Maternity and child health clinics have reason to celebrate this year, as it marks 100 years since the establishment of the first maternity and child health clinic in Finland.
The first clinic started operating in the Children’s Castle hospital in Helsinki in 1922. The beginning of this institution is largely thanks to Professor Arvo Ylppö and the active work of the Mannerheim League for Child Welfare.
The activities of maternity and child health clinics quickly yielded results: in Helsinki and the surrounding areas, infant mortality decreased from 15 % to 3 % in three years.
Over the years, the clinics became so cherished by people in Finland that, when the national broadcasting company Yle carried out a survey on the best Finnish innovation some years back, the maternity and child health clinic system won, surpassing inventions such as AIV silage, the dish-drying cupboard and SMS.
In terms of public health, it remains important even today that the clinic staff reach almost all expecting mothers, children and families with children.
Customers are the best
Over the century, Finland has seen war, recession and the development of the welfare state, but what is everyday life in a maternity and child health clinic like today?
Let us visit the Paloheinä Maternity and Child Health Clinic, which is already over 40 years old.
Sharing her everyday work with us is public health nurse Kaisu-Liisa Hänninen who is doing her dream job. When she was five years old, she declared that she would become either a nurse at a clinic or a director of a children’s home when she grew up.
The clinic’s walls are decorated with children’s drawings and thank-you cards from customers. The colourful decor with mobiles has been designed with the youngest customers in mind.
Hänninen’s dream job never changed over the years. After completing secondary education, she studied to become a nurse and then a public health nurse.
Now, after over 40 years of working in this profession, she has not regretted her career choice. Her customers at the Paloheinä maternity and child health clinic include families expecting a baby, babies and children up to the age of 6. Her professional partners include maternity and child health psychologists, dietitians, speech therapists, physiotherapists and doctors.
Kaisu-Liisa Hänninen is having an appointment with very familiar customers: her grandchild Teo, 4 months, and daughter-in-law Annette Hänninen.
Hänninen monitors expecting mothers’ stages of pregnancy, supports and monitors the development of children, shares information and guides families on everyday matters in detail, from successful nursing to cooking semolina porridge.
She believes that a key part of her job is the ability to listen. Each clinic appointment has its own programme, whether it is about foetus growth, the family’s wellbeing, monitoring the child’s growth, or vaccinations.
Hänninen emphasises that while the staff needs to take care of the monitoring, they also need to be sensitive and detect the customer’s feelings and thoughts at a given time.
Maternity and child health clinics have reason to celebrate this year, as it marks 100 years since the establishment of the first maternity and child health clinic in Finland.
The first clinic started operating in the Children’s Castle hospital in Helsinki in 1922. The beginning of this institution is largely thanks to Professor Arvo Ylppö and the active work of the Mannerheim League for Child Welfare.
The activities of maternity and child health clinics quickly yielded results: in Helsinki and the surrounding areas, infant mortality decreased from 15% to 3% in three years.
Over the years, the clinics became so cherished by people in Finland that, when the national broadcasting company Yle carried out a survey on the best Finnish innovation some years back, the maternity and child health clinic system won, surpassing inventions such as AIV silage, the dish-drying cupboard and SMS.
In terms of public health, it remains important even today that the clinic staff reach almost all expecting mothers, children and families with children.
Customers are the best
Over the century, Finland has seen war, recession and the development of the welfare state, but what is everyday life in a maternity and child health clinic like today?
Let us visit the Paloheinä Maternity and Child Health Clinic, which is already over 40 years old.
Sharing her everyday work with us is public health nurse Kaisu-Liisa Hänninen who is doing her dream job. When she was five years old, she declared that she would become either a nurse at a clinic or a director of a children’s home when she grew up.
The clinic’s walls are decorated with children’s drawings and thank-you cards from customers. The colourful decor with mobiles has been designed with the youngest customers in mind.
Hänninen’s dream job never changed over the years. After completing secondary education, she studied to become a nurse and then a public health nurse.
Now, after over 40 years of working in this profession, she has not regretted her career choice. Her customers at the Paloheinä maternity and child health clinic include families expecting a baby, babies and children up to the age of 6.
Her professional partners include maternity and child health psychologists, dietitians, speech therapists, physiotherapists and doctors.
Hänninen monitors expecting mothers’ stages of pregnancy, supports and monitors the development of children, shares information and guides families on everyday matters in detail, from successful nursing to cooking semolina porridge.
She believes that a key part of her job is the ability to listen. Each clinic appointment has its own programme, whether it is about foetus growth, the family’s wellbeing, monitoring the child’s growth, or vaccinations.
Hänninen emphasises that while the staff needs to take care of the monitoring, they also need to be sensitive and detect the customer’s feelings and thoughts at a given time.
“I feel I’m doing important work and that I’m good at it. I can also relay my long experience to younger public health nurses. I treasure my job,” Hänninen says.
Delightful customers are what make her come to work every day. She gets to know her customers well and becomes particularly familiar with families with multiple children. She may be a part of their life for up to 15 years – or she may even see former children come back as mothers and fathers.
Changes in routines surprise new parents
Many children are living in the Paloheinä district, compared to Helsinki as a whole. There are relatively few immigrant families, but stepfamilies are increasingly common, which is also a prevailing trend elsewhere in Helsinki and Finland.
At Hänninen’s appointments, customers talk about childcare and the stages of pregnancy, but also about relationships and managing time and life.
During Hänninen’s career, the fear of childbirth has become increasingly common, or at least people are talking about it more. Similarly, depression and anxiety are also brought up more often.
Sleeping difficulties, whether among adults, babies or children, cause distress.
“It is wonderful to share the joys of parenting, but today’s parents also face a lot of demands. A public health nurse aims to work together with the parents to find people or resources to alleviate sorrows and concerns.”
Discussions in the media are also a source of concern. Sometimes, people wonder about the possibility of colic, and at other times about acid reflux, tongue-tie or ferritin, which indicates the amount of iron stored in the body.
It is common for new parents to be surprised at how little time they have for themselves once a child is born.
Sometimes, Hänninen notices that parents are trying too hard and trying to include more things in their day than what can be reasonably expected from anyone. A little less would go a long way.
Senior colleagues support young ones
The world has changed, and so has the work description of a public health nurse at a maternity and child health clinic. The work is increasingly demanding, and nurses have more responsibilities.
For example, fathers acknowledge their paternity at the clinic, whereas in the past this was done at the child welfare officer’s. Adopting the new Apotti patient and customer data system has been an undertaking of its own, which the employees have studied in addition to their other tasks.
Medicine and health sciences are developing, and guidelines change based on the latest information.
“You have to take care that you’re following new guidelines. Luckily, regular education is available. Here at Paloheinä, we also have nice and reliable doctors with whom it is easy to work,” Hänninen praises the work community.
She believes that supporting younger professionals entering the field is one of her key tasks. She knows that no matter how high-quality an education you receive, you learn many things through practical work.
“I have agreed with my colleagues that they can and should always ask us veteran nurses for advice and support on unclear questions. It would be a shame if our competence and experience were not used more widely.”
Paloheinä Maternity and Child Health Clinic also has students practising for their future job. Guiding the students takes time, of course, but investing in it is worth it. Once the students graduate, they can become new skilled colleagues.
Never getting tired of children
Hänninen herself has four children and four grandchildren. She says she never gets tired of children and children’s matters.
Neither does she get bored with her work. The tasks are diverse, and before the COVID-19 pandemic, they also included group meetings with families with 6-month-old babies. The meetings will likely resume starting from this autumn, as will on-site family coaching, perhaps.
“We also cooperate with the playgrounds, and we hope we can also resume those activities soon.”
For young people considering the career of a public health nurse, Hänninen says that it is worth seeking out for everyone interested in working with children and parents. The work is diverse and, above all, meaningful.
Mothers and children at the Maitopisara Maternity and Child Health Clinic in Hakaniemenranta, Helsinki, in 1932.
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Experiences in a cellar inspired wide-scale services
The first child health clinic in Finland started operating in the firewood cellar of the Children’s Castle hospital where mothers and babies were served in one large room. There, a doctor and a district nurse, as public health nurses were called back then, examined the children and provided the mothers with childcare instructions.
The clinic was free of charge and open to all. Especially working-class mothers took to visiting the clinic.
At this first child health clinic, courses for mothers were held by Professor Arvo Ylppö. Helsinki was also the first place where circulating baskets for families with babies were distributed – these were the predecessor of the Finnish maternity package.
The results achieved by the clinic were so impressive that the Mannerheim League for Child Welfare established more clinics, first in industrial towns and later in rural municipalities.
Once the children’s clinic activities were underway, the focus shifted to also cover maternity care.
Finland’s first maternity clinics started in Helsinki and Vyborg in 1926.
At the time, the Helsinki maternity clinic operated on Tehtaankatu street in connection with the Women’s Hospital. The clinic received information from the Children’s Castle child health clinic regarding expecting mothers whom the district nurses visited and invited to appointments.
By the Second World War, about thirty maternity and child health clinics had been established. In addition to the clinics, the district nurses also worked for maternity care alongside their other duties. The law obliged midwives to perform preventive maternity care from 1938 onwards.
A municipal service
Gradually, the services of maternity and child health clinics moved under municipal authority. The law on bringing the clinics under municipal ownership was passed in 1944.
The allocation of maternity benefits started even before the Second World War. At the time, the maternity benefit was 450 Finnish marks, which was about a third of an industrial worker’s average monthly salary.
The Finnish maternity package became a unique invention at a global level. Today, Scotland has adopted a similar package, and smaller packages are also being used in England, Mexico and New Zealand.
Sources: the website of the Helsinki Finnish Club about Arvo Ylppö’s life’s work, ylppo.fi; Kela’s research blog post titled ‘Äitiysavustus toi äidit neuvoloihin’.
Original text: Kirsi Riipinen
Photos: Kaisa Sunimento and Helsinki City Museum, Helsinkikuvia.fi/Olof Sundström