ON SCIENCE Aspirational actions

watch birth videos through a virtual reality headset. Virtual events provide peer support and answers to puzzling questions, and they also allow you to learn from other participants’ questions,’ Marjaana Siivola says.

Continuity and solutions

Maternity and child health clinic services, including birth preparation classes, have been a part of basic healthcare in Finland, while childbirth has been categorised as specialised medical care. This has led to challenges with the continuity of the care. Maternity clinics have their own nurses, the delivery is handled by a midwife – and there can even be several if the delivery takes a lot of time – and after the delivery, there’s yet another nurse to meet.

In autumn 2022, researchers Hanna Castrén-Niemi and Annika Järvelin, working in the Biodesign Finland programme, observed everyday work at maternity and child health clinics for three weeks. They are now applying for funding for two projects that took shape during that period.

A project led by Castrén-Niemi is looking for ways to optimise the induciton of labour and improve the mother’s birthing experience. Coordinated by Järvelin, another project examines ways to better identify and alleviate a fear of childbirth.

According to the Finnish Institute for Health and Welfare (THL), the share of induced births has been on a clear rise for several years, and the same applies to the number of diagnosed cases of fear of childbirth.

‘The clinics are unable to adequately screen for clients who need help with depression or fear of childbirth, for example. If people are left to cope on their own, they lose trust in the clinics,’ Järvelin notes.

Too much information, too many wires Annika Järvelin says that scattered information is currently one of the challenges at maternity and child health clinics. This may also impact one’s experience of parenthood.

‘As the volume of information increases, parents’ trust in their own capabilities may deteriorate.’

The technological solutions used today do not convince the researchers: they may undermine the childbirth experience. For example, the outdated ultrasound scanners used at the clinics may even increase unnecessary hospital visits during pregnancy.

‘All the wires and other technology occupy a major role, which may limit movement during childbirth, for example. This, in turn, has a direct impact on the progress of the labour. Discrete technology, such as wireless systems, would respect the person in labour,’ Marjaana Siivola says.

The future shimmers ahead Some clinics have already adopted electronic clinic cards, but Professor Teemu Leinonen is keen to keep the paper format.

‘The card and the notes made in it play a major role in the clinic experience. I also wouldn’t bring much technology into the child–adult interaction.’

In Annika Järvelin’s view, the child’s viewpoint should also be accounted for when planning maternity and child health clinic services. Weighing and taking measurements, being touched by a stranger, cold hands, lifting, unpleasant cushions, vaccination, masks and white coats could all be rethought from a child’s perspective. Tailored services and their timely availability, combined with the right kind of expertise, will be key factors in tomorrow’s maternity and child health clinics.

‘I believe in multi-professional collaboration in which care paths are built systematically together. This allows combining medical, technical and business expertise,’ says Midwife and Research and Testing Manager at Metropolia

Eija Raussi-Lehto, who completed her doctorate in technology at Aalto in autumn 2022.

In a few decades, maternity and child health clinics may provide photorealistic 3D-video conferences alongside traditional face-to-face encounters. Future parents could meet the midwife as virtual characters in the space where the delivery will take place.

‘The pregnant avatar’s child would be born in a simulation, which would also allow practising for possible complications,’ Teemu Leinonen explains.

Today’s photorealistic environments are based on still photos. In the future, video footage could be used directly by adding a face from a video to the avatar.

‘The whole body could be modelled, and instead of moving the avatars with a mouse, the simulation could work with the person’s own body movement,’ Leinonen says.

Expressing empathy through video may be difficult, however, and emotions such as fear of childbirth are not only in the mind but also in the body, Leinonen points out.

In her birth preparation classes, Marjaana Siivola emphasises not only the fundamentals of childbirth but also processing the childbirth experience, the postnatal period and supporting the family through the rotina tradition, for example. Negative childbirth experiences often get a lot of publicity, but there is another brighter reality for many: a wonderful baby bubble.