It was a hard birth before Julian came into the world at Ullevål hospital. In order for Sofie Erichsen Fjeldheim to get some sleep, her boy was wheeled out to the guard room. The new mother woke up when she heard the boy crying. Terrified, she saw the nurse walk past her bed and put him in the arms of the woman in the neighboring bed. He was nursed there. – There and then I thought it was absolutely terrible. I was very scared and restless and had a thousand thoughts in my head about what could have happened if it hadn’t been discovered, says Erichsen Fjeldheim. She thought she recognized the baby’s cry, but couldn’t be quite sure. After a while she got up and alerted a nurse. Thus, the short-term change in 2009 was discovered. Sofie Erichsen Fjeldheim thought the incident at Ullevål was a strain, although she is sure that the confusion would have been discovered after a short time anyway. Photo: private Abnormalities in many maternity wards The mother of two children in Oslo is not the only one who has experienced something similar in one of the maternity wards in Norway. When news wrote about changing babies earlier this winter, several mothers got in touch. Some said that they had experienced having a stranger’s baby in their lap, others that their own children were breastfed by a stranger. Several told of newborns who had not been marked as they should have been. Some were missing bracelets, others had bracelets with the wrong name. Subsequently, news has asked all healthcare providers in the country to inspect non-conformity reports linked to mislabeling and the risk of confusing babies in Norwegian hospitals. news can now reveal that 321 incidents have been reported in recent years. Several times, mothers and fathers have brought in foreign babies. Babies have been nursed by the wrong mothers. A great many of the 321 non-conformity reports concern missing or absent plastic bracelets, which all newborns must wear around at least one hand. National Patient and User Ombudsman, Jannicke Bruvik, believes the findings are sensational. – No one should experience that their newborn child is delivered to the wrong parent at the hospital. It is not particularly reassuring and confidence-inspiring, even if the error is discovered quickly, she says. She believes that it can be positive to have many notification of deviations, if it shows that potential errors are caught quickly. 95 reports in Helse Bergen Helse Bergen is the healthcare organization that has given news access to the most non-conformity reports. In 2022 alone, ten were registered. The vast majority are about the babies not being correctly marked with the mandatory plastic wristbands. Clinic director Susanne Albrechtsen at the Women’s Clinic in Helse Bergen denies that this leads to a risk of changes. – No, it doesn’t. Today, we have routines for the child to be with the mother or partner at all times after birth. There is no chance that we can achieve a change here, she says. On the contrary, she says that she is happy about the notification of deviations. – It is an expression that we have a good reporting culture. That is what is needed so that we actually have a good overview of whether there is a risk of more serious incidents, she says. Clinic manager Susanne Albrechtsen says the non-conformity reports testify to a good culture for reporting non-conformities. Photo: Oddgeir Øystese / news – Unsettled by dark numbers There are large variations between how many non-conformities healthcare companies have given news access to. While Helse Bergen has reported 95 non-conformities to news, Oslo University Hospital HF has reported about 75. At the same time, several healthcare companies have not registered a single deviation: Helse Førde HF, Finnmarkssykehuset HF, Nordlandssykehuset HF, Sykehuset Innlandet HF, Sykehuset Telemark HF and Sørlandet sykehuset HF report back that they have zero. Helgelandssykehuset HF, Sykehuset Østfold HF, Helse Fonna HF and University Hospital Nord-Noreg HF have reported one discrepancy. – When larger hospitals have few deviations, it gives reason to believe that one has a dark record. It is worrying, says national Patient and User Ombudsman Jannicke Bruvik. She says surveys show that many employees in the health service are reluctant to report deviations, but that it is important to speak up to avoid new mistakes. National Patient and User Ombudsman Jannicke Bruvik fears that not all deviations are reported. Photo: Maria Gunnarsdotter Svedal / news – When it comes to incidents of non-compliance such as this case is about, the hospital does not see it as likely that there are large dark figures. The hospital has established good routines to prevent such errors, writes corporate lawyer Jostein Vist at Sykehuset Østfold HF. The different hospitals and healthcare companies have different systems for notification of deviations, and have provided figures from different periods. It is therefore not possible to compare healthcare companies directly. This is how we sought access news has asked all health care providers to search their non-compliance systems with the following keywords: “wrong mother”, changed, exchange, exchange, “wrong child”, exchange, baby exchange, “wrong name band”, name band, “id- tapes”, “ID marking” Several have initially refused, but then opened up to give access to anonymised extracts from the notices of non-conformity. The non-conformity notices extend to different intervals in the period from 2009 to 2022. It is therefore not possible to make direct comparisons between healthcare companies. Several say it has been challenging to apply, among other things, because the healthcare company has changed the system for registering notification of deviations. All babies born in Norwegian hospitals must be marked immediately after birth. As a rule, this happens with the mother’s name and date of birth. This is written on a piece of paper and placed in a plastic armband. Several specify that there is very little danger of babies being confused at Norwegian maternity hospitals. Neither the Norwegian Health Authority nor the state administrators have an overview of registered reports of deviations. Experienced it as a great strain For mother of two Sofie Erichsen Fjeldheim in Oslo, it’s still good. She is certain that the confusion would have been discovered after a short time anyway, since her boy was marked with her name and social security number. She still found the incident in 2009 to be a great strain. After the experience, she wanted to go straight home, and make sure not to take her eyes off her boy again. She understands that the employees have a lot to do, but thinks this should not happen anyway. She cannot bear the thought of Julian ending up with the wrong parents. – It would have been absolutely terrible, says Sofie Erichsen Fjeldheim. Head of department Hanne Knutsen at Oslo University Hospital HF apologizes for what happened, and writes in an e-mail that the staff should always check whether the right baby is placed with the right mother. Hi, do you have input or tips? Please contact!
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Julian ended up with the wrong mother after birth
