I am pregnant, what now?

You (and your partner, if applicable) are expecting a baby – congratulations! Whether you have just taken a pregnancy test or have been thinking about this news for a while, you will probably have a lot of questions. Don’t worry, in the 9-month plan you will find everything you can expect in the coming months. We give tips on how to stay fit and healthy, so that you can enjoy this special time to the fullest.

Obstetric care in the Netherlands

In the Netherlands, pregnancy is seen as a healthy, natural condition. That is why you are under the care of a midwife during a normal, healthy pregnancy. If necessary, for example if complications arise, the care is taken over by a gynaecologist in the hospital.

Midwives work independently, outside the hospital, so that healthy pregnant women do not unnecessarily end up in the medical circuit. You can usually just go to a midwife in your area. Are there multiple practices in your area? Then you have the freedom to choose yourself.

Think carefully about which practice suits you. Do you need a personal approach, or a more business-like approach? Do you feel more comfortable with a small, intimate practice, or would you prefer a larger one? The most important thing is that you feel comfortable with your midwife – after all, it is an exciting and special time in your life.

The midwife supports you:

During your pregnancy

As soon as you discover that you are pregnant, the first step is to call a midwife. There is usually one nearby, and contact is often very accessible. During your pregnancy, you will visit an average of 10 times for check-ups. As you get further along in your pregnancy, the appointments become more frequent.

The first appointment with your midwife, the intake, often takes the longest. During this appointment, you will discuss your health, any previous pregnancies and your expectations in detail. In the following blogs, you can read more about what you can expect during this intake.

During the follow-up appointments, the midwife will keep a close eye on how you and the baby are doing. She will measure your blood pressure, perform blood tests, check the baby’s growth and listen to the heartbeat. Ultrasounds are also performed regularly. At Onder de Linde, this is done at the practice itself.

In addition to the medical checks, there is also a lot of attention for questions and mental support. For example, at Onder de Linde, in addition to the individual consultations, we also offer a Centering Pregnancy program in which pregnant women can share stories and ask questions to pregnant women who are in the same phase of pregnancy. In addition to the regular appointments and sessions, our midwives are also available 24/7 for emergencies.

During childbirth

During your pregnancy, you can discuss with your midwife where you would prefer to give birth: at home, in the hospital or in a birthing center. This gives you the freedom to choose a place where you feel most comfortable. You can also discuss with your midwife how you want to give birth. By discussing your wishes and preferences in advance, your midwife knows exactly what is important to you during labor.

With a healthy pregnancy, you will be guided during labor by your own midwifery team. They will keep a close eye on the process and support you both medically and emotionally. If a complication occurs during labor, medical assistance may be required, such as a gynaecologist. In that case, care will be taken over by the hospital staff.

In your maternity period

The moment you have been looking forward to: the birth of your baby! For many (new) parents, this is an exciting and special time. Fortunately, the care of the midwife does not stop after the birth. In the first 10 days, the midwife remains available day and night, if you have any questions or if something unexpected happens.

In addition, you will also receive help from a maternity nurse, who usually comes to your home for a few hours every day. She will support you in caring for the baby and monitor the health of both you and your baby. She will also help you, if you are breastfeeding, with tips and support in starting up if this is a bit difficult.

The midwife will usually visit your home 2 to 3 times during the maternity week to check how you and your baby are doing. She will monitor your recovery and keep in touch with the maternity nurse, so that you can be sure that everything is going well and that you do not have to worry about anything.

For the follow-up check

Six weeks after the birth, you will return to the practice for the follow-up check. Where possible, we will schedule this appointment with the midwife who was also present at the birth. It is a great opportunity to see each other again, ask questions about the birth and discuss how parenthood is going so far.

If you have participated in Centering Pregnancy, we will officially conclude the care with a final joint meeting: the follow-up day. This usually takes place around six weeks after the birth and offers a great opportunity to share your experiences with the other mothers.

The importance of healthy food

For the proper development of your child, it is important that you eat healthy and varied food, especially in the first weeks of your pregnancy. This is the period in which your baby’s organs and central nervous system develop. It is of course also important that you stay fit and healthy yourself. We have a number of tips for you:

Tip 1: Eat healthy and varied

Make sure you eat enough vegetables, fruit, whole grain products, proteins and healthy fats every day. A balanced diet provides the vitamins and minerals that you and your child need. Therefore, vary with different types of vegetables, legumes, lean proteins (such as chicken or tofu) and healthy fats from, for example, avocados and nuts.

Tip 2: Take folic acid

Folic acid (vitamin B11) is essential during early pregnancy as it helps develop your baby’s neural tube, from which the brain and spinal cord develop. It is recommended that you start taking 400 micrograms of folic acid per day before pregnancy and continue to do so until the tenth week of pregnancy.

Tip 3: Eat fish regularly

Oily fish, such as salmon, mackerel and herring, contain Omega-3 fatty acids that are important for the development of your child’s brain and eyes. It is recommended to eat fish twice a week, of which one should be oily fish. Note: avoid eating predatory fish, such as tuna and swordfish. These contain higher concentrations of heavy metals, such as mercury. . Do you not eat fish? Then you can take Omega-3 supplements that are suitable for pregnant women.

Tip 4: Take vitamin D

Vitamin D is necessary for the absorption of calcium, which is important for building strong bones for you and your baby. It is recommended to take 10 micrograms of vitamin D daily throughout your pregnancy, in addition to the vitamin D that you get from food and sunlight.

What to avoid

During pregnancy, there are a number of foods that you should avoid to prevent risks for you and your baby. This will be discussed in detail during the intake interview, but here are a few important points to consider:

The first appointment with the midwife: the intake

The first appointment at Onder de Linde, the intake, is coming up. During this appointment you will receive a lot of information and good preparation helps to get the most out of this conversation. In this second part of the 9-month plan you can read what you can expect from the intake.

Did you know that you can also have an early ultrasound with us? This ultrasound often takes place around the 7th to 8th week of pregnancy and can sometimes be scheduled before the intake interview.

In this part of the 9-month plan you can read about:

• The questions you can expect during the intake, such as about your medical history
• The checks and examinations that we perform
• The early ultrasound
• Information about prenatal tests

Your first appointment: the intake

You are now between 6 and 10 weeks pregnant and so the intake is on the program. For many expectant parents, this is the first meeting with the midwife and an important part of the 9-month plan. After your registration, you will receive a link to an intake questionnaire at Onder de Linde. Fill this in at home and send it back to us before the intake interview.

The intake interview

The intake interview can be extra exciting during your first pregnancy, which is why we take plenty of time for it. The appointment lasts about 45 to 60 minutes and prepares you for what you can expect in the coming months.

During the intake interview, we discuss a wide range of topics. For example, we talk about your wishes and those of your partner, we provide information about medical examinations and ultrasounds, and we answer all your questions. Some important topics that we discuss during the intake interview are:

Medical history

The midwife wants to get to know you and your partner well. A large part of the intake is therefore the medical history, also called anamnesis. Questions are asked about your general health and possible congenital abnormalities. Together with the midwife, you discuss whether there are diseases in your (or your partner’s) family that could affect your pregnancy.

 

Checks and tests

During the intake, we also perform a number of medical tests. For example, we measure your blood pressure, calculate your BMI and sometimes take blood at the same time. The following data are checked in the blood of all pregnant women in the Netherlands: blood group, rhesus D and C factor, lues (syphilis), HIV and hepatitis B. We also check the iron content in your blood.

Additional tests may be recommended based on personal circumstances, such as work, diet or medical history of you or your partner.

Early ultrasound

The early ultrasound is performed if you wish or if the midwife sees a medical reason, for example previous miscarriages or blood loss. During this ultrasound, usually around 7-10 weeks, we check whether the fetus is in the uterus, whether the heart is beating and whether there is a multiple pregnancy.

The care plan

Based on all the information discussed, you and the midwife will draw up a personal care plan. Which tests do we recommend, based on your medical history and wishes? We will also discuss signals or reasons to contact the midwife. This will create a care plan that perfectly matches your wishes and situation.

You are almost halfway through your pregnancy

Congratulations! You have already reached many milestones and are now almost halfway through your pregnancy. This often means that you have already told most people around you about your upcoming baby and that the first preparations have started. In this part of the 9-month plan, we share important information that can be useful around the 20-week mark, such as:

• The 20-week ultrasound
• Recognition of your baby
• Pregnancy complaints and courses

You’re halfway there!

The second trimester brings new energy for many expectant parents. As you prepare for the second half of your pregnancy, we want to give you some useful tips and information for this period.

The 20-week ultrasound

The most important part of this period is the 20-week ultrasound. This takes place between 18 and 20 weeks. You decide whether you want to have this examination performed. During this ultrasound, extensive examination of your baby and your uterus is performed.

Our sonographer will take you through what she sees during the examination. She will explain everything clearly and show you what it means. She will look at the growth of the baby. The development of the baby will also be examined; is the spine closed properly, are all limbs well developed and are all organs well formed? She will also check the amount of amniotic fluid and the location of the placenta. The ultrasound generally takes 40 minutes.

The ultrasound does not provide complete certainty about the health of your baby, because some abnormalities are not visible. If the sonographer sees something abnormal during the ultrasound, a follow-up examination can be scheduled (this is the case for approximately 1 in 20 women). This follow-up examination may be necessary due to abnormal growth or a placenta that is in a different place. Fortunately, most women appear to be fine after the second ultrasound.

If your pregnancy is going well, the 20-week ultrasound is usually the last medical ultrasound. However, you may be eligible for a position ultrasound around 36 weeks, if the midwife deems this necessary to check the position of your baby. In addition, you can always opt for an additional fun ultrasound in 2D, 3D or even 4D to look at your baby again.

Would you like more information about the 20-week ultrasound? View our page here or read the RIVM brochure for more information.

Gender determination ultrasound

If you are between 15 and 16 weeks pregnant, you can also schedule a separate gender determination ultrasound with us to see the gender of your child. This ultrasound is not reimbursed. The gender can also be determined during the 20-week ultrasound, but keep in mind that this ultrasound primarily has a medical purpose.

Recognition of your child

Do you want all legal matters concerning your child to be properly arranged? Then your partner can already acknowledge the child before birth. This is not necessary if you are married or have a registered partnership, but it is certainly advisable in other situations. Recognition gives your partner legal rights and ensures that an official bond is created.

How does it work? To arrange recognition, you and your partner go to the town hall together, preferably before 24 weeks of pregnancy. You can choose the surname for your child right away. Since 1 January 2024, you can give your child a double surname. This means that your child can bear both the father’s and the mother’s surname.

Since 1 January 2023, if recognition is given during pregnancy, parental authority after birth is also automatically arranged.

You’re halfway there!

Congratulations, you’re already halfway through your pregnancy! Your belly is growing more and more, your baby is actively moving, and the delivery is slowly getting closer. You’re now in the exciting second half of this special time. In this phase, you’ll often come across a lot of new information, and new questions arise about what to expect.

In this part of the 9-month plan, we discuss:

• How your baby grows and moves
• Nutrition for your baby after birth
• Ways to rest and take care of yourself

Read on for valuable tips, information, and handy facts that will help you have a relaxed and well-informed last half of your pregnancy.

How your baby grows and moves

You may feel your baby moving regularly by now! Around 28 weeks, it is important to feel your baby’s movements every day, so that you learn what is normal for him or her. As your pregnancy progresses, your baby will have less space in the womb, which can make the movements feel a little softer. Be especially alert to these changes: a different movement is usually not a problem, but do not hesitate to call us if you have any doubts.

Tip: Relax regularly and try to sit still for a while at fixed times. This will help you to feel and recognize your baby’s movements well.

Feeding Your Baby: Breastfeeding or Bottle Feeding?

This is a good time to think about how you’re going to feed your baby. Breastfeeding and bottle feeding each have their own benefits. Here’s a look at what each option entails and how to prepare.

Breastfeeding

Breastfeeding contains all the nutrients your baby needs to grow. It is tailored to your child’s needs at any given time. Breastfeeding also contains antibodies that strengthen the immune system, promotes bonding between mother and child, and protects against lifestyle diseases and obesity. That is why breastfeeding is the best food for your child, if you have the opportunity to do so, of course.

Breastfeeding is not only very good for your child, but also quite efficient. You always have it with you at exactly the right temperature. It also has advantages for you as a mother:

The birth is really getting closer

The final preparations are being made and you are starting to prepare for the birth. Perhaps you have already taken a birthing course or are busy writing a birth plan. Because you don’t want to leave anything to chance, we will give you the most important information and tips for the birth in this episode.

In this part of the 9 month plan we share the latest tips and facts about:

• The place of birth
• Writing a birth plan
• Birth positions
• Pain relief and pain relief

Everything you need to know about preparing for childbirth can be found on this page. Check it out now and put the finishing touches on it.

The birth is in sight

Your birth is getting closer. You may already be preparing yourself by taking a birthing course or watching birthing videos. It is good to prepare yourself for this special day, so that you know what to expect. That is why we have listed the most important points for preparing for your birth in this part of the 9-month plan.

Where do you want to give birth?

You are probably busy preparing for your birth. Not only by completing your to-do list, but your body is also slowly preparing itself. Your cervix is ​​softening and shortening; these are the first steps your body takes to prepare for the birth. It is important to think about where and how exactly you want to give birth.

The place where you want to give birth is crucial. An environment where you feel relaxed and safe ensures that you can give birth in the best possible way. This is where your body produces the most oxytocin, also known as the labor hormone.

Home birth

Giving birth in your own familiar environment is an option. Scientific research shows that home births are just as safe as hospital births. Just as many healthy babies are born at home as in the hospital. Even during a home birth, midwives have all the necessary resources with them to make the process safe and pleasant. Did you know that no less than 96% of women who give birth at home look back positively on their experience?

Outpatient delivery

If you give birth in the hospital without a medical indication, we call it outpatient. You rent a hospital room, as it were, where you give birth under the supervision of a midwife. We work together with the Spaarne Gasthuis, where most outpatient deliveries take place. On rondzwanger.nl you can view a digital tour to get an impression of the delivery rooms.

Giving birth in a bath

Giving birth in a bath is also possible at home in your living room. Some hospital birthing rooms also have a birthing pool. Giving birth in water has several advantages:

• You experience less pain due to the heat and counter-pressure of the water.
• The water pressure provides more pressure on the dilation edge, which makes dilation go more smoothly.
• You can easily change positions.
• The chance of tearing is smaller.
• Babies are born calmer in a bath and are often more relaxed immediately after birth.

If you would like more information about the options for giving birth in a bath, please feel free to contact us. One of our midwives can tell you which hospitals offer these options and where you can arrange a birthing pool for home.

The countdown can begin

Your maternity leave has probably already started and the countdown can begin. It is good to take it easy during this period. You want to have enough energy to start the delivery. That is why we are giving you the information and tips you need in this final phase.

In this part of the 9-month plan we provide information about:

• When to sound the alarm
• Preparing your flight bag
• Being late, inducing and stripping

View the most important information and fun tips now on our page about the final stages.

The final stretch

You are probably currently on maternity leave and have really started counting down. Soon you will become mom and dad, or your family will be expanded even further. It is an exciting period of the final stretch. Here you will learn everything about this phase and get tips to get through it.

The countdown can begin

Your maternity leave has started and the countdown can begin—finally. Chances are that it feels that way, as things may be getting a bit tougher at this stage. Most women:

• Experience lower back pain
• Have trouble sleeping
• Have to urinate more often
• Retain more fluid
• Experience more frequent pre-labor pains

It is good to take it easy. For example, take a nap during the day and try to do things to relax. It is important to guard your own boundaries and listen to your body. Contact your midwife if you notice signs of a bladder infection, for example if you feel like you have to pee, but in the end you don’t. Other reasons to contact your midwife are:

• Headache
• Tingling fingers
• Upper abdominal pain
• Nausea
• Seeing stars

The movements in your belly

You may notice that your baby’s movements are becoming less. That’s not surprising; your baby has less and less space to turn and kick. The movements become smaller and you no longer notice them every time. Your baby’s sleep pattern also changes. The periods between powerful movements become longer as a result.

When you are on maternity leave, you can give all your attention and energy to your baby. This way you can easily take a rest when you feel the need. Are you unsure whether your baby is moving enough? Don’t hesitate to contact us!

You’re really going into labor

Your waters have broken, or your contractions have started. In this episode, we’ll give you the latest information and tips for during labor.

In this episode we discuss:

• The stages of your labor
• The golden hour
• The transfer of care from midwife to gynecologist
• Pain relief and medication

Read the latest tips and information for your labor here, but remember: keep breathing calmly! Every contraction will pass.

The baby is really coming

Your waters have broken, or your contractions have started: you are in labor. The baby is coming. Read all the tips and information about labor in this part of the 9-month plan.

The stages of your labor

Your waters have broken or your contractions have started. When do you call us?

• Call the midwife if your contractions come every 3-4 minutes for 1 to 2 hours and last 60 seconds.
• Also call us if you need us or are worried.
• Call if you lose more blood during contractions than normal during your period.
• Call if you lose amniotic fluid and the baby had not descended at the last check.
• Call if the amniotic fluid you lose is green or brown in color.

Please note: If your waters have broken and the amniotic fluid is clear, the baby was in the lower position at the last check and it is night:

• Go to sleep; there is a good chance that your contractions will start.
• If there are no contractions, let us know around 9:00 that your waters have broken.

Waters have broken

When your waters break, it is usually thought that labor has started, but only about 1 in 10 deliveries start with waters breaking. In the other 90% of cases, your waters break during the dilation phase.

Dilation and contractions

As mentioned above, in 90% of deliveries the waters break during the dilation phase. Contractions often start short and irregular. When you relax, they often become stronger.

During the latent phase, the first phase of your labor, your body prepares itself. Your cervix shortens and you become slightly dilated. It can still weaken if your contractions are irregular. They will then resume after a few hours or days. Just do everything you would do on a normal, relaxed day and save your energy for later.

During active labor, you need that energy. The contractions become more intense and come every 3 to 4 minutes. Try to time and keep track of the contractions. If the contractions last about 60 seconds and you have to sigh the contractions away, then it is time to call the midwife. With a first child, this phase lasts ten to twelve hours on average; with a second child, four hours.

From the first contractions, your cervix will shorten and open to a full dilation of 10 centimeters. Your baby will descend deeper into the pelvis and turn with his back to the front.

The delivery is (almost) over!

Maybe you’re just on your way home from the hospital, or the midwife has just left. And then… What now? Don’t worry! In this episode of the 9-month plan, we share useful information and tips for the postpartum week, so that you can get through this special time calmly and well-prepared.

What to expect in this part of the 9-month plan:

• Important information about your and your baby’s recovery
• Support from maternity care and midwife
• Nutrition for your baby
• How and when to register the birth

Discover everything you want to know about these first days after giving birth.

The delivery is behind you

You’ve just given birth and are on your way home from the hospital or the midwife has just left your home. Uh, what now? Don’t worry. In this penultimate episode of the 9-month plan, you’ll find all the information and tips for the first 24 hours after your delivery.

A healthy baby and mother

A newborn baby has certain characteristics that indicate that he or she is doing well:

• A pink or slightly tinted skin color
• A temperature of between 36.5 and 37.5 degrees
• A little nausea due to swallowed amniotic fluid in the first 24 hours is normal
• Your baby can breastfeed as often as he or she wants in the first 24 hours

 

Your baby also communicates immediately after birth by crying. This can mean that:

 

• Your baby is too hot or cold
• They want to suck, for example on your little finger
• They are hungry
• They need a clean diaper
• Or your baby just wants to be with you

There are also certain signs of good recovery for you as a new mother. In the first hours after giving birth, you can expect that:

• You will lose a maximum of one maternity pad per hour
• A paracetamol will help with any afterpains
• Urinating in the shower can help keep wounds clean
• Your body will drain fluid by sweating and urinating more

Support from maternity care and midwife

You are certainly not alone after giving birth! During the first eight days, you will receive help from a maternity nurse. She:

Your first weeks as a (larger) family

You have been living as a (larger) family for a few weeks now. It may have taken some getting used to at first, but you have probably (almost) found your feet now.

In this last part of the 9-month plan, we will tell you the last things about:

• Life with a baby
• Pay attention to your pelvic floor
• Working after your pregnancy
• Contraception

Read all the important information and facts about the last phase of the 9-month plan on this page.

Life as a (larger) family

You gave birth to your baby a while ago. Maybe you are already completely used to the new family structure, or you are still getting used to it. In this last part of the 9-month plan, we will give you information and tips for the last time that you can use during this period.

Life with your baby

When you become a parent for the first time, you usually have to search for what exactly your baby wants. That is very normal. Babies between 2 and 10 weeks old cry an average of 2 hours a day.

By crying, your baby indicates what he or she needs, which also contributes to development. Rest and regularity can help your baby cry less. The Happiest Baby method by Harvey Karp helps many parents to calm babies and help them sleep better.

This method mimics the soothing environment of the womb. The idea is that babies need extra comfort in the first three months, because they are still in a kind of “fourth trimester” and are adjusting to the outside world. The “5 S’s” technique is used for this:

 

• Swaddling – Tightly wrapping the baby gives a sense of security.
• Side/Stomach Position – A safe, calming position (under supervision only).
• Shushing – Mimicking the rustling sound in the womb.
• Swinging – Gentle rocking movements help to calm the baby.
• Sucking – A pacifier or breastfeeding can have a calming effect.

Pay attention to your pelvic floor

The muscles in your pelvic floor are softened by the pregnancy hormones and are stretched considerably during childbirth. It is therefore important to pay attention to the recovery of your pelvic floor after your pregnancy. Pelvic floor exercises help to get these muscles back in shape.

For example, you can learn these exercises at a course for women who have just given birth. It is important to keep this up for a few months. Research shows that training specific muscles has a positive effect on preventing (stress) incontinence later in life.

Do you continue to have complaints after doing these exercises consistently for a few months? Then visit a physiotherapist who specializes in pelvic floor problems. They can help you train these muscles.

Recovery and exercise

If you have just given birth, you may not be thinking about exercising yet. Or maybe you want to get fit again from week one. It is important to take a lot of rest in the first period after your pregnancy. Your body needs to recover and recover from pregnancy and childbirth, which requires a lot of rest and good nutrition in the first weeks.

When can I exercise again?

On average, women are ready to start exercising again six weeks after giving birth. Build up your fitness and muscles slowly, listen to your body and respect your limits.

For example, you should train your abdominal muscles by feel. During your pregnancy, your abdominal muscles spread apart to make room for the growing baby. A few weeks after giving birth, you will notice that your rectus abdominis muscles come back together.

Do you want to know if you can exercise all your abdominal muscles? The midwife will check this for you during the follow-up check.

I want to get pregnant quickly

You’ve figured it out: you want to get pregnant! Probably as quickly and healthily as possible.
Read
what you can do and more interesting facts for a good start, your cycle,
LH peak
and your fertility.

In brief

• The placement of an IUD can be experienced as unpleasant or painful.
• Of all couples who try to conceive, 80-90% of them succeed within a year.
• The chance of pregnancy is greatest if you have sex every 2 or 3 days in the six days before ovulation (ovulation is 2 weeks before the start of the next period).
• Take 400 mg of folic acid daily from the desire to become pregnant until 10 weeks of pregnancy.

Your cycle and your fertility

In order to become pregnant, an egg must be fertilized by a sperm cell. In women, an egg is released from one of the ovaries, this happens (almost) every month, the so-called ovulation. Ovulation occurs 14 days before menstruation. If you menstruate regularly, the moment of ovulation can be predicted fairly accurately. If your menstrual cycle is irregular, it is more difficult to predict.

• More vaginal discharge, which is thicker and more slimy than you are used to. This makes it easier for sperm to reach the eggs that have traveled through the fallopian tube to the uterus.
• Your libido often increases (handy!).
• Some women feel ovulation in the lower abdomen, just above the groin.
• The LH peak in your urine increases around ovulation. If you keep track of when you menstruate, what your temperature is and what your vaginal mucus looks like for a few months, you will gain a lot of insight into your own menstrual cycle and this will increase the chance of pregnancy.

Calculate when you ovulate with an ovulation calculator. Or use ovulation tests
that measure the LH peak in your urine: the LH hormone is increased around ovulation. The
chance of ovulation can decrease, for example due to: stress, very intensive
sports or heavy physical labor, losing a lot of weight, low body weight,
overweight or the menopause (the beginning of the menopause).

Having sex in the fertile period

To get pregnant, it is usually enough to have sex every two or three days. More often is allowed, but is not necessary. The sperm cells remain alive in the uterus for a few days. Do you know when you ovulate: most pregnancies occur after having sex in the six days before ovulation.

Preparing for your pregnancy: live healthy

Fortunately, nature ensures that almost every child is born healthy. However, there are also things you can do to increase the chance of a healthy child and a healthy pregnancy. This starts when you get pregnant. In addition, the first weeks of pregnancy are very important for the development of a child. Most women only know they are pregnant after those first weeks.