Directing the birth
Through your antenatal classes and the information evening with the midwife you will be well prepared for birth. During your check-ups you will also receive all the information you need and you will know exactly when and how you can contact the midwife on duty. It is you who will direct the birth. We will make every effort to cooperate with you to achieve the delivery you would like. Everyone starts labour at home. The midwife always comes to your home to see how things are going. If all is well, you determine during labour where you want to deliver your baby, at home or in hospital. If a risk arises, there is a so-called "medical indication". This means that for medical reasons you have to give birth in hospital, and it is entirely covered by your insurance. The obstetric practice works closely together with the hospitals and obstetricians in Amsterdam. If during the pregnancy or birth there is a medical reason for you to be seen by an obstetrician, the midwife on duty will arrange it for you.
Safety comes first. The safest birth is one during which the least intervention is necessary. Any intervention, whether it's a drip, a vacuum extraction or an anaesthetic, always brings extra risk for both mother and baby. This is why it is important for you to have powerful contractions during the birth. The stronger the contractions, the faster the birth, and the greater your chances of having a smooth delivery without complications. The cervix will dilate smoothly and the contractions will be powerful enough for you to push the baby out under your own strength. A delivery is therefore safest when you have very strong contractions and there is little or no outside intervention needed to bring the baby into the world. The midwife's art is to ensure that during each delivery the woman trusts her instincts and gives free rein to her body. The womb is then able to work flat out, and the cervix can open smoothly. Sometimes women need help to literally open up and let loose their animal instincts. The midwives are entirely focused on helping and supporting women during this process.
The birth of a first baby is always more difficult than subsequent ones. The cervix and the pelvic floor have to stretch for the first time and that doesn't happen without a struggle. The majority of women take a full twenty-four hours to deliver a first baby. A warm bath, making a sound as you breath out, or even a foot massage can help you to go deep inside your body and give yourself up to the pain of the contractions. With each birth the midwife looks afresh to find the right approach to help the delivery progress. Sometimes the woman needs a good cry, which has been waiting to come out. Sometimes acupuncture can help. Sometimes the midwife needs to say close by, but in other situations she needs to go away for a while for the breakthrough to happen. Every woman and every birth is different. With a first delivery, a transfer to hospital is more often necessary than it is with subsequent deliveries. A second birth nearly always goes more smoothly.
Labour pain is severe and it's no picnic. A positive conviction and attitude towards pain helps. It gives you the power to transform normal feelings of fear and uncertainty into ones of challenge and curiosity. At a certain point you start looking forward to the delivery, you go full out and you know you can do it. You take on the challenge actively. You don't let it spoil your mood and you just see how things go. The delivery becomes a challenge to bring your baby into the world as safely as possible, not a measure of your achievement. It might sound crazy, but pain is an aid during delivery. The pain actually contributes to the safety of the birth. It makes the body start producing the essential morphine-like substance endorphin. This hormone reduces the effect of stress hormones. The womb then becomes more receptive to the hormone that causes contractions, oxytocin. As the contractions become stronger a self-reinforcing process is set in motion. It's like a rolling avalanche, and it can only come to a halt when the baby is finally born. Pain is actually the vital link that strengthens the contractions and thus keeps the birth normal and safe. During the birth, oxytocin and endorphins flow as "love hormones' through the placenta to the baby. During the first hours after the birth, for both mother and baby they play a beneficial role as bonding hormones. At no other time are there so many bonding hormones active in the mother and child. The sparks fly and even spread to the new father. His oxytocin level is also higher after the birth.
Pain relief is an option. Every woman has a different pain threshold. During long, difficult births, the pain can be experienced as too severe or unbearable. Sometimes this also happens during a normal birth. In these cases effective pain relief is needed. Women decide themselves when they have reached this point. For women who have had negative sexual experiences in the past, such as incest or abuse during childhood, the pain of labour is sometimes particularly hard to bear. In these cases pain relief is also a solution. Midwives know the important function of labour pain and will therefore try their best to help women cope with it. However, if the pain becomes counterproductive, pain relief is the best option.
If you would like to read more in Dutch about birth, see the book
"Veilig Bevallen" by Beatrijs Smulders and Mariël Croon (Kosmos Z&K).
If you would like to read more in Dutch about pregnancy, see the book
"Veilig Zwanger" by Beatrijs Smulders and Mariël Croon (Kosmos Z&K).
De Genestetstraat 2
1054 AX Amsterdam
The assistent of the midwifes can be reached by phone mo-fri
The midwife on duty can be reached 24/7 in case of labour or emergencies:
020 - 260 1706
020 - 260 1287