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I arrived at the low risk birthing unit at 7am where the midwives were just about to start handover. The handovers were always completed in Norwegian so I never really understand what was going on until my mentor explains it to me afterwards.
Today I was working with a lovely midwife called Ragna who works part time at the hospital and part time in her own private antenatal clinic. She specialises in normality and has a particular interest in the effects of Oxytocin. She was an incredibly interesting woman to chat to. We spent some time talking through the types of antenatal care and information women receive in Norway. From what I was told, not all women have access to a midwife antenatally. It depended on your community doctor and whether they had an agreement with a community midwife.
It seems there aren't enough 'trained' midwives in Stavanger. The jobs are available, but are not being filled. Women then quite frequently look for private antenatal care and classes. Additionally, postnatally there isn't the community support from midwives. The women deliver, stay on the ward until they are stable and self caring, and then the move to the hospital hotel (where I am also staying whilst here), where midwives help with feeding and basic postnatal care until they are fit for discharge to the community. However, once in the community, they might receive one postnatal visit if the midwives have the time to do so. Therefore, the midwives were very interested in our postnatal community care where we visit all women on their first day into the community, 72 hour weight if breastfeeding, a visit between day 6-9 for the newborn screening, contact with the health visitor between day 10-14, and then if all well to be discharged from maternity care between day 21-28. The midwives were very impressed with this system.
They were also keen to know how well midwives were paid in the UK. I explained the banding system, PADR's and increments, and revalidation for nurses and midwives. The midwives here were shocked at our yearly salary. A junior midwife here earns approximately £50,000 a year before any enhancements. The cost of living does seem higher but I don't feel this is relative. The training of a midwife also differs considerably. To be a midwife in Norway, you must first do 3 years of nursing at degree level, then work as a nurse for a minimum of 2 years before you can do a 2 year masters in midwifery.
I saw a number of patients with Ragna, and assisted in a transfer from the low risk birthing ward to the high risk ward for an epidural. This process was considerably different to ours at Cardiff as there was no obstetric review upon transfer and no CTG whilst the epidural was being sited. This I believe is common practice for women transfered soley for an epidural and no other risk factors.
In the late aftenoon, I tried a typical Norwegian speciality called Komle. This consisted of a dumpling, swede mash and salted meat covered in a reduced butter sauce. I didn't particularly like the look of it but it was actually quite tasty. I had really enjoyed my time with the ladies on the low risk ward, they had been particualrly kind to me. I will look forward to joining them again when I return in April.
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