When we moved to Norway, we had a 2 year old and a 4 month old. We always knew we wanted 3 kids in our family and now it was likely we would be having the third in Norway! Since my previous 2 kids were born in the USA, I of course wondered how the prenatal care and birth would be different in Norway. I found the care was very similar to what you would receive in the USA but much less intensive and expensive.
When we found out we were pregnant, we were so excited! Norway has a universal healthcare system: It is the government’s responsibility to provide healthcare to the public regardless of age, race, gender, income, and area of residence. Healthcare is universal and automatic for all residents.
The below is my opinion on my birthing experience in Norway and the comparisons to the care I received in the USA. Of course my experiences and opinions are my own and yours may differ, that’s ok!
Prenatal Care
Who Follows you throughout your pregnancy?
One of the first glaring differences between the USA and Norway is in who handles your prenatal care. In the USA, I saw a specific OB that followed me through my pregnancy. In Norway, there is no specific OB that you go to for prenatal care when a woman becomes pregnant.
When a woman in Norway finds out they are pregnant, most will call their GP (general practitioner) to confirm the pregnancy and go for prenatal care. There are private practices that you can also go to; however, because prenatal healthcare is free for women in Norway, so many choose their GP-route. There is also a Midwife Service Center that you can choose to go to instead of your GP for monthly check-ups. The Midwife Service Center is also covered as prenatal care and free for the mother.
For the confirmation of pregnancy/first ultrasound, I called a private clinic in Stavanger. We got to bring the boys to the ultrasound and they were so excited to see the baby on the screen and their highlight was hearing the heartbeat.
After the initial confirmation of pregnancy, I chose to go to the Midwife Service Center for my monthly checkups. There they measure the belly, check the baby’s heartbeat, and answer any questions related to the pregnancy. This process is the same as in the USA. The Midwife Services does not do any tests on the mother, those all need to be done through your GP.
Common Prenatal Tests
After the initial ultrasound at the private clinic, they sent a referral to the hospital for an ultrasound and NIPT (non-invasive prenatal testing) test to be done at week 12. This screening is only done at the hospital so all women must go for the week 12 ultrasound. The NIPT testing primarily screens for Down Syndrome, Trisomy 18 and 13 and any extra/missing X or Y chromosomes.
In the USA, most everyone consents to the NIPT screening. However, in Norway, this is not normally offered to women under 35. Women under 35 can request the screening; however, they have to pay for the test and it is very expensive (around USD$2,000). Because I was 35 at the time of the pregnancy, I received the NIPT test and the test was covered under Norway’s healthcare. Therefore, I received the NIPT screening and I did not pay anything for the test.
The week 12 ultrasound was like receiving the anatomy scan back in the USA. The screen took a thorough look at the baby’s skeletal structure, heart and other organs. I was shocked they went into this level of detail on the baby this early. In the USA, many do not get this level of evaluation of the baby until their 20 week anatomy scan.
Again, this screening is free and free for all women in Norway. If you want pictures of the baby during the scan, you do have to pay for those- which I think are like USD$5 or $10. All other standard blood testing for the mom is then done at your GP during week 12.
Finding out the sex
When it comes to finding out the sex of your baby, many in the USA find out the gender of their baby when they do the NIPT screening. The blood that is taken for the screening can also test for the sex of the baby, so many in the USA know what they are having around week 15.
In Norway, the screening for sex early is not done. They do not do any sex screening early in order to prevent early abortions due to knowing the sex of the baby. In Norway, you wait until the anatomy scan to find out the sex of your baby.
Another difference from the USA is the gestational diabetes test. The Midwife Services did not recommend me taking the test since I did not have gestational diabetes with my previous 2 pregnancies. In addition, my current pregnancy was healthy with no current risks. In the USA I did this test with both my previous pregnancies, no indication from my doctor that this wasn’t necessary or recommendation to skip due to low risk of gestational diabetes.
Thoughts on Prenatal Care
One of the big differences I notice between the 2 countries in prenatal care is that Norway has this “no unnecessary testing” philosophy. If there is a low risk pregnancy or the pregnancy is healthy, then Norway tends to not do any testing if not needed and lets the pregnancy unfold naturally.
While at first this seems like a lack of care compared to what I received in the USA, I think the Norwegian way makes sense. Why spend more money on tests (at least money in the USA), and subject yourself to these tests if there is low probability of something happening based on your medical history?
Labor and Delivery
Who delivers the baby?
In the USA, your OB is most likely the one that delivers your baby. In Norway, when you go to give birth you have the midwives on call that day that attend to you and deliver your baby. I never missed having 1 single person that I saw throughout my entire pregnancy be the one to also deliver my baby.
The midwives at the hospital only deliver babies, so I felt comfortable with them attending to my care and delivering the baby. All my medical information was available for them to review and read, so they were knowledgeable of my pregnancy.
To induce, or not to induce?
The “no unnecessary procedures” philosophy of Norway also applies to labor and delivery. I remember in the USA for my first pregnancy, my OB asked me at 38 weeks if I wanted to schedule an induction for the baby. I was shocked I could just schedule a time to get the baby out, and before the 40 weeks!
Scheduling an induction for the baby early during a healthy pregnancy would never happen in Norway. Of course there are certain scenarios or exceptions to this. If a mother reaches 40 weeks, there is a score system to determine when to induce a pregnancy. With a healthy pregnancy, Norway can let a mother go 42 weeks before inducing a pregnancy.
This philosophy also applies to the actual delivery of the baby. Norway strongly encourage women to deliver naturally. They also provide many options and resources for mothers to assist with a natural delivery.
I do appreciate this approach, as they believe the body can do this without medical intervention. In the USA, I felt the nurses tried respecting my wishes to try naturally first; but did make comments about the epidural making labor painless, and why not get it?
Laboring
Once a mother is in labor, the woman starts on the 7th floor of the hospital where they labor naturally. This floor is only available for those that want to deliver naturally. If a mother chooses an epidural, or they have a higher risk pregnancy, they will go to the 1st floor of the maternity ward. This floor is to more closely monitor the pregnancy and the mother during labor and delivery.
I knew that I wanted an epidural so the hospital put me on the 1st floor. I was not in active labor yet, so they waited until I was in active labor before administering the epidural. I was able to move around freely and bounce on a ball to help get things moving.
One thing I loved about my delivery in Norway was that I was able to eat and drink while I was laboring. I also did not need to be hooked up to the monitors the entire time. In the USA, once I was in the hospital, they had me hooked up to monitors immediately for the entire time and I was not allowed to eat or drink anything.
In Norway, after they administered the epidural they monitored the baby for 20 minutes and then that was it. I was free to move around, which was actually encouraged. The midwife would come in and check every 30 minutes or so on the baby and how labor was progressing, but otherwise they trusted my body and the baby to do its thing.
Immediately after delivery
Once I finally delivered, the baby was placed on my chest for me to bond and breastfeed. In the USA this is called the “golden hour,” where the baby is on the chest of the mother for the first hour before the nurses come in and do the routine examinations.
In Norway, they handed me my new baby and said, “ok, enjoy your time, we will be back in a couple hours to weigh the baby and take you up to the hotel.” We didn’t see another nurse until about 2.5 hours later.
When they came back, they weighed the baby, but did no other blood testing examinations. I rather liked not being interrupted and getting so much time with my baby right after delivery which is extremely different from my experience in the USA.
Hotel Stay
In the hospital I was at in Stavanger, the women do not stay in a room in the maternity ward after delivery. Women with healthy deliveries/babies are taken to the hotel attached to the hospital.
This is like a regular hotel room with the nurses on that floor available to assist with breastfeeding, any questions about the baby, etc. This was amazing. My husband and I got a room with a double bed where we both got to sleep and it was like a regular hotel experience.
In the USA, my husband had to sleep on a couch in our room and I slept on my hospital bed. Also in the USA, we had nurses coming into the room every hour to check on me. This can be very annoying, especially when you are sleeping. We had none of this in Norway. We called the nurse to ask for some saline to rinse out my baby’s nose, but other than that, we saw no nurses.
In talking with my Norwegian neighbors about this, they mentioned many women in Stavanger are unhappy with this care because the moms want the nurses to be more available for questions and help. There is a shortage in nurses at the moment, so if it is a healthy delivery/baby (like mine) and if this is not a first time mother (like me), they left us alone, which I rather appreciated.
The next day, a pediatrician saw our baby and did the routine blood tests, administered medicines. This is the only pediatrician in Stavanger and your baby only sees a pediatrician at the hospital once they are born.
Everyone stays 2 nights at the hotel and then are discharged. We did see a nurse the second day to go over all the things about taking your baby home and newborn care, just like we had back in the USA.
Reflections on giving birth in Norway
When reflecting on my experience in Norway compared to my previous 2 experiences in the USA, there are things I liked/didn’t like about giving birth in Norway. Overall, I felt more supported through the entire process in Norway.
The midwife center and midwives at the hospital trusted my body would do its thing and I gained more confidence in the natural process of pregnancy and labor. I loved how in one midwife appointment she used a wooden Pinard Stethoscope to hear the heartbeat. She mentioned her father made it for her many years ago when she first began studying to become a midwife.
The midwives were also interested in learning what my birthing plan was and what my wishes were for the birth. The midwives wanted to create a comforting environment for me and were more open to what I needed to help with a natural birth.
In the USA, when I asked my OB about hearing my birthing plan she immediately shut me down and said, “we do not do x,y,z because things need to be done a certain way for the health of me and the baby.”
Of course there are doctors and hospitals that might be more accommodating to alternative birthing methods. My experience is not to say all USA hospitals and OB’s are like this. But this goes back to the USA seeing birth as just a business and to get the mom in/out fast with the least amount of accommodations for the mother.
Cost to give birth
And finally, the biggest glaring difference is the cost to the family. For all my prenatal care appointments and testing in the USA, I paid thousands of dollars to my OB. We then paid thousands of more dollars to deliver at a hospital.
In Norway, all my prenatal care was free when I went through my GP and the Midwife Service Center. Our hospital bill and my 2-night stay at the hotel was also free. However, my husband did have to pay for his stay with me at the hospital for the 2 nights which was about USD$60 per night, plus his food.
Of course, my pregnancy in Norway was healthy and the birth went smoothly with no complications. I don’t know how this might change if I had complications with the baby and/or birth. There are pros and cons to every situation and how different countries do things. I feel lucky I got to experience something different with my 3rd child.
