The midwifery practice

Pregnancy

Fresh flowers, the latest edition of Linda and Happinez and a children’s play stove. Every week, we write all of the names of the mothers who have recently given birth and the names of their babies on the large mirror. And all women are looking forward to finally also see their own names on the mirror. Many pregnant women know each other from the antenatal classes, so checking the mirror is often the first thing women do when they step into the waiting room. Who had their babies this week?

Consulting hours

check-up

While you are pregnant, you will have 10 check-up appointments on average.
Our consulting hours are Monday to Friday from 9:30 to 17:00 and on Tuesday evenings from 18:00 to 21:00. We have consultations by phone from 09:00 to 09:30 from Monday to Friday. If you have an urgent question, you can always reach the on-call midwife via the emergency number.

Consultations by phone
If you have questions about your pregnancy that are not urgent, you can call us every working day from 9:00 – 9:30 at 020-6831640.
For urgent questions, you can always (including weekends) contact the on-call midwife via the emergency number.

Intake
The first time you visit our practice, you will have an intake consultation of about one hour. We find it very important to have enough time to get to know you, and your partner when this is possible. We would like to know what being pregnant means to you, about your health in general, and what your wishes and hopes are for the remainder of your pregnancy. We will also give you information about the various prenatal screenings, should you wish this, about blood screenings and the ultrasound scans, and about how we work and what you can expect from us.

Follow-up appointments
During the 15-minute follow-up appointments, we give information about feeding and daily routines and we will answer your questions. We will give you tips to prevent and reduce potential pregnancy complaints or complications, we check your fitness and blood pressure and, of course, how the baby is growing.

The gynaecologist
In the event of a complication, you will be referred to the gynaecologist or another specialist. In consultation with this specialist, a decision will be made about which care policy should be followed. In many cases, if everything appears to be going well, you will be referred back to us again. Even if you are under the supervision of the gynaecologist for a while, we will stay in touch with you.

Antenatal classes
The Birth Centre tries to offer you everything you need during your pregnancy. An important part of preparing for childbirth is to follow a good pregnancy or antenatal class. That is why we have our own course centre where we work with instructors who reflect our vision. They will provide you with loving and expert support during your pregnancy and prepare you for the birth of your child. We offer a wide range of classes so that every pregnant woman or couple can choose the class that suits them best.

"We are here for you 24/7"

Prenatal tests
Test or no test? The choice is yours.

At the beginning of the pregnancy, you will have a standard blood screening, which is with all pregnant women in the Netherlands. We check your blood type, antibodies against blood types, and infectious diseases

Nowadays, there are a number of additional tests available that can inform you about the health of your unborn child. This means that, as an expectant parent, you have to make a choice: do I want this or not? And if so, which test do I want?

We will explain these tests to you in detail and discuss these choices so you will be able to make a well-informed decision on the choices you have to make. There are no right or wrong decisions. It is our job to help you to make the right decision for you.

If you like, we can discuss the following tests with you, and you can also check the web site on the website ‘prenatal screening‘ which has all the information clearly available.

  1. The NIPT test, a non-invasive test by which, after some of your blood has been taken, the baby’s DNA is filtered out and examined. The test may show if your baby possibly has Down, Edwards or Patau syndrome. Other abnormalities may sometimes also be detected. The blood collection can be done at the Salt laboratorium at the ultrasound centre with the application form given by the midwife. The information brochure about screening for Down’s, Edwards and Patau syndromes is available in several languages on the RIVM website.
  2. The 13-week-scan, is a medical ultrasound and is part of an official national population survey (IMITAS studie). It is offered to all pregnant women who are under the care of a midwife or gynaecologist. With the ultrasound we will examine the baby for any physical abnormalities. The 13 week scan is very similar to the 20 week scan. A brochure can be found at the rivm website in various languages.
  3. During the 20-week scan, your baby will be checked from head to toe. We will check for any indication of physical abnormalities to the major organs as well as the size of your child, the position of the placenta, and the amount of amniotic fluid. This medical scan is also done at our own ultrasound centre. A brochure about the 20-week scan can be found in various languages on the RIVM website.

Ultrasounds
Ultrasound scans are not compulsory but we know that most pregnant women like to have a scan at some moment(s) during their pregnancy. We make the ultrasound scan at our own ultrasound centre in Amsterdam: Echo Amsterdam. Highly qualified, experienced and friendly sonographers take the time to thoroughly examine your baby on high-quality ultrasound devices.

Echo Amsterdam has the most extensive opening hours in the city: you can visit us seven days and three nights for your ultrasounds
Health insurance companies cover at least three ultrasound scans: the due date scan, the 13-week-scan and the 20-week scan. In addition, all additional scan carried out at the request of the midwives, for instance when we have doubts about the growth or position of your baby, are also be covered by your health insurer.

Many pregnant women like to see their baby at an earlier stage in their pregnancy. For example, to see if it is a boy or girl (as of 14 weeks), and/or later on in the pregnancy to have a comprehensive 3D scan. All pregnant women are free to have as many scans as they wish, however, health care insurers do not reimburse such scans so will be at your own expense. The rates of the various scan can be found on the Echo Amsterdam website.

"Safety comes first and this is ensured by our many years of experience"

Alcohol, smoking, drugs, and medication

More information about smoking, alcohol and drugs: see the folder on the midwife’s website or the Trimbos Institute.

Alcohol

A question that is frequently asked during the intake interview: I still drank alcohol before I knew I was pregnant, could it do any harm? It is best to also avoid alcohol during the period of conception. However, there is no direct blood contact between mother and foetus during the first few weeks of the pregnancy, so the alcohol cannot reach the baby. This means that there is no harm done until the time of your missed period.

Unfortunately, the same cannot be said for the rest of the pregnancy. Alcohol has a very adverse effect on the development of your baby. The alcohol level in your own blood is almost equal to that of the baby’s, and the baby needs 24 hours to process one glass of alcohol. To stop drinking is really the only safe option for your baby. Luckily, there are enough non-alcoholic alternatives these days for the times that you don’t feel like fruit juice or mineral water.

Our favourites are: ginger beer (with or without sparkling water), non-alcoholic beer, crodino, ginger ale with some mint and lemon or (home-made) elderflower syrup with still or sparkling water!

For more information: the FAS (foetal alcohol syndrome) foundation

Smoking

Smoking when pregnant causes the blood vessels in the placenta to contract and this reduces the flows of oxygen and nutrition to the baby. As hard as it is: to quit smoking is the best you can do for your baby. Ask your partner and other people to support you. Ask them not to smoke in your environment and we can help you as well. We can support you with a programme that has great results for those who want to quit smoking.

More information about the effects of smoking.

Stop smoking app: https://www.ikstopnu.nl/stop-methode/apps/

Drugs

If you used drugs during (early) pregnancy, it is important to discuss this with us. Together we will look at the best possible care. We may choose to do a more extensive ultrasound at 20 weeks. Drugs can have serious consequences for the development of the baby and cause other complications during pregnancy. One of them is an increased risk of premature birth.

More information.

Medication

When you are or want to become pregnant and you are taking medication, then you need to discuss this with your GP or specialist as soon as possible. During the intake interview, we will also assess whether your medication can be used safely during your pregnancy. If this is not the case, then your specialist or GP will need to adjust your medication.

Fortunately, for many complaints and ailments (such as headache, heartburn, constipation) there are also medications that can be used safely. We will advise you about these when this is necessary.

Pregnant? Is everything taken care of?

Acknowledgement of paternity (12-24 weeks)

Acknowledgement of paternity is only important for couples who are not married (and have no registered partnership).

Quite early in the pregnancy, preferably before 24 weeks, you and the father need to go to the municipal district office of the area you live in. You also need to bring your identity papers. By acknowledging paternity, the father confirms that the child is his. This does not automatically mean that he will have custody of the baby. This can only be arranged after the baby has been born.

At the time of the acknowledgement of paternity, you can also determine the baby’s surname.

Maternity Care (12 - 18 weeks)

We recommend that you register for maternity care anywhere between 10 and 18 weeks. A good maternity nurse is of great value in the first week after the birth of your baby. Birth Centre Amsterdam also has its own maternity services. We know our maternity nurses well, which enables us to jointly give you and your baby the best possible care. Naturally, you may also choose a different maternity care provider.

Antenatal classes (around 20 - 22 weeks)

So many women, so many different types of classes given by our own course centre. We recommend that all women follow an antenatal class. Also when you are pregnant with your second child because it just feels really good to take some time and an hour of relaxation per week for this baby as well. During the antenatal class, you will learn many things about being pregnant and childbirth. You will also meet other young mothers who will have a child of the same age as your own child. This sometimes results in friendships for life!

We recommend that you register for a class around the 20th week.

22-week vaccination whooping cough

As of 16 December 2019, the 22-week vaccination against whooping cough is offered to pregnant women free of charge by the Dutch National Immunisation Programme. Vaccination during pregnancy protects women and their babies until they are three months old.

You can get the vaccination in Amsterdam, during a walk-in clinic at the Child health clinic of the Birth Centre. At thursdays from 15.00-16.30. See also for other locations and opening hours of the walk-in clinics in each neighbourhood.

Parental leave

All pregnant women in the Netherlands, whether they are self-employed or working on an employment contract are entitled to 16 weeks of maternity leave. Most women go on leave at week 34 (or at week 36) and go back to work 12 weeks after childbirth.

After 12 weeks of pregnancy, you need to show your employer the pregnancy statement that we will give you to let them know that you are pregnant. They will process your leave request. As a self-employed person, you can request this via the UWV.

Childcare

It is wise to think carefully about how you want to organise the childcare when you resume your work. There are several options: you can arrange this within your own family, you can opt for a private childminder, or for a nursery. It is important to arrange for these last two options early on in your pregnancy as there are often waiting lists in Amsterdam.

What do you need at home (from 37 weeks)

You will need to have certain things ready at home to ensure a good childbirth and maternity period. Whether you plan to have a home birth or hospital birth, it is recommended that you have certain things organised and ready at home around the 37th week. You can download the list here.

Checklist pregnancy

Discomforts
One woman sails through her pregnancy without any complaints, another is weighed down by multiple pregnancy-related symptoms. These problems can make your pregnancy pretty challenging and some women confide in us when they wonder: ‘what have I let myself in for?’.

Fortunately, things are not that bad for most women. Generally, a little bit of perspective and humour go a long way, apart from the obvious end result; the baby who usually puts an end to all complaints straight away.

Pelvic pains

What causes them?
Even at an early stage in pregnancy, the hormone progesterone causes weakening of the pelvis. The three bones that form your pelvis start to be less firmly attached. This is necessary to provide more space for the baby during childbirth.

 

What can I do about them?

  • Try to make symmetrical movements as much as possible. Smaller steps, keeping the pelvis straight. Additionally, avoid sitting cross-legged.
  • Discuss your complaint with us as we can give tips and, when necessary, refer you to our Mensendieck therapist or manual therapist who can work miracles with pelvic complaints.
  • Firmly wrap a scarf or band around your pelvis.
  • Tips for various postures during pregnancy: the Rost Moves Mamas app.

Heartburn

What causes it?
Heartburn usually develops when the baby is larger and kicks or pushes against the stomach with its head or bottom. Add a more relaxed oesophageal sphincter, which is meant to seal the oesophagus from gastric acid, and the heartburn problem starts.

 

What can I do about it?

  • It may help to eat smaller portions of food more frequently to avoid filling up the stomach too much.
  • Try to eat less seasoned or less acid food for a while.
  • Try to identify what makes your heartburn worse and delete this from your diet.
  • Taking a Rennie, Gaviscon, or another antacid every now and then is not a problem. It is better to have a good night’s sleep with a tablet then stressing all night due to heartburn.

Sleeping problems

What causes it?
Sleeping problems are often caused by various ailments; back pain, heartburn, worrying. On the other hand, sleeping less soundly be lying awake for hours sometimes is also a preparation for time to come: interrupted sleep will become the norm because your baby needs feeding during the night as well. In a way, your body is already in training.

 

What can I do about it?

  • First you need to assess whether you start the night in a relaxed way. Are there things that you worry about or need to take care of? Avoid using your smartphone late in the evenings.
  • The most important tip we can give you is to accept it and not to stress about it during the night. You will notice that you still feel fit after just a few hours of sleep. Perhaps you can take an afternoon nap. Try to repeat this mantra: ‘I’m comfortable, warm and safe, I will rest well’.
  • Stressful or gloomy thoughts and worries tend to pop up at night because you no longer produce endorphins. It might help to tell yourself this: there is nothing wrong, I’m just running low on endorphins now. The world will look so much brighter again in the morning.
  • Above all, make yourself comfortable. (see also: the rost moves mamas app)

Constipation

Hoe kom ik eraan?
Ook hier is weer het hormoon progesteron de boosdoener. Die zorgt ervoor dat je darmen trager samenknijpen en dus voor obstipatie.

 

What can I do about it?

  • Drink plenty of fluids: 2 litres per day
  • Eat plenty of fibres: 2 pieces of fruit and 250 grams of vegetables per day
  • Take your time when you go to the toilet and slightly elevate your feet. This helps the muscle at the base of your intestines to relax which makes it easier to pass the stool. You could even buy a ‘squatty potty‘.

Haemorrhoids

What causes them?
Haemorrhoids are often caused by too much pressure during defaecation. During pregnancy, stools tend to be harder and your tissue structure is weakened by progesterone. This combination makes it easy for haemorrhoids to develop.

 

What can I do about them?
You can apply the same tips for haemorrhoids as for constipation.

  • Curanol, a haemorrhoid ointment, can offer some relief.
  • Haemorrhoids usually shrink away during the few weeks after delivery. Always contact your GP if you experience serious complaints.

Varicose veins

What causes them?
The cause for these is also progesterone. The weakening effect of this hormone is, unfortunately, not limited to your pelvis; the walls of your blood vessels may also succumb to this. Combined with the increased pressure in your legs from the baby in your belly can cause your veins to lose their shape, resulting in varicose veins.

 

What can I do about them?

  • Try to lie down for half an hour, every now and then, with your legs up; this is good for your veins, the pelvic floor, and the baby.
  • Elevate your legs in the evenings.
  • If you need to stand for long periods, for example in the queue at the supermarket, you can walk on the spot; the leg muscles pump the blood upwards, thus reducing the pressure in the blood vessels.
  • You can also be measured for support stockings. You can discuss this with your midwife.

Nausea

What causes it?
Nausea mainly occurs during the first and final stages of pregnancy. In the first stage, it is caused by the hormone HCG. At a later stage, it is mainly caused when the stomach finds it difficult to empty itself due to the size of the baby.

 

What can I do about it?

  • A light breakfast in bed can sometimes help
  • Eat small portions during the day
  • Try to eat some more ginger or drink ginger tea.
  • Take it easy, get enough rest. Women who work too hard or experience much stress, often suffer more from nausea than women who lead a quieter life.
  • If you vomit frequently, discuss this with us so we can see what we can do for you. Sometimes medication via the GP will help.

Mood swings or sadness

What causes it?
Being pregnant and having a child is a huge event in a woman’s life. There are also many hormonal changes happening in your body. Some women are more affected by this than others. It is not uncommon for pregnant women to feel down, irritable, anxious, and/or stressed.

 

What can I do about it?

  • Talk about it with people you trust.
  • Talk about it with us.
  • Know that you are not alone in this.
  • Take your time and get sufficient rest.
  • Consider a course in mindfulness or mindfulness in pregnancy. This has proven to be effective when you feel sad or anxious.
  • If you feel that you need extra help, feel free to discuss this with us. We also have positive experiences with:

Fatigue

What causes it?
Especially at the beginning of the pregnancy, you can feel extremely tired. It may feel as if every cell in your body is tired and you even wake up tired after a good night’s sleep. This is caused by the enormous changes taking place in your body. Your body is screaming for rest and relaxation.

At the end of the pregnancy, often after about 25 weeks, you may experience another period of fatigue. But this time it feels different: as if you are dragging a heavy backpack with you all day. Exhausting!

What can I do about it?

  • Allow yourself plenty of rest.
  • Have a lie down in the middle of the day; this is very good for your body and for your baby.
  • Take a nap whenever possible and don’t feel embarrassed about it; it is the strong women who dare to take good care of themselves.
  • Take a day off from work every now and then. Let others play Superwoman while you take good care of yourself and your child.

Ligament pain

What causes it?
Your uterus is attached by ligaments. As the uterus grows, these ligament stretch, and you can feel it! Especially with sudden movements and sneezing or coughing, you may feel a sharp sting in your right or left lower abdomen.

What can I do about it?

  • Turn over carefully in bed, holding your belly if necessary.
  • Turn onto your side before sneezing or coughing.
  • Heat can help, such as a heat pack, hot water bottle, or relaxing in a hot bath.
  • If you have a lot of ligament pain, please let us know. Sometimes, a referral to a pelvic therapist can help.

Incontinence

What causes it?
That same progesterone again! In this case, it weakens the muscles that hold the urine in the bladder. The result: you can lose some urine when you cough, sneeze, run, jump, or just spontaneously.

What can I do about it?

  • Well, try not to cough, sneeze, run or jump. If you really need to, squeeze your pelvic floor muscles tightly. You can do this by pulling your vagina inwards to your belly.
  • Exercise your pelvic floor muscles. When doing this, learning to relax the muscles properly is just as important as tightening them. If you find this difficult, ask us for advice.
  • Sometimes you may need just a little more help or information. If so, we recommend that you meet up with Meike Wouda, instructor at ‘fysiomom’ and ‘mom in balance’. She is sure to know a few good exercises. Or you can have a consultation at the physiotherapy studio or with Marianne Voet, a pelvic floor specialist at Da Costa physio, to get more informed.
  • Online tips:
    Apps: Pelvic floor (Bekkenbodem) app
    Instagram: fysiomom, sterkher

Midwife on call in case of any emergency and / or pending birth

team Rood 020 2601706

team Geel 020 2601287