Delivering

After a long period of physical and mental growth, a pregnant woman is ready to give birth and the baby is big enough and ready to be born. Most deliveries take place between 37 and 42 weeks pregnant, which is between three weeks before and two weeks after the estimated due date. An average pregnancy lasts 280 days, which is the same as 40 weeks or nine months. Each delivery is different and requires a different approach. We will help you to create a situation that suits your wishes.

If you give birth between 37 and 42 weeks pregnant, we will assist you during your delivery. We will do so at the location of your choice: at home or in the hospital. You can choose between the HMC Westeinde or HAGA hospital (the delivery rooms in the HMC Bronovo are closed per 15th of June 2019) We will also assist you during a water birth. If your baby is born before 37 weeks or after 42 weeks pregnant, the gynecologists at the hospital will assist you during your delivery.

If there are no complications during your pregnancy and you want to have a home birth, we will come to your home when you are in labor. As far as we are concerned, you can even choose where you want to give birth when you are already in labor. If you want to give birth in the hospital we will help you decide what the best time is for you to go to that location.

Pre-labour

Women often experience a hard stomach in the last weeks of their pregnancy. Sometimes they also have short, painful contractions. This is perfectly normal; this is called ‘false labor’. These contractions help soften and shorten the cervix. You are not yet in labor.

Active labour

Good, strong contractions are the main prerequisite for an easy and uncomplicated delivery. Three hormones play a key role in those contractions:

  • Adrenaline; your body produces adrenaline when you are stressed, anxious, or cold. This hormone suppresses the contractions.
  • Oxytocin; stimulates contractions, causes the muscle of the uterus to contract.
  • Endorphin; is a kind of morphine that alleviates pain.

For more information on how to stimulate the production of the right hormones, please read the information below (under the title ‘Pain’).

Pushing

When you are almost fully dilated, you will feel the urge to push. This sensation is caused by the fact that the head of the baby has descended and is now pushing against your rectum. This feels as if you urgently have to go to the bathroom. The baby is slowly being pushed out of the uterus. Many women experience this stage of labor as very intense. The reflex of the uterus is to contract strongly; it feels as if your body is taking over control. Try to welcome the urge to push – strong contractions that urge you to push often lead to a quick delivery. If you are having your first baby, this stage can take 1 to 2 hours. If you’ve given birth before, the baby can arrive as soon as 5 to 30 minutes.

During labor, we will check whether you and the baby are doing well. We will monitor the progress of the delivery closely, and we will listen to the baby’s heartbeat regularly.

After you have given birth to a healthy baby, you will have time to admire and hold your baby. Giving birth is always an intense and emotional experience. That is why we prefer to interfere as little as possible. The baby will not be dressed right away and will stay close to you, in the arms of his or her mother or father. This is a great time for you to recover and to enjoy the baby. Only in case of a medical necessity, we will interfere and do follow-up tests on you or the baby.

We determine the Apgar score in the first ten minutes after birth. The Apgar score tells us whether your baby is healthy. We will also weigh the baby and do a physical examination. With your approval, the baby will be given 1 mg of vitamin K.

If you plan on breastfeeding the baby, you should give the baby time to find the nipple and to latch on. Research has shown that babies that are given enough time to find the nipple have less trouble latching on. You can find more information about breastfeeding on the section of our website called ‘breastfeeding‘.

The placenta should be delivered within one hour after the delivery of your baby. This usually happens within 10 to 15 minutes. We will monitor the amount of blood that you lose after the delivery. If you need sutures, we will give you anaesthetics.

Safety and confidence

Feeling confident and secure has a positive influence on the pregnancy, and is the best preparation for the delivery. To gain self-confidence, it is important to decide beforehand where and how you want to give birth, and how you want to prepare for the delivery. Our job is to assist you in this process. If you want to document your wishes, we can help you to make a birth plan.

A delivery without any medical interventions poses the least risks for mother and child. We will do everything we can to stimulate the natural course of childbirth. We will assist you during the dilation and pushing stages, and we will monitor the progress of your delivery. You can choose in which position you want to give birth. Should any complications arise, we will call a gynaecologist. After the delivery, we will stay with you for a couple of hours to make sure everything is alright.

Pain

Everyone knows that giving birth causes pain. The big question for each pregnant woman is: how will I experience the pain; will I be able to cope with the pain? This uncertainty can cause concern and anxiety. Dreading the pain is a normal reaction. As you reach your due date, your desire for the baby to be born will become stronger and, ultimately, conquer your anxiety.

We will discuss labor pain during your checkups and the information meetings. We will discuss what a good preparation for the delivery would be for you. Some women have a lot of questions, read a lot of books about pregnancy and attend antenatal classes. Other women turn inwards and do not want to be overwhelmed with information. We will always respect your wishes. Both attitudes are fine. In short, everything is allowed; nothing is required of you.

If you want to have epidurals, we will support you for 100 percent and we will take the necessary precautions. For further information about all kinds of pain relief, see also www.bevallingspijn.nl.

If you want some form of pain relief, we will support you 100 percent and we will make the necessary preparations. You can find information about the different types of pain relief on: www.bevallingspijn.nl (in Dutch) or https://www.nhs.uk/conditions/pregnancy-and-baby/pain-relief-labour/ (in English).

Which birth posture suits you?

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Birth postures

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General tips for coping with the pain

Pain is different for each individual, but here are some general tips on how to cope with labor pain and how to stimulate the production of hormones that contribute to an easy delivery.

  • Make sure you give birth in a safe place. Let people know in advance that you want them to be present during the delivery.
  • This safe place may be at your own home or in the hospital.
  • Try to always keep in mind that, however painful they might be, contractions lead to the birth of your child. This helps to keep your spirits up.
  • Do not fight the pain, but try to accept it.
  • Contractions last about a minute, followed by a break during which you can relax. Try to focus on that.
  • Do not be distracted by people or an atmosphere that bothers you. Let people know what bothers you.
  • Focus on yourself and do not be distracted, try to find inner peace.
  • Let people know what you want and need and what makes you feel comfortable.
  • If you are anxious or worried, talk about your fears.
  • Make sure to keep your body warm.
  • Hot water – taking a shower or a bath – may help to cope with the contractions.
  • A massage of the lower back, a hot shower or a bath can alleviate the pain.
  • Try to find a position that helps you to cope with the contractions. Keep moving.

Coping with the contractions with help of the TENS machine

The midwife on call always brings along a TENS machine to help you cope with the contractions. The TENS machine alleviates the pain caused by the contractions. Small electrical pulses are transmitted to the body that inhibit the pain caused by the contractions. The pulses also stimulate the production of endorphin. Endorphin, produced by every woman during the delivery, is a natural painkiller. You can change the pulse rate during the delivery, depending on the severity of the pain. If you want to use our TENS machine, you can order the electrodes on the website https://www.geboortetens.nl/. The electrodes cost 15 Euro, including shipping costs. The use of our TENS machine is free.

You can also rent or buy the TENS machine yourself. Some insurance policies partially or completely cover the costs of the TENS machine. Please contact your health insurance company for more information.

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