2016

New in Denmark
– pregnancy and birth

Engelsk/English
Recommendations for expectant parents
Congratulations on your pregnancy.
This leaflet has been written for you and your husband/partner to tell you what is
recommended in Denmark when you are expecting a baby. The leaflet provides a brief
overview of pregnancy and childbirth, and introduces you to the examinations and
tests and other types of pregnancy care which are available. The leaflet only covers
normal pregnancy and childbirth.

Normal pregnancy signs and symptoms in early

pregnancy
Once you have stopped menstruating after becoming pregnant, you will soon notice
various physical changes and symptoms which you might not have been prepared for.
Most of these changes and symptoms are completely normal.
Tiredness: At the beginning of pregnancy, many women feel extremely tired. If this is
also the case for you, try resting during the day, and make sure to get a good night’s
sleep. The tiredness usually lifts after week 12.
Nausea: Many women experience nausea (morning sickness) to a greater or lesser
degree during the first weeks of pregnancy. For most, the nausea usually disappears
after the first couple of months, but for some it lasts longer. If the nausea is extreme,
and if it is followed by vomiting, it is a good idea to talk to a midwife about your
condition. She can provide useful advice and assess what sort of help you need.

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Being pregnant is a normal condition and not an illness, so you can continue to live life
as usual. However, it is completely normal to feel anxious, and to worry about whether
everything is as it should be. You may also experience mood swings and tender
breasts. That is also quite normal. Talk to your husband/partner about how you feel,
and discuss what you are experiencing with the midwife and your family doctor (GP).
They can help you to understand your feelings and concerns.

When should you be examined by a doctor and the

midwife?
A normal pregnancy lasts between 37 and 42 weeks. All pregnant women can see
a doctor and midwife free of charge during pregnancy. Your doctor or midwife will
examine you, and keep an eye on you to ensure that both you and your baby are well,
and that your baby is growing and developing as it should. You will also be invited to
have blood tests and an ultrasound scan early on in your pregnancy. The examinations
and tests will show whether there is anything the matter with your baby.
When expecting your first child, the normal examinations and tests are:

Week of pregnancy Examination Examination Ultrasound and blood tests

by doctor by midwife
6-10 x
8-13 Blood test (double test)
11-13 Ultrasound scan
15-22 Ultrasound scan and possibly a blood
test (triple test)
25 x
29 x
32 x
35 x
37 x
39 x
(41) x
4-5 days after birth Home visit by your health visitor.
5 weeks after birth (baby) x
8 weeks after birth (mother) x

If you have been pregnant before, the midwife will usually carry out slightly fewer
prenatal examinations. If you are circumcised, it is important that you mention it to
the midwife the first time you meet her.

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If problems occur during your pregnancy, you will be offered more examinations and
tests regardless of whether it is your first child or you have given birth before. It is
a good idea if your husband or another family member can also attend the prenatal
appointments with both the doctor and midwife.
You can also talk to a health visitor during your pregnancy if you find yourself worrying
about what it will be like to breastfeed or care for your baby once you have given birth.
An interpreter can be provided if necessary. You can discuss this with your doctor. Your
doctor, midwife, health visitor and interpreter are bound by a duty of secrecy to other
authorities and persons.

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Which prenatal examinations are carried out by the
doctor and the midwife?
At the doctor’s: During the examinations at your family doctor, the doctor will ask you how
the pregnancy is going, and about your family and your life in general. Blood samples will
be taken, and the doctor will check your blood pressure and your urine, and weigh you. At
the last two visits to the doctor, the doctor will check that the child is growing as it should.
If you are taking prescription medicine, the doctor will decide whether you can continue
with the same medicine, or whether you should switch to something else or perhaps
take a break. It is important that you talk to your doctor about any medicines you take –
including non-prescription drugs. This is because everything you take passes through your
bloodstream to your unborn child, who might not be able to tolerate the medicines.
At the midwife: At your first visit to the midwife, you and the midwife will draw up
a pregnancy care plan to ensure the best possible pregnancy for you and your baby.
The plan will take into account your health, previous pregnancies and births and any
mental problems you may have. The midwife will also check your blood pressure, urine
and weight, and she will assess whether the child is growing as it should. She will also
talk to you about how you feel, both physically and mentally.
You should try to be as open as possible with both the midwife and the doctor, as this
will ensure that you receive the best possible support and care for you and your child.
This also applies if you have been subjected to violence or threats of violence or if
you have experienced other dramatic events in your life. Such experiences can affect
you more in connection with pregnancy and childbirth. It is important for the health
professionals to know about it, so they can help you in the best possible way.

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Healthy habits during pregnancy
To ensure that your child can grow and develop in the best possible way in your womb,
it is important that you eat healthily, that you do not smoke and do not drink alcohol
while pregnant, and that you lead an active life.
It is good to eat as many different types of food, fruit and vegetables as possible. Talk to
the midwife and your doctor if you have any doubts about what is healthy for you and your
child, and about the foods you can buy in Denmark which you may not be familiar with.
When cooking, do not use too much oil or salt. It is also a good idea to cut down on
sugar, i.e. sweets, biscuits, cakes and soft drinks. You only need to eat a little more
than usual when you are pregnant. Be careful not to eat for two, as otherwise you will
quickly put on too much weight, which can be hard to lose later.
Tobacco smoke is unhealthy for the child in your womb. If you smoke, you can get help
from your midwife or local authority to stop smoking. If the child’s father smokes, it is
a very good idea if he stops smoking too. Passive smoking – the inhalation of smoke
by persons other than the smoker – is also not healthy for your child. If your family and
friends are smokers, make sure that they always go outside to smoke.
Go for walks or find other ways to stay fit. This is good for both you and your child, because
it helps to keep your weight down and builds up your strength before you give birth.

During pregnancy, it is recommended that you

take the following dietary supplements:

400 micrograms of folic acid a day for the first 12

weeks of pregnancy

10 micrograms of vitamin D a day throughout

your pregnancy

40-50 milligrams of iron a day from week 10 and

for the rest of the pregnancy

500 millilitres of dairy products or 500 milligrams

of calcium a day throughout your pregnancy.

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Pains and discomforts later in pregnancy
Constipation and haemorrhoids: It is normal to be constipated during pregnancy,
and this may result in haemorrhoids. Haemorrhoids are a kind of varicose vein in the
rectum, and may cause slight bleeding. Constipation can be relieved by drinking plenty
of water, and eating wholemeal bread and lots of vegetables. If you get haemorrhoids,
your doctor or midwife can tell you what to do to treat them.
Heartburn: Heartburn occurs because the lower oesophageal sphincter at the top of
the stomach becomes more relaxed so that gastric acid is regurgitated. You can relieve
heartburn by taking medicine, but talk to your doctor or midwife about it first.
Braxton Hicks contractions: From about the middle of the pregnancy you may
experience Braxton Hicks contractions, which feel like strong, frequent cramps.
The pain may also extend to your lower back during a contraction. Braxton Hicks
contractions are usually harmless, but talk to your doctor or the hospital where you are
due to give birth if you have many contractions, even when you are relaxed.
Pains in the body: It is normal to experience pain or discomfort in various parts of your
body, for example in your legs, calves or in your pelvis. It is not dangerous, but it may be
uncomfortable. It is possible to relieve such pains, so talk to your midwife about your needs.
Discharges and frequent urination: You may often notice an increase in vaginal
discharge. Normally, the discharge is whitish/clear and odourless. If your discharge looks
different or smells, then you should talk to your doctor or midwife about it. You will also
find that you urinate more frequently during pregnancy, which is completely normal.
Water retention in your body: Many women experience water retention in their bodies
during the latter stages of their pregnancy. Legs and feet in particular are prone to
swell, and it is a good idea to sit with your legs up and sleep with them raised on a
pillow. Your midwife can also show you exercises which can help.

Serious symptoms during pregnancy

Bleeding: If you start to bleed, it may be insignificant or something more serious. It is
usually harmless, but always contact the hospital where you are due to give birth or
your doctor if you start to bleed.
Diabetes: Some women develop diabetes during pregnancy. Fortunately it is rare, but
it has an impact on both your health and that of your child. If you develop diabetes,
it will be discovered through the prenatal checks carried out by the midwife and the
doctor, and you will be advised what to do for the rest of the pregnancy.
High blood pressure: If your blood pressure becomes too high during pregnancy, it can
have serious implications for both you and your child. Your blood pressure will therefore be
checked at every prenatal visit to your family doctor or midwife. If you experience constant

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headaches, dizziness, blurred vision or extreme water retention in your body between your
prenatal appointments, it is important that you always contact your doctor, midwife or the
hospital where you are due to give birth and tell them about your symptoms.
In the last few weeks of pregnancy, you may feel greatly inconvenienced by your
growing tummy, and you may experience Braxton Hicks contractions more frequently.
Your baby may be pressing down on your bladder so that you have to urinate even
more often, and it can be difficult to breathe normally and sleep lying flat. Therefore,
make sure that you rest during the day, and accept all the help you can get from your
relatives or friends. However, you should also keep going for walks and stay active.
This is good for both you and your child.
Elective caesarean section: In some situations, the baby cannot be born vaginally, and
it may be necessary to plan a caesarean section in advance. A planned – or elective –
caesarean is perfectly safe for both the mother and child. If you need to give birth by
elective caesarean section, your midwife will tell you about the procedure.

When labour starts

There are various signs that labour has started:
• You may produce a small amount of
slimy, brownish or palish discharge
tinged with blood once labour starts.
This is called the ‘bloody show’.
• You experience contractions. Your womb
will harden during each contraction, and
you may feel pain across your tummy
and back. To begin with, the contractions
are irregular and ease up, but they will
steadily become more regular.
• Your waters break, either as a gush or
a trickle. The fluid must be completely
clear. For some women, it feels as if
they have wet their pants.
Always contact the hospital where you will
be giving birth once your waters break. And
tell the hospital if the fluid is not completely
clear. If labour starts in some other way,
you are advised to call the hospital first and
talk to the midwife about how you feel and
the signs that are telling you that labour

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has started. She can then assess when you need to leave for the hospital, and she will be
ready to receive you when you arrive. In Denmark, it is quite normal to have your husband or
another relative with you when giving birth. They are able to provide support for you.

If labour does not start spontaneously

If your pregnancy lasts more than 41 weeks, your doctor or midwife will talk to you
about inducing labour. The decision to induce labour is yours and yours alone, so spend
some time talking to the staff about when it might take place, and the implications
for you and your child.

Birth
All births are different, and women react differently to the pain and how the birth
proceeds. Some women feel worried, while others largely feel excited and expectant
between the contractions. How you react depends on many factors. Some women can
tolerate a lot of pain, some find it difficult to relinquish control of their own bodies,
and others re-experience unpleasant events from their past because of the pain and
the uncertainty of not knowing what is going to happen.
The first time you give birth, labour can last as long as 24 hours. For women who have
given birth before, labour is usually shorter. There are several stages to labour and
birth. To begin with, the birth canal starts dilating, and during this period it is best to
stay at home. When you arrive at the hospital, the midwife will guide you through the
different stages of labour. Once your cervix has dilated to 10 cm, the child is ready to
be pushed out. The second-stage contractions feel different, and you will know that
you have reached this stage.

Pain relief
Several pain relief options are available during labour. You can be given hot towels or
a massage, you can take a hot shower or bath, or you can be given gas and air or an
epidural, which is a local anaesthetic in your back. Some hospitals provide acupuncture, or
sterile water injections, which can also relieve the pain. It also helps to change position,
so you create as much space as possible for the child to pass down the birth canal.

Emergency caesarean section

If there are sudden complications during labour, it may be necessary for you to have
an emergency caesarean section. This is a situation which you and your husband or
other relative may experience as being quite chaotic and unsettling, but you will be
told about the procedure as it happens. You can be sure that the medical team knows
what they are doing, and that they will do their utmost to ensure the best possible

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outcome for you and your baby. Usually, you will be conscious while the caesarean
section is being performed, and your husband or other relative can also be with you in
the operating theatre.
Afterwards, the midwife will discuss the birth with you, so you can find out what
happened, and why it was necessary to perform an emergency caesarean.

Immediately after the birth

Immediately after the birth, your baby will be placed on your tummy, and your
husband or the midwife will cut the umbilical cord. The placenta will be expelled
shortly afterwards, and then the midwife will check to see whether you need stitching.
Your baby can find its way to one of your nipples and start breastfeeding.
You will be served some food and drink on a tray shortly after you have given birth, and
after a while your baby will be examined, measured and weighed by the midwife. This
examination does not happen immediately, as it is important not to disturb the initial
bonding between mother and baby. After a couple of hours, you will usually be offered
admission to a maternity ward or patient hotel if it is your first child.
Many women who have given birth before choose to go home within 6-8 hours of
giving birth, and they are then contacted by the midwife the following day. Everyone
who returns home within the first 72 hours receives a visit from a health visitor after
4-5 days at home. If you have been admitted for an extended period of time, the
health visitor will visit you at home by prior agreement.
Days following the birth: You may
experience pain in your womb, which is a
sign that it is contracting. This is called
afterpains. The first day in particular
you will bleed quite a lot, but this will
gradually become less and less. Talk to
your doctor or the health visitor if you
have any symptoms which you don’t
understand or which persist.

Newborn baby tests and checks

All newborn babies are checked for congenital diseases by taking a sample of blood
from the heel within 72 hours of birth. You will only be informed of the results of the
heel-test if there is anything the matter. All babies are also examined to check their
hearing. This examination does not hurt the child. However, some children will need to
have this examination done twice if the first examination was unsatisfactory.

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Many babies are jaundiced after being born. This is also quite normal. Only if your child
is very jaundiced and becomes lethargic and will not breastfeed will it need treatment in
hospital. Breastfeed your child as often as possible, as it can help to relieve the jaundice.
If you are in doubt, contact your family doctor, the hospital or the health visitor.

Breastfeeding
Breast milk is the healthiest nutrition for a baby, and in Denmark it is normal to
breastfeed your baby. When you breastfeed, you are providing your child with important
nutrients, vitamins and minerals. Your milk also protects your child against a wide range
of diseases. And the more you breastfeed, the more milk you produce. Breastfeeding
usually has to be learned by both the mother and child. It may be painful for the first
few days. However, this is quite normal and usually passes. The midwife and the health
visitor will help you, and can provide assistance if breastfeeding continues to be painful.
If you are unable to or do not want to breastfeed, you have to give your child infant
formula. Follow the instructions on the packet carefully.

Becoming parents can be difficult, but it is also wonderful. By helping each other, it
will be easier for you to enjoy being parents and spending time together as a couple.
You can read more about infant health in the leaflet “New in a Foreign Country –
Health Guidelines for Parents with small Children”. You can ask your health visitor for
the leaflet or find it online at www.sst.dk.

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sst.dk

©2016 The Danish Health Authority

(Sundhedsstyrelsen)
This publication may be freely quoted with
appropriate acknowledgement of the source.

Images from this publication must not be reused.

Danish Health Authority

(Sundhedsstyrelsen)
Islands Brygge 67
2300 Copenhagen S
Denmark
sundhedsstyrelsen.dk

Language
English

1st edition