A personal account posted in 2009, however many of the points are still relevant today.
Making the Appointment
Norway is very advanced in using technology, so quite often to make a non-emergency appointment, most clinics have an online booking system. Now providing you are already registered with a doctor, all you need to do is log onto the clinics booking page, select a day and time, and wait for a confirmation. Our clinic actually sends us a text message to our mobile phone and then we type in the confirmation code into our booking page to confirm our identity. Each clinic will have their own booking system but you can guarantee that everything will be in Norwegian.
In Norway, all medical treatment for pregnancy and birth is free. (With regular health consultations you would normally pay a yearly cap under NOK2000.) Most medical practitioners speak a little English (but you can never guarantee) so if you don’t have a Norwegian speaker to accompany you to appointments you can try and book in with a confident English speaking doctor/midwife or arrange a translator if the service is available. However, as mentioned in the introduction post, it is important to learn as much as you can about pregnancy and birth, as well as knowing a little Norwegian and the Norwegian medical basics, so you can understand what is going on and you can ask questions.
The first time you will meet the doctor they will lead you through basic registration. They will fill in your details in your medical record which will also be used for your Pregnancy Healthcard (Helsekort for Gravid) that you will need to take to every pregnancy related consultation. The basic details to be filled in is name and address of the parents to be, married status, education, job title, nationality, religion, other children and complications during previous pregnancies, allergies and medical conditions, medications, smoking, drinking and Rubella. The sheet will also be used for weight, urine, blood pressure and oedema tests, ultra sound details, tummy measurement graph, baby’s heart beat and position.
Your doctor or midwife will do a general check-up of your health – blood pressure, weight, urine – and ask you about any of the common problems in early pregnancy such as nausea and vomiting. This is the time when you need to speak up if you have any other problems or concerns. If you don’t ask they won’t discuss it with you.
Your doctor or midwife will likely talk about folic acid. It has been recommended by the World Health organisation for pregnant women to take folic acid supplements during the first trimester to help prevent Spina Bifida. (Doctors can advise you to take folic acid even before you are pregnant to give your unborn a good head start.) You can get folic acid supplements from your local pharmacy (apotek).
Resources and Information
Information will be given you about your community’s (kommune) pregnancy and birth resources and facilities – hospitals, health clinic etc. In Tromsø we have a midwife health clinic (Jordmorhelsestasjon) and all the midwives (jordmødre) also work at the hospital’s maternity clinic (kvinneklinkken). You will also be given a recommended pregnancy appointment schedule (kontrollprogram for gravide). As you can see below appointments are split between your doctor or midwife. You can arrange any visits you want – all doctors appointments or all midwife appointments – what ever you like. I do advise to visit at the midwife clinic as they provide great support throughout pregnancy and birth and will also provide check-ups for your baby until one years old. When you visit the midwives clinic they will also give you extra information – pamphlets, sample bags, reflectors – I even got a cute little new born jumpsuit with a print that said “This Way Up”! But, of course, each clinic will have their own materials.
Below: ‘Uke’ means week, ‘Lege’ means doctor and ‘Jordmor’ means midwife. As you can see from the table the appointments set for certain weeks are very casual. My current appointments don’t even follow this schedule as my scan revealed my baby to be bigger than normal so they brought forward my expected due date. What’s important is not to get caught up in details – like exact dates and exact appointments – try to be casual about things and you’ll make life easier on yourself.
You will likely receive information about maternity benefits if you have been in paid employment in Norway in the last year. In general, you can receive 80% of your average pay for 52 weeks after birth or 100% for 42 weeks. Fathers can also go on financially supported paternity leave (if they have worked in Norway in the last year). This will need to be arranged with your employer so they can fill your position while you are on leave.
If you are unable to work while pregnant because it could cause you or your baby harm then your employer is obligated to assign you less physical tasks. Sometimes you might have to stop work due to safety of yourself and the baby (you have severe placenta praevia for example) and therefore you will likely receive pregnancy benefits. Of course, this will need to be supported by a doctors recommendation.
If you are a student or not employed then you cannot receive benefits until after birth. if you are an asylum seeker you are not entitled to maternity benefits or child allowance. You can find out more about maternity and child benefits from www.nav.no. Most information is in Norwegian but if you go to the ‘Familie og Omsorg‘ (Family and Care) pages from the top categories they have a quick-find information list on the right in English.
The doctor will order a blood test (blodprøve) for you. A lot of doctor’s clinics have their own blood lab and technician so you can get your blood work done straight away.
They test is to see what blood type you are. (Even in subsequent pregnancies they check your blood type. Moose questioned it at my last first appointment and I said “it’s to make sure I haven’t been captured by aliens and had my blood replaced”. The doctor was in stitches for the rest of the consultation.)
The other things they test for is HIV, Treponema pallidum, Rebella, Toxoplasma IgG and IgM, and concentrations of certain proteins. As you can see on my earlier test below I tested negative for both Toxoplasma. This meant that I didn’t have enough antibodies to fight against the Toxoplasma parasite. These parasites are carried by the normal household cat. Cats pick them up from dirt and transmit them to humans. At the time I was living on the farm in Alta and since farms do have cats this information was important for me to know. The microbiologist at the blood clinic actually called me up herself (very late at night!) and explained the potential danger immediately after she found out. Even though all results are sent out in the mail, it was nice to be able to talk to her and discuss preventative measures. So that summer, poor Big Red (the farm cat) missed out on some lap time from me.
Before you leave, the doctor will apply for an ultra sound appointment for you at the hospital’s maternity clinic. The maternity clinic will send a letter out to you with your appointment day and time, and information about scans.
Depending on your choice of care, the doctor will set up another appointment for you or give you the contact number to make your next appointment at the midwife clinic.
Because of the language barrier, not a lot of conversation takes place in an appointment. Just the bare essentials. This can sometimes make outlanders a little apprehensive about what is going on and what will be happening in the future. (I find English speakers like to talk when they are nervous.) But you must remember, even though Norwegians can speak English, a lot of them aren’t confident enough to go first. I find when you make the first move to ‘chit-chat’ the doctor/midwife will gladly make conversation.
If you are unsure of anything, or don’t know about something – ASK the medical professionals. I find that even though my Norwegian husband has lived here all his life he knows little about what goes on when it comes to pregnancy and birth. I would always ask him ‘But you’ve lived here all your life… how could you not know this?’ I stopped asking when one day he replied ‘I don’t know… maybe it’s because I have never had a baby before?’ Even though it’s fun to discover about having a baby together, it can be frustrating making your partner scour the Norwegian pages to find the information you need. Asking the pros straight up will save a lot of time and you will get the correct information that is relevant for now.