Children Sweden's top priority

BBC medical correspondent Fergus Walsh has been to Sweden which has the lowest level of child mortality in the world.

In delivery suite number 11 at the Karolinska University hospital, Asa Andersson is in the middle of labour, her husband Per at her side along with a highly trained midwife. At quarter to midnight, Asa gives birth to a healthy baby boy. Everything went well. But had there been complications doctors and a fully equipped operating theatre were just down the corridor.

This is childbirth in Sweden, the safest place in the world to be born - fewer children die here under the age of five than in any other country.

For Sweden, the figure is three deaths per 1,000 children, compared to six per 1,000 in the UK, and 270 per 1,000 in Sierra Leone, which has the highest child mortality rate in the world.

I was also present at a Caesarean delivery, just as I had been in Sierra Leone only days before.

Expert staff

In Sierra Leone the operating theatre was almost bare: there were no monitors to check the mother's vital signs and just one doctor.

In Stockholm there were two specialist obstetricians, a paediatrician on standby and an anaesthetist.

Add to that a wealth of monitoring equipment and it's easy to see why childbirth in Sweden is so much safer.

Premature birth

One in 17,400 mothers die in childbirth, compared to one in eight in Sierra Leone and one in 8,200 in the UK.

If an infant is premature then it can be taken to the neonatal care unit where there are two staff to every cot.

Sweden has one of the best staffed health services in the world.

It has 320 doctors per 100,000 people compared to two doctors per 100,000 people in Sierra Leone. The UK has 230 doctors per 100,000 population. I visited Louisa and Matias Verner and their son Gasper. Gasper had been born three months premature weighing just 830g.

Now he was nearly 2500g and in a few days, the family would be going home. The family room was attached to the special care unit, and Gasper was monitored in his cot.

The parents both had beds and had been living at the hospital throughout. Matias told me that he was having paid time off work because his son was sick - his paternal paid leave would not start until Gasper went home.

Both parents praised the medical staff and said a team of more than a dozen had been on hand when Gasper was born. "They not only looked after our son, they cared for us too," Matias said.

All-round care

So what are the factors which set Sweden apart from other developed countries in terms of child safety?

Medical staff at the hospital told me that the quality of ante-natal and post-natal care was very high.

Almost 100% of mothers give birth in hospital - home births are not encouraged. The maternity units are large and modern. But it is about more than just buildings and staff. It has something to do with Swedish society and the way parents and small children are given the highest priority.

Take for example, parental leave.

Swedish parents get 480 days off after the birth of a child. Most of it is on 80% of normal pay, but many employers top that up to 90%.

Each parent must take 60 days, but how they divide the remaining 360 is up to them. And the time off is valid until the child is eight years old.

I went back to see Asa and Par the day after their son was born. They had been transferred to a family post-natal room (again with beds for mother and father) and Asa was cradling their son, Viktor in her arms.

Subsidised nurseries

Asa told me she would take the first few months off: "I'll be breast feeding, which obviously Per can't help with, but after seven months then he will step in and take some time off.

"One of us will be at home for around 18 months".

Per added: "It's very important to be there when he is young, so that he has a role model. I'd miss a lot if I wasn't there."

When Viktor is around 18 months old he'll go into one of the many state-subsidised nurseries.

The fees are capped, to make them affordable to everyone.

One of the senior obstetricians at the Karolinska University Hospital said there was something special about Sweden which made it a great place for families: "Swedish society is very cohesive and there isn't a huge gap between rich and poor.

"Society has given a lot of support for parents for decades."

I went to the Ekens BVC child health clinic in Stockholm to see some new parents being given a talk on safety in the home.

Whilst there I met Anthony Hill, his wife Lena and their son Finlay, who was there for his MMR jab.

'Easy for parents'

Anthony is British and used to live in London. The family have been in Sweden for four years and now have two young children.

"Everything is easy here for parents," Anthony said.

"My brother has two children in England and there's a huge contrast between the ordered, logical system here regarding immunisations and child health checks and the one in Britain, where no-one seems to know what is happening.

"My brother got about 10 days off when his children were born.

"Here you get to share a year and a half.

"People in England can't believe it when I tell them.

"You often see men with pushchairs in the street and it's common for fathers to take six months off."

After having three children myself in the UK, I looked with admiration and a little envy at the lot of fathers in Sweden.

I have no doubt that many employers find it an incredible burden having to do without staff for months on end.

But as a parent, Sweden seems the perfect place to have children.

BBC

Carla Bruni reveals she has not wed Nicolas Sarkozy

Carla Bruni has ended speculation that she has secretly wed Nicolas Sarkozy, the French President, by telling a French newspaper that the couple are not married - yet.

The Italian supermodel-turned-musician also used the interview with Liberation, a leftwing publication, to put protocol-conscious bureaucrats in Delhi out of their misery by confirming that she will not be accompanying Mr Sarkozy on his official state visit to India in three days' time.

Yesterday Indian officials revealed that they were agonising over whether to treat her as a First Lady, a "First Girlfriend", a simple spouse, a member of the presidential delegation or just as a private visitor.

The answer could determine where she sat at official banquets, whether she was admitted to meetings with the Indian Prime Minister and President, and whether her name should be mentioned in speeches. "It's a little confusing," one Indian official told The Times.

French officials have stoked the tension for weeks by refusing to comment on whether Ms Bruni would accompany the President and in what capacity.

There has been speculation in the Indian media that Mr Sarkozy, 52, and Ms Bruni, 40, might even be intending to announce their engagement during a private visit to the Taj Mahal, the white marble monument to love.

"Sarkozy has put his hosts in a spot. If he were bringing his wife, she would have been given the highest honour. The girlfriend cannot get the same status," Tarun Vijay, the editor of the Panchjanya weekly paper for the Hindu community, said yesterday in an interview with the Calcutta Telegraph.

"This is something unusual and embarrassing, not just for the Indian Government but also for the French. The occasion his coming here for is a very serious one. It is definitely not going to be amusing for the host country."

Today Ms Bruni put them out of their misery, telling Liberation: "I cannot take part in an official trip with the President." The couple were not yet married, she said, although "it is in our plans".

Ms Bruni said that her recording commitments on her third album meant that she could not go away in February and in any case, the couple "hadn't really planned" that she should go to India.

"Also for health reasons it's not good," she added, perhaps referring to the gruelling round of social engagements involved in such trips.

Ms Bruni did not accompany Mr Sarkozy on a recent trip to Saudi Arabia, after a senior Saudi official urged him to respect the country's conservative Islamic culture. The President's public enthusiasm for his relationship with Ms Bruni, a famous beauty, has captured acres of space in gossip columns around the world since the couple were photographed hand in hand in Egypt last month.

Mr Sarkozy has seemed at times to court publicity, by teasing journalists that when he married Ms Bruni they would learn about it after the event.

"It's serious," said the President, who was widely reported to be lovestruck. His second marriage, to Cecilia Ciganer, ended in divorce in October.

L'Est Republicain newspaper even went so far last week as to report that Mr Sarkozy had probably already wed Ms Bruni at a small, private ceremony in the Elysee Palace, the official Paris residence of French presidents.

The coverage, and Mr Sarkozy's disregard for the French tradition of drawing a discreet veil over the president's private life, has caused his previously buoyant popularity ratings at home to dip. Yesterday it emerged that Francois Fillon, the Prime Minister once derided as "colourless" by Sarko loyalists, is now more popular with the French electorate than his boss.

Times on line, UK