contend it’s safer to centralize services for those giving birth, but expectant mothers fear long and dangerous drives to the hospital.

The hospital in Nordfjordeid is among those faced with losing its maternity ward. PHOTO: Finn Ove Njøsen/Helse Førde

Local birthing units, called fødestuer, are usually staffed by midwives. Locations where the fødestue staff had been strengthened with a resident gynecologist now also face losing that post, reports newspaper Aftenposten. New national standards for maternity care are based on the assumption that small, lightly staffed maternity care units give a false sense of security, making it less safe to give birth there than in bigger hospitals.

New minimum staffing rules, a shortage of gynecologists and budget pressure at local hospitals have led regional health authorities to consolidate gynecologists in bigger units.  At the same time midwife-run fødestuer are praised as a good alternative for healthy expectant mothers.

The Minister of Health has promised improved medical assistance when it counts, but expectant mothers in remote locations, which in many cases require a ferry journey to reach a hospital, are not satisfied. According to Aftenposten many are deeply worried and unhappy that local maternity units and gynecologist services are being withdrawn and worry that they are not going to get to hospital in time. Several hundred women gave birth involuntarily other places than clinics or hospitals last year, in most cases in cars by the roadside on their way to hospital.

“If the local hospital’s maternity ward is shut down, I won’t dare have more children,” claimed Marte Haukås, who recently gave birth for the second time at Nordfjordeid Hospital just two hours following a routine check. She hadn’t even experienced labour pains before the birth occurred, quickly.

Regional health authority Helse Vest has decided to close the maternity unit at Nordfjordeid, however, and move an estimated 250 annual births to Volda, 40 kilometres and a ferry crossing away. This extra number of births will help make the maternity ward in Volda more viable, it’s argued, reducing the threat of closure there as well.

“People who make plans like that don’t know the geography or the climate we have, with ferries, closed roads and winds which often make it impossible for helicopters and flying ambulances to land,” Marit Nore Sørhaug, a local representative of the Center Party told Aftenposten. “It’s undemocratic to close local hospitals if we are supposed to offer the same quality of care to everyone in the country irrespective of where they live.”  She lives in Vågsøy, an island that’s about two hours away from Volda in good weather.

“We haven’t seen any documentation that shows that we have any worse quality than the larger maternity units. I don’t understand what Helse Vest has based its decision on,” Linda Grotle Hauge, department leader and chief midwife at Nordfjordeid maternity unit, told Aftenposten.

Views and News from Norway/Sven Goll
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