Today was my first pre-natal doctor appointment in Helsinki. I think the best way to sum it up is "it will be different, but it will be OK." We are lucky enough to be able to use a private medical system while we are here. The public system is very good, but with the private option, you get the choice of scheduling with a doctor instead of a nurse or midwife, more doctor choices (you don't just go to the assigned clinic in your neighborhood), and shorter wait times for appointments. There will be aspects of my care that are through the public system, including some of my pre-natal care, all of my labor and delivery, and some post-natal care.
The doctor was referred to me by an American friend who has seen her once. That was good enough for me. I know lots of us have picked a doctor out of a book from our insurance company or from a website, so it is always nice when you can get some type of referral. The doctor thought it was very kind that my friend had made the referral. Mike and I met with the doctor for 40 minutes for our 20 minute appointment (I never said that the private option meant longer appointment times!). I was very thankful she took the extra time with us. It really helped allay some of my fears and concerns.
Almost the entire appointment was spent as a discussion. She reviewed my records, told us about what care we can expect from her and from Mehilainen, the health care group she belongs to, and what our expectations should be regarding the care we will receive from the public system. She also checked my vital signs and did some blood work. All standard things and so far, so good.
We will see her throughout my pregnancy, but she also encouraged me to go to my local maternity clinic in my neighborhood. At those clinics, nurse midwives handle most of the routine pre-natal care. This person is called a neuvola. If there are any issues or concerns, there is always a doctor on staff that will be brought in to consult/treat. Nurse midwives here are required to be educated and trained as RNs (or the Finnish equivalent), and then take additional schooling to become a neuvola. The clinics also offer education to the soon-to-be parents about pregnancy and birth and then after the baby is born, they will also come to your home and do checks on the mom and the baby. When was the last time you heard of a doctor in the US coming to your house?!
When we go to the hospital to deliver the baby, we will be assigned a neuvola when we check in. This will be someone we have never met before. That is the part I find the most disconcerting. Another American friend I have made here had a baby on Saturday. This is her second child, so she was able to compare this experience to giving birth in the US. For the most part, she thought her experience in Finland exceeded her US experience. The thing I find most interesting is your neuvola stays with you throughout almost the entire time you are in delivery. At the beginning when you aren't in active labor, she will come and go a bit, but as soon as things start to intensify, she stays in the room the entire time. She actually has a desk set up in there where she also does her office/paperwork. Once you start to deliver the baby, she is the one who does the delivery. She does have an assistant come in for that portion, and an anethesiologist comes in if you have an epidural, but no one else if you are having a complication-free birth. Of course, if there are complications, there are two or three doctors there that will become active with the delivery.
That brings me back to my overall assessment. "It will be different, but it will be OK." We're not doing this in a field in some third world country. We're doing it in the number one country in the world (according to Newsweek), the country with one of the lowest infant mortality rates in the world (and well ahead of the US), and one of the lowest maternal mortality rates in the world (again, well ahead of the US). It will be different, but it will be OK . . .