Sleep

Three days before Henrik was born in late February, an article appeared in Norway’s Aftenposten newspaper; the headline read Norsk uskikk at spedbarn skal sove ute. The Norwegian bad habit that newborns should sleep outside.

It was a well-timed article, as I was well aware of the Norwegian, or perhaps more accurately the Scandinavian habit (as an article with similar theme appeared on the BBC around that same time about babies in Sweden) of babies taking their daily naps outside in their strollers, no matter what the weather.

Outside? you ask. But isn't it cold in Norway, like, 11 and a half months out of the year? 

Why yes, it is, but that doesn't seem to stop anyone. In fact, there are written recommendations from pediatric health offices stating that it is acceptable for babies to sleep outside until it is -10C (or 14F)!

Napping out in a stroller, bundled up in layers of wool and downy sleeping bags, is one of the few Norwegian habits that Greta did not adapt particularly well to upon our move here when she was 2. 5 years old and she began at the barnehage. It was too different and she was too curious—she kept peeking out of the stroller to see what the other kids were doing. Greta was a Champion Napper until this point, and we felt like had really gotten the nap thing nailed first time around. Naturally, I was both a little resistant and, I admit, defensive, against the thought of having to a) adjust my parenting habits which had served us quite well with baby #1 and b) make me and my baby somehow more “Norwegian”.

Uhh, Emily? you say. There is no one forcing you to have Henrik sleep outside. The worst that could happen is that the Norwegian Nap Police won't come and award you with Integrated Foreign Mother of the Year, right? 

True, but. . . that's a really cool award! Seriously, though. . .  once Henrik begins barnehage, which he will likely do around one year of age, he will be taking his naps outside in his stroller with all the other one-year olds. So, there is an incentive to train him to sleep outside now when he is young, otherwise it could be difficult once he is older. We had even bought a new stroller for baby #2 that could better accommodate a napping child because we knew this child would be napping outdoors.

But appearance of this article just days before Henrik’s birth only added to my mixed feelings on the subject, and also justified some of my resistance. The article quoted a number of Norwegian parents and barnehage employees who talk about how healthy it is and how soundly babies sleep outside. “It has never occurred to me that it was anything other than healthy than to sleep outside,” said one mother. “The fresh air is healthy. And she likes her stroller,” said another.

But apparently a number of utenlandsk  (foreign) parents are asking the doctors and barnehage leaders why it is so healthy to sleep outside, and in this article Norwegian pediatric leaders are admitting, yeah. . . we actually don’t have any studies proving this is more healthy than sleeping indoors. One doctor in particular was “very skeptical” that babies should sleep out, especially in the cold. “I think it’s an odd Norwegian habit, or actually bad habit, that infants should sleep outside, even in the winter.” He continues and says he gave a talk in Buenos Aires several years ago and told that a “certain percent” of Norwegian SIDS deaths happen while the babies sleep in their stollers in the winter.

While alarming, this did not come as a surprise to me, and in fact confirmed a concern that I have had, as Norwegians are very fond of piling puffy dyner – down comforters—on and around their sleeping infants in the stroller, very much against all the anti-SIDS recommendations we have in the US. It is not uncommon to see babies buried under a thick down comforter even in the middle of the summer. Unfortunately, the article did not pursue this point at all, which I found very frustrating, since the SIDS rate is something that I have wondered about.  Instead the doctor continued that the bad habit must be a kind of misdirected belief in “hardening” or toughening up the babies by breathing in cold air, but that there really isn’t any research or studies to back up any of these long-held beliefs.

One barnehage leader was questioned by a foreign parent about the whys of outside naps, she responded that there is less danger for spreading infection between the children when they are all sleeping outside (again—not documented or studied, just a “belief”). But a belief that I can see some truth in. Interestingly enough, the sleeping outside habit is so well institutionalized in Norwegian culture that there probably aren’t any barnehages that could accommodate all of their infant and toddlers sleeping inside—the barnehages are simply not built with that need in mind.

When Henrik was about 6 weeks old in the beginning of April and the weather was still in the 30s F, I attended a postpartum group at the health center. The group was lead by a helsesøster—kind of a pediatric community health nurse—to answer questions we might have. I had taken Henrik out on walks in his buggy, having dutifully dressed him in a layer of wool long underwear and bundled inside a baby sleeping bag, and he did seem to sleep quite well. I had occasionally let him finish off a nap on our porch if we finished a walk and he was still sleeping, but quite nervously. But I had not grown comfortable with the idea intentionally putting him outside to sleep, so I finally asked, “Soooo. . . I’m not Norwegian. (eyebrows raise around the room, curious looks abound). I’m not used to having my baby sleep outside in the cold. Or when it’s warm! I never dressed my daughter in wool until she was nearly 3 years old. What do you dress your baby in when it’s outside? How do you know it’s warm enough?”

And at first, they seemed rather surprised: where does your baby nap if not in its stroller? What do you dress them in if not wool? Seriously! And not surprisingly, the answers were basically what I expected: dress them in wool (ahh Norwegians and their love of wool) and the sound advice of check to see if they are warm. Duh. The helsesøster laughed,  “Did that help?” she asked. Not exactly, but at least I felt like I wasn’t doing anything wrong.

So, don’t leave me in suspense, you say. Where does Henrik take his naps?

As the weather warmed this spring, I became more comfortable with leaving him on our porch in his buggy after a walk and allowing him to finish off a nap, with a baby monitor in the side pocket, within full view of my kitchen and living room window, and safely in our back yard. It wasn’t until about 6 weeks ago, in a moment of this-kid-won’t-stay-asleep-and-he’s-driving-me-crazy frustration, that I tossed him into his buggy where he laid calmly and quietly awake for half an hour, then put himself to sleep and proceeded to sleep for another hour and a half. Later that afternoon, I started his nap in the buggy. He slept for 3 hours.

He’s been sleeping outside ever since.

Now that's customer service

I am not alone in saying that Norway is not exactly known for its customer service. Norwegians themselves even admit this. No local grocery store offers to bag your groceries and certainly would never offer a very pregnant woman if they could help her push a heavy grocery cart through the icy, snowy, uneven parking lot or even lift her heavy bags into the cart. Ask me: never happened. Nor does a cashier even bother to push the button to assemble my groceries in a smaller pile at the end of the grocery conveyer belt when I have a small infant strapped to my chest, making it nearly impossible to stretch across the counter and grab those few remaining items that are out of reach. The cashiers instead sit and stare, or better yet, get up and walk away.

So I was shocked to see the following parking sign at the Norwegian Outlet mall that we stopped at on our recent trip to Sweden.

Special designated parking spots for families with young children! How novel! How helpful! How very customer friendly!

But the Norwegian Outlet malls took customer service to a level that I have not even seen in America.

They have special designated parking spots for their headless, wheelchair bound customers.

Now that's customer service.

Yeah, Norway!

America's Newest Citizen

 Much to the surprise of many, Henrik is not granted Norwegian citizenship just because he was born in Norway. Norway does not have Jus soli (italics used to highlight Latin and not Norwegian this time, and meaning right of birthplace) unlike the United States. He is, however, an American citizen, due to Jus Sanguinis (right of blood), since Erik and I are American citizens. But, since he wasn't born in the United States, the actual documentation of  his American citizenship was not a straightforward case.

We had to apply for a "consular report of birth abroad" through the American Embassy in Oslo, along with an application for his American passport (necessarily to travel with, even for an infant), and his American social security number. This required that Erik and I make a trip together--along with Henrik, and of course, Greta--to the Embassy in Oslo to apply for these in person, along with a stack of supporting documentation proving Erik and I are who we say we are: our own birth certificates, original marriage certificate, 5+ years of school records (proving we actually lived in the United States), Henrik's Norwegian birth certificate, our own passports (along with Greta's passport, simply so she could enter the Embassy along with us), and the three separate applications for the birth abroad certificate, social security and passport. And then pay about $200.

But for all of this to happen we first had to have Henrik's Norwegian birth certificate in our hands. We applied for this online a few weeks after he was born. On the website, we had to fill in his first, middle and last name. These names must be on a list of approved names, and if it's not, you must apply for the name and explain your reasons for choosing this name. My Norwegian friend Karianne said that her name--40 years ago--was not on the list! This is something that perhaps the United States should consider, in order to stop people from naming their kids Lemonjello, Se7en, and Neveah Legna (Heaven Angel backwards). Don't get me started on stupid people picking stupid baby names. Oh wait, you already did. . .

So, interestingly enough, Henrik's middle name "David" was rejected as a "middle" name. In Norway, many people have two first names: Tor Kristian, Jon Gunnar, Mette Marit, Ann Kristin, and they use both names in everyday life. But what we consider to be the space for a "middle" name in the United States, is reserved for a last name--like the mother's maiden name--if the parents aren't doing the hyphenated last name thing. So, you could have, for example Tor Kristian Sandvik Hammarshaug. Or, Tor Kristian Sandvik Hammarshaug-Lien if the parents are hyphenating their names. Confusing, perhaps. But as a result, when we got Henrik's Norwegian birth certificate, it read that his first name is Henrik David with no middle name.

No biggie.

The birth certificate itself, however. . . . I'm sorry Norway, but it really made me laugh. It is perhaps the most unimpressive, unofficial-looking official document I have ever seen. It looked as if it was printed on regular printer paper, black and white, no raised ink seal, no watermark, no fancy flowery edging, just a single blue ink stamp at the bottom. I emailed an American friend of mine who has given birth to two babies in Norway, expressing my amusement over this underwhelming official document, and she responded that she had printed more official looking birth certificates from the internet for her cat's kittens than what Norway gives their kids.

Thankfully, the US pulled through when it came to providing us with an official looking document. Henrik's Consular Report of Birth Abroad certificate arrived in the mail last week, and a more over the top document it could not be. The contrast between the two certificates only make the situation more absurd: fancy watermarked paper with italics and impressive fonts, shiny raised gold seals, a shimmery 3D stripe of colorful stars (not kidding), eagles and tendrils and even the Declaration of Independence.

God Bless America. Our boy is officially American.

Will I ever write again???

Maybe, maybe not. . .

I've written some really great blog entries at 4am, while I'm awake and nursing Henrik. Too bad you can't read them, as they are only written in my head.

Many of my favorite "ex-pat" bloggers seem to have fallen off the wagon as well and months are going by without updates from them, so I know I'm not alone in struggling to sit down and pound out an entry for my loyal readers. I'd love to tell you my experiences with maternity care in Norway (mostly good, but sparten), my stabs at meeting other new Norwegian mothers and finding my BNFF (Best Norwegian Friend Forever (have chickened out a few times), my 5 year-old daughter whittling with a knife--an activity endorsed by her daycare, a 5-year old birthday party hosted by Pippi Longstocking, and my personal internal struggles over the sleep habits of babies in Norway, including that of my own newborn son (involving napping in a stroller outside). And other funny, light-hearted blog entries about garbage and recycling, the graduating high school students who dress up in red overalls every May, paint color choices for Norwegian homes, and the ubiquitousness of black station wagons. All of these you will some day get to read about, if only I had the time. . .


But, when I sit down to write, I never know if I'm going to have ten minutes or two hours, depending on the still unpredictable napping habits of one young Henrik. And my To Do list includes sorting through boxes of toddler girl clothes that I will now no longer need to hold on to, calling a Serbian nurse who is getting his decision from SAFH over-turned--but in the wrong way, doing my American taxes (yes, I know it's now April 24th), finishing Henrik's baby blanket, and, last but not least, sewing a pair of bunad bukser (Norway's national costume pants) for my dear friend's son, in time for Norway's national holiday on the 17th of May. And, I'll throw in for good measure, my average day includes being the sole source of nourishment for a small human being 24 hours a day, occasionally putting together an evening meal for my family, special laundry loads of poop-stained wool baby clothes, transporting to and from barnehage and also, last but not least, letting the dog in and out of the house TWENTY GAZILLION TIMES BEFORE NOON AND WIPING HER SANDY MUDDY FEET EVERY SINGLE TIME! (But honestly, who can fault her? It's springtime in Norway, and who doesn't want to be outside, soaking up the sunshine, only to realize 10 minutes later that it's really not as warm out as it looks. Even with a fur coat.)

On that note, goodnight. It's 10pm and someone will likely soon be crying out for a little boob time.

Introducing. . .

We were blessed with the arrival of a healthy baby boy on the 23rd of February, just two days before my own birthday. Henrik David weighed in at 3.93 kilograms (8lbs 10oz) and 51cm (20in) long.

Labor was a relatively short and intense experience, as we arrived at the hospital around 8:30pm and Henrik entered the world at 11:23pm. It was a textbook labor and birth, and an even better recovery, leaving this midwife/mom quite relieved and pleased with the whole experience.

Erik had two weeks free from his job after the birth (thank you Norway!) and my mom is now visiting for two weeks. Greta stortrives (is thriving) and is a flink (capable) and stolt (proud) storesøster (big sister). It is all we can do to keep her from smothering him with kisses. 

Once we establish a more regular sleeping/nap schedule, I'll make an attempt at writing all the "maternity care in Norway" blog entries that I promised back in November. Until then. . .

Velkommen hjem Henrik!

Hope is waning and FAQs

I really should have learned my lesson by now, it's been taught to me enough: don't get my hopes up. I admit, I did finally allow myself to get hopeful after meeting with two nursing figures two weeks ago. One all but promised me we would get this straightened out within weeks; her conviction and fearlessness and simple interest and passion in our case--something we haven't gotten from anyone outside our own four walls at home--won us over. I had hope again.

We spoke with her last evening, after she had a meeting with a higher-up in the authorization office, and she admitted she now has a better understanding of what we are up against, namely Norwegian bureaucracy and Norwegian laws, and that sheer determination mixed with a little piss and vinegar isn't enough to break down those walls. There are official roads that we must take, and none of them are quick. Or easy (but c'mon. . . who was expecting quick and easy after 28 months?). Our two options at this point are essentially using a sivilombudsman (kind of a civil court of judges) to review the case and/or hiring an attorney.

Fun huh?

Did I mention that I am now 3 days away from my due date of our second child, and the thought of filing a law suit to fight for the right to work in this country has me (oh, what adjective captures my feelings) . . . a combination of disgusted, infuriated and exhausted. I'm sure the Finns have a word for it.

I thought I'd take a few minutes and address some of the questions and suggestions (all well-intentioned, of course) that I've received over the last few months about what-exactly-is-the-problem??? (And then maybe I'll stop writing about this for a while, because it's really becoming a way-too common theme of this blog, and I think I'm boring my readers!).

FAQ:

What exactly do the Norwegian authorities feel is not good enough in your nursing education?
It essentially boils down to how Europe and the US count credit hours. To put it generally, in Norway--and Europe--the number of hours spent both in and outside of class is included in the grand total of credit hours. In the US, our credit hours reflect the number of "contact hours" that students spend in-class, with the assumption that for every credit hour in class a student is spending 2-3 hours outside of class in preparation, research, projects, group work, etc.

This is a well-documented fact. There are several references that give guidance on how to convert American to European credits. My advisors and chair department heads at my bachelors and masters degree institutions explained this in depth. A Norwegian college dean compared her nursing program to mine and declared that my degree had more hours than the Norwegian program. My two degrees have been approved by NOKUT (the Norwegian Agency for Quality Assurance in Education), which recognizes foreign higher education degrees.

All of this was ignored and not acknowledged by the authorization board and the health professionals appeal board.

Can't you just take a test or something? 
Norway actually does not have a national nursing exam that all newly educated nurses must pass in order to be licensed. Unlike the "nursing boards" in the United States, of which every newly graduated nursing student must take in order to become a Registered Nurse.

So, no. There is no test for me to take.

Is this happening to other American nurses?
Yes and No.

This is where the handling of these cases becomes completely arbitrary and inconsistent.

Most foreign applicants (from outside of the European Union) for nursing authorization in Norway are required to complete 8+ weeks of clinical time in various areas of nursing training. This most often is in the areas of psychiatry or on a medical/surgical unit.

It seemed that around the time of my decision from the appeals board (in May 2012) that the authorization board was getting more strict with its decisions regarding American nursing educations, but then I met two American-educated nurses while I took the national nursing course in November. Both of them had been approved by the authorization board--one without a single extra requirement, and with only verbal complaints via telephone, and nothing through the formal channels.

It is this inconsistency and arbitrary treatment that is infuriating.

You know, Norwegian nurses have the same problem getting a license in the United States. . . 
This may be true. But to be honest, this is not the issue at hand. We're talking about inconsistent, arbitrary and poorly researched treatment of American nurses in Norway, and not vice versa.

Can't you just reapply, just send in all your papers again to a different case manager?
This was suggested time and time again to me by my fellow students in the national nursing course.

No. I can't just reapply, and pretend that I haven't been the biggest pain in their ass over the last two years. According to Norwegian law, I have gone through the all of the appropriate legal channels--two written appeals with the authorization board, one appeal with the health professionals appeals board--and now my case is considered completely closed.

Can't someone at a college/university evaluate your transcripts and education and say which classes you would have to take to get a Norwegian nursing degree?
Funny you should suggest that. . . because we have done that, and a dean at a local college that offers a nursing program has evaluated my transcripts and work experience and has deemed that my education looks whole and complete and that her nursing program can't offer me a single thing.

Additionally, a college can't just hand me a degree and say "you seem to have done enough work". I need to take at least one years of courses (out of three) before I can be granted a degree.

Hope

Months have sped by, and my motivation to blog through the after-effects of my nursing course, Christmas preparations, two solid months of work, growing a baby and general day-to-day life busyness has been minimal. 

But I do owe you a few updates. . . 

The last real development in my quest for nursing/midwifery authorization was in late November, when a few members of Parliament spoke out in my behalf. But the buzz and momentum fizzled a bit after that, due to a combination of more pressing healthcare and other political events (hard to believe, I know) and Christmas break. 

I cannot be terribly specific in describing with whom we've been consulting, but after months and months of emails and phone calls and referrals from one person to another, we've eventually nailed down a few players in higher-up nursing/midwifery circles who are supportive, understanding, disgusted, and began working "undercover," so to speak. Many feel that they cannot officially come out and support me publicly, which has been a bit frustrating. It was also suggested that we form a Facebook "support group" where people can officially and publicly voice their support and let it be known to SAK (the artists formerly known as SAFH, the Norwegian authroization office for health professionals) that we ain't goin' away. Two who have supported the group include the local county/regional office of the Norsk Sykepleierforbund (the Norwegian nursing association/union) who is calling for SAK to reevaluate my application, based on the evaluation done by the local college research dean who judged that my bachelor's degree nursing education and work experience equaled (and exceeded) what her educational institution could offer me as a new nursing student. Also supporting the group is the member of Parliament who initially spoke out on my behalf. You can find the support group here: Støttegruppe for Emily Stange. 

Since then, Erik (and Greta) and I traveled to Oslo this past week, armed with binders of documents and correspondence, and met with the member of Parliament to discuss possible courses of action. We also met with two other powerful nursing figures who seem to have more connections than the Queen herself. For example, when we mentioned that we had been in contact with (names have been changed for the time being. . . ) Kari Nordmann, former head of a midwife organization, who cannot understand the reasoning behind SAK denying my midwife application, one of our two powerful nursing figures said, "Oh yes, she's my best friend. I'm having lunch with her next week. We'll contact this other Powerful Nursing Figure and get this straightened out." 

I have not allowed my hopes to get raised at all in the past few months, as they have tended to get dashed shortly thereafter. But even I will admit that these were very positive meetings with tremendous potential and--dare I say it outloud--I do have some hope for the first time in a very, very long time.