Signe Jansson was a pioneer in the field of Swedish obstetrical care during the 1960s–1980s. She sought to provide a safe, homey birthing environment in hospitals and she advocated a breathing method which reduced the level of pain experienced during childbirth.
Signe Jansson was born in Gothenburg in 1936. She was the first child born to Bertil and Olga Jansson, who were qualified as a doctor and a nurse respectively. Her parents died when she was ten years old. Following her mother’s death she lived with relatives in Eskilstuna. There she graduated from high school in 1955 and two years later she began attending Statens sjuksköterskeskola (the state-run nursing school) in Stockholm. It was during her internship at Allmänna barnbördshuset (an obstetrical ward) that Signe Jansson decided to become a midwife.
Signe Jansson gained her midwifery qualification in 1959 and that same year she began to work at the Karolinska Sjukhuset obstetrical department in Stockholm. There she met Kerstin Uhrus, a gynaecologist and psychiatrist, who ran an experimental unit with a psychosomatic ward for women afraid to give birth. Kerstin Uhrus wrote a letter of recommendation on behalf of Signe Jansson in 1961 which enabled her to visit the French obstetrician, Pierre Vellay, author of Att föda barn utan smärta which had been published that year. During her first visit to Vellay’s clinic Signe Jansson was impressed by the women she saw there ‘breathing out’ their children and giving birth without general anaesthetic. These mothers were able to hold their newborns immediately after giving birth. Upon returning home to Sweden she described what she had seen to her colleagues at Karolinska Sjukhuset, but quickly realised that they were not receptive to her news.
In 1962 Signe Jansson was employed at Malmös allmänna sjukhus (MAS) (general hospital). At that time the hospital’s obstetrical department was old-fashioned and run-down. No prenatal care was offered to pregnant women. In fact MAS did not introduce that kind of care until 1966 and it was the last municipality in Sweden to do so. It was not unusual for two women to undergo the birthing process in the same room at MAS. Signe Jansson worked at that hospital for thirteen years during which time her methodology met professional disagreement. Some of this opposition was related to wider polemics regarding pain-relief during childbirth. Signe Jansson viewed the demands for pain-free birth by giving all women in labour spinal anaesthesia as a step too far. As a result of this debate she was encouraged to begin running courses in psychoprophylaxis and to be present at every birth by a woman who had attended the course. She returned to Pierre Vellay’s clinic in Paris on another study trip. Signe Jansson’s focus on psychoprophylaxis generated severe problems with other midwives at her workplace to the extent that she felt she was being sabotaged.
Nevertheless, throughout Sweden interest in psychoprophylaxis increased and when Signe Jansson was unable to gain a sabbatical in order to hold courses elsewhere she resigned from her post at the women’s clinic in Malmö. She then began to work as the director of the Ystad obstetrical and birthing centre in 1975. She and her son moved to a small farm in Vollsjö. She had been the only person to apply for the post and given the dearth of midwives she was able to demand that the hospital management allow her to work according to her own methodology. That year Signe Jansson organised a study trip for midwives to visit Michel Odent at his obstetrical clinic in Pithivier.
To Signe Jansson it was important that midwives who attended births knew themselves very well and understood that the focus of their work was the mother who was giving birth. Mothers were not to be separated from their babies. This meant that resuscitation stations and other medical instruments had to be available in every labour suite so that a newborn never had to be taken out of the room if complications arose. A spacious environment was incredibly important in supporting the parasympathetic nervous system as well as the birthing woman’s sense of safety in the initial stages. The lighting in the room was accordingly dimmed, the temperature raised to allow the parents to be lightly dressed, a warm, soft colour scheme used, and music and movement was used to encourage relaxation. Pre-ordained breathing patterns were strictly adhered to.
A newly-built obstetrical and maternity centre in Ystad, designed according to Signe Jansson’s concept, was inaugurated in 1984. It was connected to a large, child-friendly day-room. The number of births rose from 400 to 1,200 per annum and the clinic pulled in over two million Swedish kroner from women from neighbouring countries as well as other county councils across Sweden who came there to deliver their children. Signe Jansson finished working at Ystad around this time and then went on to work as a mentor for midwives in places including Lund, Växjö and Värnamo.
Signe Jansson, who had an extensive network of international contacts and was receptive to ideas from a variety of environments, believed that in other countries doctors were increasingly taking over obstetrical care and felt similar trends developing in Sweden. She felt that doctors were not willing to listen to subordinates, which made it difficult for midwives to have their ideas heard. Meanwhile she was very uncomfortable with the way that many midwives and parents who appreciated her methods often placed her on a pedestal: “the mystique which has been created around my person has been both positive and negative for me”.
Signe Jansson and Arne Weiber, a doctor, received a major prize of 100,000 Swedish kroner from Malmöhus county in 1985. The following year, on the occasion of the 100th anniversary of the midwives’ association, Signe Jansson was awarded a prize in the form of a ceramic apple and the tree of life which can now be seen in the entrance to the Ystad maternity unit. In 1990 Signe Jansson gave the inaugural speech at the first midwives’ conference, held in the Sollentuna exhibition centre and hosting participants from all the Scandinavian countries. In 1992 she received the Aftonbladet newspaper’s medical prize, known as the Gunnar Rosell prize, personally presented by Bengt Westerberg, minister for health and social affairs at that time. In addition, Husmodern magazine awarded her a gold heart in recognition of her contributions to life. Her final merit was awarded posthumously when one of the Scanian regional trains was christened with her name in 2010.
During her last summer Signe Jansson asked her friend, Anita Wedin, to accompany her to Havängsbadet just below Ravlunda church. She did not want to be buried in Vollsjö, Sjöbo municipality where she had actively protested against the Sjöbo-faction. Thus, following her death, Signe Jansson’s ashes were placed in an urn in Ravlunda church cemetery.