After the entire body of midwives in Iceland quit their jobs in home-based postnatal care two days ago, the future looks grim for both new mothers and The National University Hospital of Iceland.
The 95 midwives decided to quit en masse on Monday April 23rd after having worked for two months without a contract with the National Health Insurance. Their current salary amounts to about 4,394 ISK per hour, or 43,50 USD, but since it is extremely difficult for midwives to work to a full time position, they are asking for an updated contract with a 13.8% salary increase.
Only 20 beds available
The work provided by home-based midwives is not only invaluable for new mothers, but also rather cheap for the state. When mothers are sent home, they receive postnatal care by midwives five to seven times after the birth of their child. Tasks include basic check-ups like blood tests and weight tracking of the baby, as well as teaching mothers how to breastfeed and monitoring both their bleeding and their psychological health. This also takes a lot of pressure off the National Hospital, as there are only 20 beds available at the moment in the maternity wing with an average of nine births a day.
“We do a lot of different things that should otherwise be the responsibility of the hospital, which would be much more expensive than doing it at home,” midwife Ellen Bára Valgerðardóttir told RÚV. Mothers can call their midwife with any problem related to the child without having to wait an extensive amount of time, and they don’t need to queue at the hospital for regular check ups. “So it saves the hospital a lot of work,” Ellen adds.
How will it affect the hospital?
Sigríður Gunnarsdóttir, Head Nurse at the National Hospital, expressed her concerns about the impact this decision will have on new mothers, especially with an increase risk of infection for women and children who are forced to stay in longer than they should. But the decision will also affect the hospital itself. “Naturally we’ll have to prioritise mothers who are in our maternity wing right now, and especially those who need it the most,” she told RÚV yesterday evening. “The wing will fill up fast, which means that we’ll have to let the healthier women with the healthier children go and redirect them to their neighbourhood’s health clinic.”
The nurses who work at local health clinics often take care of visiting newborn children to weigh them and make sure they’re healthy, but the services provided by midwives are of a wider range and can hardly be substituted by increasing the work load of nurses. “The simplest things to do would be to accept our request to increase our wages without trying to review other solutions, like is being done now, which is just an emergency measure,” Ellen told Visir.
The oblivious Minister
According to Ellen, a new contract had been drafted with the Health Insurance before Easter. “The contract was then sent to the Ministry of Health to be approved and it’s still there—we have not heard anything from them yet,” Ellen told RÚV on Monday. “We have been working without a contract since February so we can technically quit our job whenever we want.”
Despite Ellen’s comments, the Minister of Health Svandís Svavarsdóttir seemed completely oblivious to the fact that a contract had been pending approval on her desk since March. Instead, she says, she only found a memorandum on her desk with proposals regarding changes to the midwives contract. “I’m really surprised that this came out first in the news and only with a one-day notice,” she told Morgunblaðið. “Otherwise I haven’t heard anything from the midwives themselves.” Svandís was expected to discuss the situation within the Ministry itself as well as with the Health Insurance in the past few days, but no outcome has been delivered so far.