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Initial check-up
Around the 8th week of your pregnancy, you will visit us for your first check-up (about 45 minutes). Your partner is very welcome to join you during this check-up (but this is not mandatory). We need more information from you and will ask you questions about your lifestyle and dietary habits, medical history (any surgery, medication, etc.), allergies, the course of any previous pregnancies and your menstrual cycle.
We will also ask about the health of your partner and your family. This will help us to find out if there is an increased medical risk for your child.
We will take your blood pressure and provide you with a form for a blood test. This blood is examined for blood type, Rhesus factor, irregular antibodies, Rubella and for the sexually transmitted diseases of lues (syphilis), hepatitis B and HIV. Your iron levels will also be determined and your glucose levels will be determined if required.
During this first check-up, we will also provide you with information about applying for postnatal care and make an appointment for an initial scan.
Please bring the following to your first visit:
- Results of the blood test (if this has already been done through your GP)
- The details of your health insurer
- Valid proof of identity, such as passport, ID card or a residence permit
- If you have previously attended other midwifery practices for previous pregnancy(s), your pregnancy chart of that pregnancy/those pregnancies
Follow-up visits
During your pregnancy, you will visit us about 10 or 12 times. We like to keep a close eye on you and it's good to get to know each other on a more personal level. The visits take 15 minutes. We will measure your blood pressure during each visit, determine and monitor your uterine growth and your baby's position, and we will listen to your baby's heartbeat together. And we always take time to answer questions and/or explain any complaints you may be experiencing. In addition, during every visit we will discuss different subjects, such as breastfeeding or bottle feeding, weight-gain during pregnancy. We will also plan a comprehensive check-up around 33 weeks to discuss labour and your birthing plan.
Finally, it is good to know that we have concluded a contract with all health insurers and that midwifery and obstetric care is always covered under the Basic Insurance. You do not use your excess for our care!
Also good to know: We have a partnership with the midwifery college course. You may therefore encounter a trainee midwife in our practice.
Pregnancy Declaration
Would you like to apply for a pregnancy declaration? Please complete the form. You will receive the declaration from your midwife.
Antenatal Course
An antenatal course can contribute to a good start to your pregnancy. This could include an information evening or a breastfeeding course. The offer changes regularly. Ask us about what is available.
Nutrition Advice
You probably already know that a healthy lifestyle during pregnancy is very important. You are laying the foundation for your unborn child. The most up-to-date information about nutrition during pregnancy can be found on voedingscentrum.nl (only available in Dutch) and there is a practical app from the Voedingscentrum: ZwangerHap (only available in Dutch).
Childbirth
Labour
Labour usually starts with contractions. But how do you recognise a contraction? Contractions come on slowly, reach a climax and ebb away again. As soon as the contraction is gone, the pain also disappears. Braxton Hicks contractions can also feel like this, but are less intense and more irregular. Take our word for it, when your contractions have truly started, you will feel it in your body and you will know right away.
What happens during contractions?
A lot of important stuff happens during contractions. But why do you need contractions? The sturdy long cervix needs to be softened and shortened before it can open. This takes a long time and is called the latent phase. You will get irregular contractions that are not too painful. With good abdominal breathing, you will be able to manage these contractions effectively. When should you call the midwife?
The midwife can measure your dilation and the active phase begins at about four centimetres. Now you will have to start ‘actively‘ breathing away the contractions. The dilation will now progress about one centimetre per hour. The midwife will keep a close eye on whether it is progressing sufficiently.
From about seven centimetres things usually start happening fast, and you feel the intensity of the contractions all the more. Around this time we will contact the maternity nurse or we will go to the hospital if you have chosen a hospital birth. We leave this quite late because the birth hormone ‘oxytocin’ may decrease due to stress (for example, due to a change of environment).
The last few centimeters of dilation are the hardest. When you are dilated ten centimetres, you can start pushing. Many women experience this as a relief, because you can finally actively do something, and the end is in sight. Still, pushing may take a while. With your first child you can push for a maximum of two hours, with a second child this is one hour.
Everyone is different, just like every delivery is different. The best approach to going into labour is to let it wash over you and wait and see what happens. We, the midwives, will be with you every step of the way to support you and reassure you with our expertise.
Preparation
How to prepare for childbirth:
We recommend making a birthing plan. This contains your wishes and requirements during and immediately after childbirth. For examples, see deverloskundige.nl (Dutch).
Take a preparatory antenatal course
This is definitely advisable with a first delivery. This will help you understand what is happening in your body and what you can do to deal with contractions. For more information, please contact us or ask us during one of your appointments. Make an up-to-date list of phone numbers of people you want to call when labour starts. Put your pregnancy chart in a set place where you can easily find it. Arrange for a babysitter for any older children. Make sure that a number of essentials are ready for before and after labour. A maternity pack from your health insurer will be delivered to your home around 30 weeks of pregnancy. Make sure the maternity pack is at hand.
Get a hospital bag ready!
- ID
- Toiletries for yourself
- A pair of clean socks, 2 sets of underwear, outerwear and underwear for yourself
- A babygrow or a pair of baby trousers and a jumper, socks, hat, blanket and a jacket/cardigan for your child
- Also consider night clothes for your partner
- Camera and/or video camera, charged or with extra batteries!
- Make sure to keep the baby carrier basket with your hospital bag
- A two-euro coin for the wheelchair
A large part of this list is included in your maternity pack.
- 1 mattress protector
- 1 navel clamp
- 15 large sterile gauzes (10×10 cm)
- 10 bed underpads
- 1 pack of large postpartum pads
- 1 pack of nappy inlays
- 1 pair of mesh postpartum underpants
- 1 disinfectant soap (pump)
- 2 packs of small gauze
- 1 bottle of alcohol 70%
- 1 pack of zigzag cotton wool
- 10 washed hydrophilic nappies
- 2 metal hot water bottles and hot water bottle bags
- 2 buckets
- 2 bin bags
- 4 bed risers (or beer crates) for under your bed (borrow from the Thuiszorgwinkel 0800 – 2887766)
- 1 lamp with sufficient light
- 2 digital thermometers, for mother and child
- 1 baby changing pad
- 2 hats for your baby
- 1 pack of Dextro Energy or bottle of energy drink
At home or in the hospital
Do you want to give birth at home or in the hospital (outpatient) in Almere? As long as there is no medical reason for a hospital delivery, the choice is yours. It is important to you choose a place where you feel comfortable.
In the event of a home delivery, the midwife and a maternity nurse will be present. The maternity nurse will assist with labour and will be there to take care of your child. Depending on the maternity centre where you are registered, the maternity nurse will also assist in the event of a hospital delivery. If you have registered with a maternity centre that does not have a partnership with the Flevo Hospital, a nurse from the delivery room will assist us. We will also be your obstetrician in the hospital!
Do check your health insurance policy and keep in mind that your excess applies in the event of an outpatient delivery. If you unexpectedly have a medical delivery, your excess is waived.
Points to consider when giving birth at home
At 32 or 34 weeks of pregnancy, we will discuss this with you extensively. During childbirth, you will be on the first floor (preferably not in the loft). If you have a spiral staircase, the delivery will be on the ground floor. If your BMI is >35, we recommend outpatient delivery. If you really very much prefer to have a home birth, this will be on the ground floor.
For different positions, visit: deverloskundige.nl/bevalhoudingen (Dutch)
When should you call us?
Before 37 weeks of pregnancy you should call us in case of:
- Unexplained abdominal pain or cramps that come at regular intervals
- Blood loss
- Loss of amniotic fluid
- If you feel less or no more movement
- Other urgent or acute complaints and problems
From 37 weeks of pregnancy you should call us in case of:
Contractions
With your first child, you shouldcall us if you are having regular contractions for about an hour, every three to four minutes that last 60 seconds. If you have given birth before, you should call us if you are having contractions every five minutes. Listen to your body and call us when you need us!Water breaking
You should call us immediately (even at night) if your waters break and your amniotic fluid has a green or brown colour! If your waters have broken and the amniotic fluid is clear or a little pink and you do not have contractions every five minutes, you do not have to call us straight away. This means that if it happens at night, you can call us early in the morning (around 9 am). When this happens during the day, you can call us to let us know you're in labour. If your baby's head has not yet engaged during the checks and your water breaks, you should lie down as soon as possible and call us immediately, including at night!Blood loss
If you lose a lot of blood, you should call us right away. By a lot of blood loss we mean a full sanitary pad within 30 minutes. If you can see a slightly pink or slimy secretion (the mucous plug), you do not need to call us. This means that your uterus is preparing for labour, but labour has not yet started. It can start between now and a few weeks.Anxiety
If you're feeling anxious, please feel free to call us. Don't keep your worries to yourself, because that will only increase your anxiety!Pain relief
Let's not beat about the bush here. Giving birth is painful. There is no denying that. Yet many women are able to cope well with the pain! The most important thing is relaxation. This does not work during contractions, but it does in between. Retreat to a quiet, warm place. This can be in bed with a hot water bottle, lying on your side, on your hands and knees, leaning on a chair or table, or in the shower, for example. Deal with the contractions in a way that is comfortable for you and do what feels good for you! Labour comes in phases so that your body gets used to the pain. The female body can deal with an increasing amount of discomfort, and as long as you relax properly between contractions, your natural pain relief, ‘endorphins‘, will work.
Tips for dealing with contractions:
- Heat: hot water bottles, a hot bath or a long hot shower can do wonders. Make sure you have a seat in the shower.
- Massage: have your partner massage your back just above or on your tailbone (this gives relief particularly in case of back contractions).
- Breathing techniques: In the beginning, abdominal breathing is an excellent way to help dilation progress smoothly. You will need to puff more later on.
- Regularly change position, do not lie, stand or sit in the same posture continuously.
Essential for labour:
- Hot water bottle bag
- Dextrose
- Seat for in the shower
- Calming music or something that will make you relax
Tip: Make a birthing plan if you wish. More information can be found at: make a birthing plan
Pain relief
Plenty of women give birth without pain relief. With the above tips, you will come a long way. Still, it's good to know that pain relief is an option. Our advice: first wait and see how labour is progressing, you can always ask for pain relief if you need it.
There are three suitable types of pain relief:
- Pethidine
- Remifentanyl
- Epidural
There are advantages as well as a number of disadvantages to pain relief. Still, you may really need them. In that case, we won't argue with you! If you wish to have pain relief and it is medically possible and responsible, we will do everything we can to provide it for you!
Read more about pain relief here: deverloskundige.nl/pijnbehandeling (Dutch)
Postnatal care
Time to enjoy each other! After your baby is born, we will visit you at home two or three more times during the first eight days to check whether you, your baby and your partner are doing well.
In addition, the maternity nurse will be with you to give you plenty of information and to take on light household chores. In order to closely monitor you and your child, your midwife will work together with the maternity nurse. In Almere there are several maternity centres. Please contact us for further information.
Breast or bottle feeding
You have two choices when it comes to your baby's nutrition: breastfeeding and bottle feeding. We believe breastfeeding provides the best nutrition for your child. However, it is your choice whether to breastfeed or bottle feed and we respect your choice. As midwives, we do think it is important that you are properly informed about the choice of nutrition. You can obtain this essential information by taking a course and reading more information, for example at deverloskundige.nl/voeding-baby (Dutch)
These are some of the places offering a breastfeeding course:
Why do we support breastfeeding? There are many benefits, such as:
- You always have breastmilk with you
- Breastmilk is always at the right temperature
- Breastmilk is free
- Breastmilk contains the right composition that changes with your baby's age
- Breastmilk contains antibodies, which makes your child more resistant and therefore better protected against germs, allergies, cardiovascular diseases and diabetes
If you are unable or unwilling to breastfeed, it is important to have infant formula at home before your baby is born. Make sure it is infant formula for children from zero to six months. It is worth considering giving hypoallergenic formula in case of a risk of cow's milk allergy. There is an increased risk if the mother, father or a previous child suffers from a food allergy, eczema, asthma and/or established hay fever. If you have any questions, please feel free to ask them!
Follow-up visit
You may come back for a follow-up visit after about six to eight weeks after the birth. Even if you have given birth in hospital, you can contact us for this follow-up visit. During this visit, we will catch up and talk about how you are coping with your baby, how you are doing physically and whether your baby has developed well in the first few weeks. You can always contact us with all kinds of questions and we can investigate, for example, your iron levels and how you are recovering physically. In addition, we can inform you about contraception and prescribe or place it.
If you are struggling with motherhood or you often think back to the birth as an unpleasant experience, please come see us for a follow-up visit or make an appointment with Mama Coach Manon. She will definitely be able to help you!