Förlossning: giving birth in Sweden
A friend from Hamburg who has lived in Gothenburg for three years summed it up like this after her daughter was born: "In Germany I felt like a hospital was looking after a patient. In Sweden I felt like a midwife was looking after a woman who was having a baby. It's a different mode."
That exact shift is what surprises many parents from abroad in Sweden: some are delighted, others unsettled. If you arrive with the reflex of "better a few extra checks, just in case", common in Germany and elsewhere, you'll meet a system that deliberately intervenes less. That isn't poor care. It's a different philosophy.
This article explains how giving birth in Sweden actually works, from registration through the maternity ward to going home, and what you should have sorted out before the birth as a newcomer.
The system in one sentence
In Sweden, birth is the midwife's domain. Doctors (obstetricians) come in when there are complications, not before. That shapes every step: antenatal care, the birth itself, aftercare.
In practice: antenatal care runs through the Mödravårdscentral (MVC, the antenatal clinic) with a dedicated barnmorska (midwife). The birth itself takes place on the förlossningsavdelning (labour ward) of a hospital and is led by barnmorskor. In Gothenburg that mainly means Sahlgrenska (Östra) and Mölndals sjukhus. Only when a medical intervention becomes necessary (caesarean, ventouse, complications) does a läkare (doctor) take over.
If you come from a country like Germany, you know the gynaecologist-centred model. Here the midwife isn't the "friendly companion" next to the doctor. She's the one in charge.
Before the birth: what really needs sorting out
Registering with the labour ward
You don't have to register yourself. Your MVC midwife automatically registers you with the regional hospital as soon as the pregnancy is officially recorded. In Gothenburg that usually means Östra sjukhuset (part of the Sahlgrenska group) for most births, with Mölndals sjukhus as the second option.
Important: you don't get to choose the hospital. You're assigned to the relevant sjukhus based on your address and current capacity. If you live in Majorna or Linné, you'll usually end up at Östra. If you live in Mölndal, at Mölndal. Exceptions apply for high-risk pregnancies (Sahlgrenska Centralsjukhuset has a specialised unit) or when all beds are full. In that case you're redirected while in labour, sometimes as far as Borås or Trollhättan. Sounds extreme, but it happens regularly.
The förlossningsbrev
From around week 35, you write a förlossningsbrev together with your midwife, a kind of birth plan. What matters to you, which pain relief you're considering, whether you want the father or another person with you, how you'd like things after the birth (immediate skin-to-skin contact, delayed cord clamping). The letter goes into your file and is read in the delivery room. That's not symbolic; it's genuinely taken into account.
My tip: also write down how much of a language barrier you have. English works on all labour wards in Gothenburg, but speaking English while in labour isn't comfortable for everyone. If you'd like a midwife who speaks your language, you can mention it in the letter. Sometimes it can be arranged, often not. Realistically, it'll be Swedish or English.
What you should have done before the birth
- A personnummer (Swedish personal identity number) for yourself (essential for all routine treatment billed via patientavgift, the patient fee)
- Registration with your chosen MVC (usually from week 8–10)
- Föräldraledighet (parental leave) applied for with Försäkringskassan (can also be submitted after the birth, but it's cleaner beforehand)
- Clarity on who takes care of the personnummer application for the child (see below)
During the birth: what to expect (and what not to)
The phone call, not the dash
When contractions start, you don't drive straight to the hospital. You call the labour ward first. A midwife on the phone listens to you (how far apart the contractions are, how strong, whether your waters have broken) and decides whether you should come now, in two hours, or only once the contractions get closer together.
That often feels wrong to people from countries like Germany. The reflex there is: off to the clinic. The Swedish system says a two-hour hospital stay in early labour helps nobody, neither you nor the staff. Stay at home until things really get going.
At the hospital
On the labour ward you get your own förlossningsrum (delivery room), a room where you give birth and where you stay until the baby is born. No moving between different rooms. One midwife is responsible for you, often together with an undersköterska (assistant nurse). A doctor only comes if needed.
Pain relief: less reflex, more choice
An epidural (epiduralbedövning) is available in Sweden, but it isn't suggested automatically. The standard sequence is:
- Lustgas (gas and air, nitrous oxide): self-administered, available at any time, much more of a given in Sweden than in Germany, for example
- Sterila vatteninjektioner (sterile water injections): four small injections of sterile water into the lower back, surprisingly effective for back pain during contractions
- TENS machine: electrical stimulation along the spine, often started at home
- Epidural: available, but as a conscious decision, not the default
If you want an epidural, you'll get one. It just won't be offered the moment you double over. You have to ask for it or have it written in your förlossningsbrev. For women used to having it offered as a matter of course, as in Germany, that takes some getting used to. It isn't restrictive, just a different set of priorities.
Caesarean section
Planned caesareans (kejsarsnitt) are only carried out when there's a medical indication. An elective caesarean without indication isn't the normal route in Sweden and is typically only accepted after previous trauma or severe fear of childbirth, following a conversation with a psychologist. Emergency caesareans during labour are of course available; the Östra clinic in Gothenburg has anaesthetists and an operating theatre on standby around the clock.
After the birth: the Swedish short version
This is perhaps the biggest difference from the German system: in Sweden, after an uncomplicated birth you typically stay in hospital for 6 to 24 hours. That isn't a cost-cutting measure; it's deliberate. The idea is that the family functions best at home, in their own bed, in their own surroundings.
BB Familjevård
Some hospitals, including Östra sjukhuset, offer "BB Familjevård": a family-room arrangement where the second parent stays too, instead of leaving mother and baby alone in a shared ward. Availability depends on bed capacity and how the birth went. Not everyone gets it automatically, so it's worth asking.
Straight home
If you're discharged early (6–24 hours after the birth), you're not left on your own. Three to five days after the birth, the MVC midwife either comes for a home check or you go to her with the baby. The PKU-prov is taken no earlier than 48 hours after birth, so from the third day of life: a drop of blood from the heel, used to screen for around 25 congenital metabolic and hormonal disorders. The hearing screening is a separate test and usually happens in hospital.
What this means in practice: 24 hours after the birth you're at home with a newborn, often tired, often unsure. Swedish families usually have a close-knit network of family and föreningsliv (clubs and community life). Newcomers without that network often experience the first days as a brutal learning curve. Plan for someone to come over from home, or for your partner to stay home full-time for two weeks.
A personnummer for the baby: not automatic
The baby doesn't get its personnummer automatically at birth. The hospital reports the birth to Skatteverket (the Swedish Tax Agency), and the personnummer usually arrives by post within 1 to 3 weeks, if both parents are registered in Sweden.
It gets more complicated if:
- Only one parent has a personnummer
- The parents are unmarried and the father hasn't yet acknowledged faderskap (paternity) (you do that with the municipality's familjerätten, the family law office, not with Skatteverket)
- The mother has a foreign nationality and the child doesn't automatically receive Swedish citizenship
In these cases the personnummer can be delayed by weeks. No personnummer means no BVC appointment (barnavårdscentral, child health centre), no benefits, no barnbidrag (child benefit). Sorting this out before the birth saves you a series of trips to the authorities later.
What to do as a pregnant newcomer
1. Register with an MVC from week 8–10. Via 1177.se you can find the right Mödravårdscentral. Registration is free.
2. Understand the Swedish maternity record. The Swedish graviditetsjournal doesn't exist on paper; it's kept digitally at the MVC. If you bring a maternity record from home (a German Mutterpass, for example), you can keep using it when travelling back, but for Swedish care only the digital file counts.
3. Go to föräldrautbildning (antenatal classes). Swedish birth preparation is usually organised in 2–3 group sessions, often in Swedish. English-language föräldrautbildning is available in Gothenburg on request at the MVC. Privately offered courses (e.g. by doulor, doulas) fill the gaps.
4. Write the förlossningsbrev together with the MVC. From week 35.
5. Pack your bag, Swedish-style: you're expected to bring your own clothes and toiletries. The hospital provides minimal linen and toiletries. Unlike in Germany, for example, there's no "hotel feeling".
6. Register föräldraledighet with Försäkringskassan. Both parents, ideally before the birth.
7. Make a plan for the first two weeks after discharge. Who's coming, who's cooking, who takes over when the mother is exhausted. That's not a "nice to have"; it's the most important preparation of all.
What newcomers appreciate about the system, and what grates
What most people praise: the matter-of-fact way women are treated as competent people giving birth. Little intervention. A midwife who listens to you. The idea that pregnancy isn't an illness.
What grates for many, especially those coming from Germany: the short hospital stay. The feeling of suddenly being alone with the newborn. Giving up the reflex of maximum safety through maximum monitoring. If you come from a system like the German one, where routine antenatal checks are an emotional anchor, you'll have some relearning to do.
The Swedish answer would be: less intervention doesn't mean less care. It means a different kind of trust, in the woman, in the body, in the network that closes around the family after the birth.
Who decides when things get tight
Swedish obstetric care is among the best in the world. Infant and maternal mortality have been below German levels for decades. That isn't luck; it's a system choice.
Still, every birth is different. If you come with risk factors (diabetes, high blood pressure, multiple pregnancy, previous complications), you'll give birth on the specialised labour ward at Sahlgrenska Centralsjukhuset, with obstetricians closely involved. The midwife-centred model is the standard for the uncomplicated majority, not dogma.
If you're having a baby in Sweden as a newcomer, you should know the differences beforehand. Not so you're afraid, but so you're not caught by surprise. The system works. It just works differently.
If you want to go deeper: my authorities roadmap PDF covers the first weeks after the birth from the bureaucracy side (personnummer for the baby, föräldraledighet, barnbidrag, BVC registration). It's currently only available in German. If you'd rather talk it through in English, book a free 15-minute call.
Buying a House in Sweden: Practical Guide, the in-depth guide on this topic, is currently available in German: see it in the shop.
I'm Sebastian Schiefner, a photographer in Gothenburg, and I help people who are moving to West Sweden with finding a home and buying property. Free intro call.
