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Croatian, Za vise informacija na hrvatskom jeziku, molimo kontaktirajte Tamaru, tamara@homeinleiden.nl

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PREGNANCY AND BIRTH

  1. Intro
  2. Midwife practices in Leiden
  3. Homebirth or Hospital birth?
  4. Pregnancy
  5. Homebirth
    P reparing for a homebirth
    The Kraamzorg
    Having a homebirth
  6. Hospital birth
  7. The 'Kraamperiode'
 

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Homebirth

Preparing for a homebirth

Depending on your insurance, you may get sent a 'kraampakket', which contains all the things you need for a homebirth, such as absorbent pads etc. If you are not eligible to receive one free, you will need to buy these things. When you register with the kraamzorg they will send you a list of things that you need. You can buy a complete 'kraampakket' in any chemist , Etos or in the Thuiszorgwinkel. You will also need to think about where you want to give birth: in a tiny bedroom up a steep flight of stairs is a bit impractical, for instance. I had mine on a single bed put up in our sitting room, which was extremely practical and made it all a lot easier. It is imperative that there is running water on the same level as where you are giving birth. It is also much better if there is a loo, as walking to the loo whilst having contractions is a big deal! The kraamzorg will be able to advise you on what modifications to make: for instance, it is important that the room is well lit (a desk lamp can be brought in if necessary). You will also need to raise up your bed (and this is true even if you are planning a hospital birth): you can hire special things to put under the legs at the thuiszorgwinkel (see below for locations):

  • Van Vollenhovenkade 75
    Tel: 0800 - 288 77 66 (free)
    Mon-Fri 9.00-17.30, Sat 9.00-16.00

  • Simon Smitweg 10
    2353 GA Leiderdorp
    Tel: 0800 288 77 66 (free)
    Mon-Fri 9.00- 17.30, Sat 9.00-16.00

You will also need to hire a bedpan for the placenta (not a pleasant thought, but very useful) and it's worthwhile buying a plastic sheet to protect the mattress on which you sleep for when your waters break, although this may be in your kraampakket.You can also hire a weighing scale for the baby, which is very useful, and make absolutely sure you have at least one functioning digital thermometer. Stock up on spare sheets, old towels, old nightwear to give birth in and some nice nightwear to change into. It's also a good plan to buy lots of very cheap pants (from Bristol or Wibra for instance) in a large size that you can just throw away, or you can get disposable underpants from Prenatal, although I found them a bit uncomfortable. Two tennis balls in a sock may come in handy during labour (sounds insane, but see the section on Having a homebirth).

Do remember to pack a hospital bag just in case, and to have a list of numbers always to hand with the midwife, kraamzorg, someone to look after other children etc.

Also, make sure you have a 'first outfit' picked out for your baby, as the kraamzorg will dress him/her and you unless you've chosen it they will do so. Somehow this matters, I found!

It's also sensible to have a list of numbers to hand in the last weeks with the midwife, kraamzorg, friends or relatives who are prepared to help etc. I had one on each floor of our house!

The Kraamzorg

picture Kraamzorg

Who they are

The Kraamzorg are one of the best things about giving birth in the Netherlands . Basically, they are carers - not trained nurses, but qualified and experienced in caring for newborns and new mothers. They are in my experience wonderful people: sensible, calming, efficient and most of all extremely comforting in that amazing but terrifying first week with a newborn. It somehow doesn't matter how bad the night has been if you know that at 9am a lovely motherly person is going to arrive on your doorstep and look after you! They are present at homebirths to provide practical (rather than medical) care - although they were too late for both my births, in fact - and then come every day for between 5 and 8 hours for the next 7 days. If you give birth in hospital, they will come once you are at home, every day up to a week after the birth date. This means that if for instance you have a caesarean and stay in hospital for a couple of days, you will have fewer kraamzorg days. Some companies offer care until 8pm in the evening, which means that if you give birth in hospital during the day, you don't necessarily have to stay the night, but can return home to find the kraamzorg waiting to look after you.

What do they do?

A kraamverzorgster (maternity carer) comes to your house for a period of a week to look after you and your baby and to teach you and your partner how to care for your newborn. It is state subsidized, but there is also an hourly rate to be paid by you ( eigen bijdrage ) of € 3.50 per hour. If you have an extensive insurance package, this will also be paid for. You can have a minimum of 24 hours of care and a maximum of 80 hours, spread out over a maximum of 10 days. I had, and found perfect, 9am to 1pm for a week. You need to check with the company you choose and with your insurance for exactly what they offer and to what you are entitled. One thing they will ask you is whether you want mornings or afternoons - I strongly recommend mornings as it is a wonderful comforting start to the day!

The kraamverzorgster is there to take care of you and the baby. Primarily, she will do things such as wash you in bed or help your shower, change your bed, help you bath your baby, take both yours and your baby's temperature, and help you with breastfeeding. She will also encourage and teach your partner how to bath/dress etc your baby - which is really great and allows you to learn together. If the kraamverzorgster is concerned about anything, she will call in the midwife.

She is also responsible for the cleaning the loo and the washing facilities that you use (i.e. your bath/shower): she is not responsible for cleaning the whole house! Some of them are happy to do ironing/washing/some other cleaning - some are not: it seems to depend on the individual. The kraamverzorgster will prepare your breakfast/lunch (although do be aware that this means bread with hagelslag and a cheese sandwich, which I must say wasn't really my idea of postpartum deliciousness) and will open the door, make tea and beschuit met muisjes for, and judiciously kick out any visitors. She is not responsible for looking after any older children, so although it's ok for them to be around some of the time, it's a good idea to have friends/babysitter/grandma at the ready to give you some time to rest and get to know your baby without a toddler jumping on your head. She will keep a record of your baby's first week in the kraamdossier , of every feed and every pee and poo (of the baby, that is). I found this record immensely comforting, especially the little 'Mama and baby are doing really well' comments.

It is a good idea to ring the kraamzorg company of your choice straight after your first midwife appointment, or somewhere between the 10 th and 13 th week of pregnancy. Depending on your insurance, you either register directly with your kraamzorg of choice or this is done via your insurance. Once you have registered they will send you written confirmation, and this means that you are guaranteed kraamzorg care. During the 7 th month of pregnancy they will make contact with you to arrange an 'intakegesprek'. If this is your first baby in this country this appointment will take place in your home; otherwise over the telephone. Do be prepared to ring them if they haven't got in contact and you are concerned. At this appointment they will ask you various questions regarding other children, pets, where in the house you plan to give birth etc, and will answer any practical questions you have.

Some Kraamzorg companies operate over a large area, but try and use kraamverzorgsters that live fairly locally to you. Not all have a Leiden office, but the companies that operate in Leiden are:

  • Take Good Care Kraamzorg
    Nieuwenhuizenweg 3
    2314 XP Leiden
    Tel: Registration line: 0900 7311111
    Other: 071 3051502
    Wwebsite: www.takegoodcare.nl
    E-email: kraamzorg.leiden@takegoodcare.nl

  • De Waarden
    Noordwijk
    Tel: 071 - 364 - 0070
    Email: info@kraamzorg.org

  • Kraamzorgburo - Gloria kraamzorg
    Phone:06 - 4663 - 5053
    Ask for Marianne van Trivum, who has excellent English and has worked as an aupair in London.
    Tel: 06 - 1080 - 5751

  • Particura Kraamzorg/De Kraamvogel ,
    Havikshorst 122
    2317 AM Leiden
    Tel: Registration line: 0900 5151575
    Other: 071 3051502
    Wwebsite: www.dekraamvogel.nl
    E-email: info@dekraamvogel.nl

  • Yunio Kraamzorg,
    Kernstraat 2
    2313 EV Leiden
    Tel: 0900 - 98 64 24hrs
    Wwebsite: www.yunio.nl
    E-email: info@yunio.nl

  • Aby Care Kraamzorg
    Lau Mazirelstraat 12
    2331 CM Leiden
    Tel: 06 54202203

  • Kraamzorg Wereldwonder
    Lange Lombardstraat 35
    2512 VP Den Haag
    Tel. : 070-3052040
    Fax. : 070-3052048
    Email : kraamzorg@wereld-wonder.nl

Having a homebirth

Calling the midwife

By 37 weeks, you should have a well prepared house,, with an accessible well-lit bed on blocks in a warm room, plenty of towels, sheets, and the kraampakket, as well as somewhere to put your baby (Moses basket or pram top), all prepared. I had the bed ready behind the sofa to be brought out when I went into labour. The midwife will also need a flat surface to prepare her equipment: an ironing board is a handy stow-away solution. Your midwife will have told you which number to ring and when: for instance, if you go into labour before 37 weeks or your waters break and they are brown/green, you always ring the emergency number immediately. Normally, you ring the midwife when your waters break or if you start having regular contractions: if this happens during the night, unless the waters are green or brown you can wait until 8am. If it happens during the day, you can ring straight away. Usually, if it's during the day, the midwife will come round when she can to see how you're coping and to check that everything is ready. If you have had/are having contractions, she will check to see how dilated you are. She will then leave (no, she doesn't stay with you for the whole labour!). You are responsible for ringing her again when you feel you need her, although she will give you an idea of when she will be coming back anyway. For a first baby, you always ring the emergency number when your contractions have been three minutes apart and lasting 60 seconds for an hour. It's worth having paper and pencil ready so your birth partner can easily keep a record of this. Of course, if you are worried or feel you need her, you can always ring the midwife earlier, although she may not be able to come immediately.. For a second baby, you are likely to have an idea of when your contractions are really going somewhere, and you ring the midwife at this point: officially here this is when the contractions have been 5 minutes apart and lasting 60 seconds for the past hour, but you may have a good idea of the sort of progress you made in your last birth to help you. You will need to ring the kraamzorg agency to say that you have gone into labour, so that they know to expect a call, and then you ring them again (or your partner does!) when your contractions are 3 minutes apart and lasting 1 minute (or when instructed to by the midwife. She may in fact call the kraamzorg for you, depending on the situation). Once the midwife feels that things are progressing towards labour, she will stay with you. You and she and your partner(s) will then work as a team to deliver the baby.

Coping with birth

Homebirth is perfectly doable for anyone with a complication-free pregnancy and history - giving birth without artificial pain relief is after all what women have been doing for millennia. You don't need to have a high pain threshold or be tough, fit, or self-controlled. Your body gives off the most fantastic drugs on its own, and the sheer exhilaration and pride of having done this in tune with your body is brilliant. There are lots of wonderful books about homebirth and it's great to read up on the subject: it's way beyond the scope of this website to deal exhaustively with the situation. My personal top tips are:

  • Prepare for the unexpected. It's hard to know how you will feel, so write a birth plan but be prepared to change your mind. It's the one time when you can do exactly what you want. It's your house, so make the most of it! Stock up with the sort of food you think you might feel like (cartons of juice are very handy, for instance, as are Dextro Energy tablets, packets of soup, bars of chocolate, ice lollies), and if you suddenly feel like a shower, or a cup of tea, or being alone for a bit: do so! Don't feel you have to live up to anyone's expectations, and don't feel you have to give birth in the position you planned... I was convinced I was going to be on all fours and terribly active, and in fact ended up very comfortable lying on my back.
  • Work as a team. Try to see the birth as something that you and your birth partner(s) are doing together. If you are visualizing, for instance, get them to help you. I visualized a beach and the waves going up on every in breath and down on every out breath. My poor birth partners had to keep going 'see the waaaaves. uuuup the beeeeach..dowwwwwwn the beach' at me whenever Istarted to lose concentration. It really helped! It has rather put them off beach holidays, I'm afraid. Also, looking into your birth partner's eyes while breathing is really reassuring and helps you stay on track. Do make sure you concentrate on the out breath, otherwise you end up with too much CO² and you start tingling.
  • Use different positions around the room to get through contractions. Leaning against a wall shifting weight from one foot to the other, on all fours on a cushion with your bum in the air, leaning on the side of your bed/sofa - whatever works for you. If you have contractions in your back, two tennis balls in a sock placed in the small of your back and then leant against on a wall can be very helpful. If you have contractions in your thighs (as I did, weirdly), then getting your birth partner to massage your thigh with baby oil helps. You can also use a birthing ball (these can either be bought or hired (ask your midwife), or a TENS machine. See www.tensbevalling.nl.

When your baby is born, the midwife will hand him/her to you while the placenta is delivered. (this is where the bedpan comes in handy). She will ask you or your partner if you would like to cut the cord. She will then check the baby's APGAR score and weigh him/her and dry him/her if need be. If this is your second or subsequent birth I strongly recommend taking a paracetamol now as the afterpains are extremely painful as the uterus contracts. If this is not happening properly, and bleeding continues longer than she likes, the midwife will give you a syntocinon shot to help the process. If you have had this problem before, this can be done pre-emptively immediately after the delivery of the placenta. Do ask for it if you know that this is the case.

Your baby will then be given to your partner(s) to hold while the midwife checks you and if necessary sews up any tears. This is done with local anaesthetic and while extremely uncomfortable isn't actually as bad as it sounds. The midwives are extremely skilled, experienced and sympathetic, and do an extremely good job.

Your midwife and/or kraamzorg will help you to put your baby on the breast, and generally get you comfortable and cleaned up. The midwife will leave once she is satisfied that you and the baby are comfortable. If it is the middle of the night the kraamzorg will leave once all is in order, otherwise she will stay a bit longer.

An important tradition in the Netherlands is the eating of 'beschuit met muisjes' (round toasts with little sugar aniseed balls in pink or blue) to celebrate the birth of a baby. Don't be surprised if your kraamverzorgster starts asking where they are! Aniseed is traditionally used to help stimulate the mother's milk. Personally, I detest aniseed, but if you would like to fully enter into the tradition you should stock up beforehand.

 

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