The conditions for women who give birth in Norway during the summer time came solidly on the agenda on Monday, through the contribution of Renate, who is giving birth for the first time, during news’s public meeting in Tromsø. Renate told about how she lost her child during childbirth at the University Hospital of Northern Norway in Tromsø this summer. iTromsø has also featured the birth stories of four women on the same day, with descriptions of giving birth in a break room, breech birth in a CTG room and pain relief with a bucket of ice cubes. The incident is one of several that have triggered a broad debate about work pressure, resources and the level of care in Norwegian maternity wards. Health organisations, politicians and midwives are now discussing the cause and solutions to what is described as a serious challenge for women giving birth in Norway. Among other things, it is proposed to close several maternity wards in the summer, in order to gather hands. Renate stands up to try to prevent anyone else ending up in her situation. Photo: Ida Louise Rostad / news – Too late for our little boy The maternity department at UNN in Tromsø only has four delivery rooms, but this “week of chaos” there were 39 women who gave birth. Figures from UNN show that a total of 136 children were born at the maternity clinic in July 2023. This is the highest recorded number since August 2021. Renate described on Monday that she and her husband were sent home from the maternity ward due to a lack of capacity, despite the fact that she had preeclampsia. – When we were finally allowed to come back again, two days after we had been sent home, it was too late for our little boy. His heart had stopped beating in his stomach after 41 weeks and 4 days, Renate told the politicians. The midwives who were at work stated in VG that they did the best they could, but that there were not enough people at work. They describe this week as “unsustainable”. Here is the birth chart at the maternity hospital in Tromsø. It shows the birth peaks on July 25 and 26. Patient safety at risk? The University Hospital of Northern Norway has apologized for the incident and Renate’s experience, and has sent the case for review by the State Administrator in Troms and Finnmark. On Wednesday, there was a board meeting in Helse Nord, which owns and manages UNN. In the case papers, it appears that there is an increasing proportion of notifications, via the Norwegian Health Authority, aimed at maternity wards and institutions throughout the country. – There is reason to be particularly aware of a possible development in medical treatment and maternity care that could endanger patient safety, the report states. Chairman of Helse Nord, Renate Larsen (in red) and managing director at UNN, Marit Lind, will meet on Wednesday to discuss maternity services in the region. Photo: Eirik Hind Sveen / news – Extremely tragic In a briefing, the managing director of Helse Nord, Marit Lind, talked about the summer’s situation at the maternity ward at UNN. She described many births in a few weeks. And that they have struggled to get hold of midwives and that they have too few birthing rooms. – Then, unfortunately, there was a tragic incident at the top of it all. I will not comment on it in particular. A thorough internal review of this is carried out at UNN. It is extremely tragic when this happens, says Lind. – The professional committees are following up on the matter, and see if we should make changes to our practice. Chairman of the board Renate Larsen also said: – We certainly have to pay special attention to this, when there is a possible challenge here. At the public meeting, Erna was moved to tears by Renate. Considering closing several maternity services At the meeting, it emerged that sickness absence in hospitals in the north is far higher than in the rest of the country. Board member and psychologist Martin Alexander Øien Jenssen asked when they would define themselves as “in real trouble”. The answer to Lind was clear: – I think we are in real trouble already. This is a downward spiral, she described. Marit Lind is CEO of Helse Nord. Photo: Bente H.Johansen She talked about the steps taken in the maternity/maternity area, with merging some of the small units alternately in the summer, because it is not possible to staff enough gynecologists and midwives in both places. – I wonder, should we shut down more during demanding weeks? We have tried to discuss it with UNN, but the will and desire is not great. But it is a move that can be made in the summer, says Lind in the meeting. UNN director Anita Schumacher writes in an e-mail to news that UNN has no plans to close down maternity units beyond the current operation. – How tasks and functions are to be distributed between the hospitals in the north is precisely what we have to find out in the restructuring process that is currently underway throughout Health North, she says to The company has set up a separate working group that will look at the organization of maternity care and emergency services in the region . The report is expected to be presented in the spring. Minister of Health Ingvild Kjerkol describes Renate’s experience at the women’s clinic at UNN as heartbreaking. Photo: NTB Discussed the maternity services Minister of Health Ingvild Kjerkol (Ap) describes Renate’s strong statement during the public meeting in Tromsø as heartbreaking. – It is important that we go through such cases, to find out what happened, why it happened, and how we can work to ensure that it does not happen again, says Kjerkol. She debated maternity services on Dagsnytt 18 on Tuesday evening, together with Lena Henriksen, political leader of the Midwives’ Association and parliamentary representative Tone Wilhelmsen Trøen (H). They pointed out several reasons why maternity services collapse in the summer: Cancellation of holidays: Midwives cancel their holidays in the summer, and unskilled substitutes are brought in as replacements, which are not always satisfactory, says Wilhelmsen Trøen. Fewer and fewer midwives: Despite more trained midwives, more and more are quitting, due to increased on-call pressure, the midwives association believes. Financing: Financing of the hospitals is based on a unit price for the hospitals which, according to a report from the Directorate of Health (2022), does not cover the cost of operation. One solution will be better framework funding for the departments, according to Kjerkol. Municipal maternity care: From 2015, follow-up of the maternity period was transferred to Tromsø. Several have pointed out that the follow-up after this reform has become worse. This increases the burden on maternity wards, says the midwives association. Closed maternity wards: Towards the summer, some local maternity wards close, thus increasing the pressure on the larger clinics, says Kjerkol. Kindergarten admission: Since kindergarten admission is in the autumn, in many municipalities, expectant parents try to plan births towards the summer. This is to ensure a nursery place the year after the maternity period has ended, says Wilhelmsen Trøen. The government plans to review the pregnancy and childbirth services in an upcoming report to the Storting in order to ensure a common professional understanding. – In recent years, there has been a focus on building up the municipal midwifery service. It follows up women during pregnancy and after birth, says Kjerkol. Tone Wilhelmsen Trøen is the Conservative Party’s health policy spokesperson, and chairs the health and care committee in the Storting. Photo: Martin Fønnebø / news – Keep midwives Tone Wilhelmsen Trøen is the head of the health and care committee at the Storting (H). She acknowledges that the summer is particularly challenging on the maternity wards, partly due to holiday closures. She listed four important measures to improve maternity services: increased preparedness, education and maintenance of midwives in the hospitals, as well as better follow-up after complicated births and changes in nursery admissions. – We must ensure better preparedness if an unforeseen number of births occurs. Children come when they come. That means more midwives. We should also train and retain more midwives in the hospitals, said Wilhelmsen Trøen. Lena Henriksen is the political leader of the midwives’ association and believes that Renate’s incident could have happened all over the country. Photo: Sonja Balci / OsloMet – Midwives clean delivery rooms Lena Henriksen, political leader of the Association of Midwives and also a professor of midwifery, says that what has happened at the maternity ward in Tromsø is not an isolated incident. Busy periods with scarce staffing and many births can potentially occur in other departments around the country. She pointed out that preparedness must be improved, and that better planning and organization is necessary. Henriksen says that in Tromsø, midwives are used to clean up maternity wards, and spend a lot of time on paperwork. She wants this to end. – We must ensure that we have staffing that ensures readiness for these busy shifts. Better planning is required, but it should be possible to achieve, said Henriksen.
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Considering closing several birthing rooms – news Troms and Finnmark
