Are you pregnant and living in Sweden as an expat? As doulas, we often meet parents who live and work here but did not grow up in Sweden.
When you don’t have family and friends around who can explain how pregnancy and birth work here, it can be difficult to know what to expect.
In this article, we guide you through how maternity care works in Sweden, your options, what happens when labour starts, and other things that may be helpful to know as an expat.
The patient act and your rights
In Sweden, you have the right to accept or decline any medical care or examinations during pregnancy and childbirth. You also have the right to receive information about the benefits and risks of different options and to be involved in decisions concerning your care.
However, you do not have the right to demand a specific type of care or treatment.
The role of the midwife
In Sweden, midwives are primarily responsible for your care during a normal pregnancy and birth.
During pregnancy, your regular check ups are done by midwife at a midwifery clinic (barnmorskemottagning/MVC), where you have regular visits and conversations about your pregnancy. Routine ultrasounds are usually carried out at a separate ultrasound clinic.
During labour in hospital, you are mainly supported by midwives and assistant nurses. However, an obstetrician is always available to assess your progress together with the midwife and monitors the baby’s heart rate in a different room. The doctor will usually become involved only if something deviates from what's normal or if a medical assessment is needed.
The midwife you see during pregnancy is usually not the same midwife who supports you during labour and birth.
Maternity care during pregnancy
When you find out that you are pregnant, you are responsible to contact a midwifery clinic (barnmorskemottagning) yourself and book your first appointment. You are free to choose which clinic you would like to attend, and you will then be assigned a midwife who follows you throughout your pregnancy.
This is usually not the same midwife who will support you during labour.
In some areas, continuity-of-care programmes are available, where a small team of midwives follows you both during pregnancy and birth. In Stockholm, this is called "Min Barnmorska". You need to find information about the programme and apply for a place yourself if this is something you're interested in.
First appointment
Your first appointment at the midwifery clinic is usually a little longer to go through you health status and any questions you may have. It normally takes place early in pregnancy, around weeks 8–12.
At this appointment, you will also receive a referral for routine blood tests.
Check-ups during pregnancy
Throughout your pregnancy, you will continue seeing your midwife for regular check-ups.
Appointments are usually about once a month until around week 30, and then become more frequent, often every one or two weeks towards the end of pregnancy.
KUB Ultrasound and NIPT
Through your midwifery clinic, you may be offered KUB, a combination of an ultrasound examination and a blood test that estimates the likelihood of the three most common chromosomal abnormalities: trisomy 21 (Down syndrome), trisomy 18 and trisomy 13.
If the KUB screening indicates a higher probability, you will usually be offered NIPT, a blood test that provides a more reliable risk assessment.
NIPT can also be done privately and is offered as an alternative to KUB in some regions.
Routine ultrasound (RUL)
A routine ultrasound is offered to all pregnant women and is usually carried out around weeks 18-20.
Your midwife at the MVC will help refer you to an ultrasound clinic. This is a more detailed examination where the baby’s organs and development are assessed, the baby is measured, and the position of the placenta is checked.
Growth ultrasound (Tillväxtultraljud - TUL)
If needed, you may be offered additional ultrasounds during pregnancy, such as a growth ultrasound (Tillväxtultraljud).
This may be recommended if your belly is not growing as expected, or if your midwife or doctor would like to monitor your baby’s growth more closely.
Specialist maternity care
If your pregnancy is considered high-risk or requires more medical follow-up than the MVC can provide, you may be referred to specialist maternity care.
There, you will receive additional check-ups and may meet specialist doctors. These appointments usually take place in addition to your regular visits at the MVC.
Turning a breech baby
If your baby is not head-down around week 36, you will usually be offered an external cephalic version, also known as a turning procedure (vändningsförsök).
Your MVC will refer you to the maternity unit, where a doctor will attempt to turn the baby into a head-down position.
Emergency care
If you need urgent medical care related to your pregnancy, you will generally go to a gynaecological emergency department before week 22 and to your maternity unit from week 22 onwards.
Preparing for birth
Chidbirth preparation classes
In Sweden, it is common to attend a child birth preparation class together with your partner or support person.
There are both private courses and simpler free courses offered through the healthcare system. If you receive a wellness allowance (friskvårdsbidrag) through your employer, you can often use it towards the cost of a private course.
Doulabyn offers private 1:1 birth preparation classes in English, in the comfort of your home in Stockholm. Read more and book here.
Preparing for Birth with a Doula
If you are planning to give birth with support of a doula during your birth, your doula can also provide guidance and support as you prepare for labour and birth.
Our doula package includes two two-hour preparation sessions, as well as a shorter online session closer to the birth. Read more and book here.
If you have access to a wellness allowance through your employer, you may also be able to use it towards this support.
Giving Birth in Sweden
Choosing a Maternity Unit
In Sweden, you can usually choose which maternity unit within your region you would like to give birth at.
However, if the unit is full when you go into labour, you may need to give birth at another hospital.
In Stockholm, you make your choice through Alltid öppet, where you rank your preferred maternity units. You can change your choice up until week 22. After that, you will receive information about which maternity unit you have been assigned to.
Home Birth
The option of giving birth at home is unfortunately more limited in Sweden than in many other countries.
In Stockholm, through Min Barnmorska at Karolinska Huddinge, and in Umeå, region-funded home birth is available if you are insured in Sweden and meet a number of criteria, including having given birth before.
You can also hire a private home-birth midwife and pay for the service yourself. The cost is usually around SEK 35,000.
Midwives who work with home births are licensed midwives with the same 5,5 year medical education as midwives working in hospital care.
Here you can find a list of private home-birth midwives in your region.
Birth center
There is currently only one midwife-led birth unit in Sweden: BB Gårda in central Gothenburg.
Two new region-funded birth centers are planned to open in Uppsala, but they are not yet open.
Planned caesarean section
In Sweden, you cannot simply choose to have a planned caesarean section. The decision is made by a doctor following an individual assessment.
A planned caesarean may also be approved for what are known as humanitarian reasons, for example in cases of severe fear of childbirth.
Giving birth with the support of a doula
Hiring a doula is becoming more common in Sweden, and interest in doula support continues to grow. In most areas, you can find experienced doulas who can support you during pregnancy, birth and beyond.
If you have access to a wellness allowance (friskvårdsbidrag) through your employer, it can be used towards part of the cost, both by you and your partner or other support persons.
Because you will usually not have the same midwife during pregnancy and labour, a doula can provide continuity and a sense of security throughout the experience.
A doula can also offer a more holistic perspective and knowledge about how to support physiological birth.
Doulabyn offers support from experienced doulas with at least five years of experience in Stockholm. Read more about our doula package here.
When Labour Starts
When labour starts, you call your maternity unit.
If your waters break before labor starts, you will usually be asked to come in for a check-up. If everything looks good, you may then be able to continue waiting at home.
It is common to stay at home during the early phase labour. You are generally advised to go to the hospital as labour approaches "the active phase", with regular, frequent and increasingly intense contractions.
When it is time to go to the hospital, you call the maternity unit first and let them know that you are on your way. They can also confirm whether they are able to receive you.
If the unit is full, they will help you find a place at another maternity unit over the phone.
Admission to the birth clinic
When you arrive at the birth clinic, you will usually meet a midwife who assesses how your labour is progressing.
You will usually be offered CTG monitoring, which records the baby’s heart rate and your contractions, as well as a vaginal examination.
If you are deemed to be in active labour, you will be given a hospital room and a midwife responsible for your care. If you are not yet in active labour, you may be advised to go home and return later.
Examinations are voluntary, and you always have the right to decline a vaginal examination.
Induction of labour
Induction of labour is primarily recommended for medical reasons. You generally cannot choose to be induced simply because you would prefer to be.
At 42+0 weeks, a pregnancy is considered post-term, and the recommendation is that the baby should be born before this point.
If labour has not started on its own, an induction will therefore usually be planned around week 41+4, or earlier in some high-risk pregnancies.
Induction, like all maternity care, is voluntary. You can choose to decline an induction and continue your pregnancy with closer monitoring.
After the birth
Postnatal Care (BB)
After your baby is born, you will usually be transferred to the postnatal ward, known as BB.
How long you stay depends on several factors, including the time of day, how you gave birth and how you and your baby are doing.
You can usually leave the hospital as early as around six hours after the birth, but it is common to stay for at least one night.
We recommend packing for approximately 3–4 days. If you need to stay longer for some reason, your partner or a family member can usually go home and bring you anything you need.
You can also take a look at our hospital and postnatal packing list here.
Child Health Centre (BVC)
After leaving BB, you contact a child health centre (BVC) yourself.
You will be assigned a BVC nurse (a pediatric nurse) who follows your baby's health throughout childhood. The first visit usually takes place at home, followed by subsequent appointments at the BVC clinic.
Visits are more frequent during your baby’s first months and become less frequent as your child grows, continuing until school starts, when the school nurse takes over.
During the first seven days after birth, you usually remain under the care of the maternity unit and can call them around the clock if you have questions or concerns.
After that, the BVC takes over your baby’s care, while the MVC continues to provide care for the mother.
Hearing test & PKU Test
After you leave the hospital, you will receive an invitation for a follow-up visit when your baby is two days old to to a PKU test.
A PKU-test is a blood test taken with a small heel prick that screens for certain congenital diseases.
You will also receive an invitation for a hearing test. This can be carried out as early as six hours after birth and no later than six weeks of age.
Postpartum doula
If you would like some extra support at home after your baby is born, you can choose to hire a postpartum doula privately.
A postpartum doula provides practical and emotional support, giving you more time to rest, recover and settle into your new everyday life with your baby.
The support is paid for privately and can include help with cooking meals, supporting you recovery, help learning the baby's signals, breastfeeding support as well as massage and other forms of physical support.
For cooking and cleaning, you may be able to use the Swedish RUT tax deduction, which can reduce the cost by around half.
Postnatal check-up with your midwife
Around 6-8 weeks after giving birth, you will have a follow-up appointment with your midwife to check on how you are doing physically and mentally after birth and how your body is recovering.
If you have given birth vaginally, you will also be offered a gynaecological examination.
