Thursday 29th of June 2017 06:39:18 AM
 

 

 

Pregnanacy&Delivery               

The pregnancy period is truly a unique and beautiful one - the planning, the expectations, the getting ready for the new baby - are truly stages of joy and happiness. But alongside those wonderful feelings come questions, fear of what’s ahead and the constant need of support

9 months of waiting in a foreign country, does not make it any easier on the parents to be. 9 months of raging hormones, physical changes, away from the
comfort of your family and friends, and lack of understanding the local policies of the hospitals, can make it even harder.

In this website we will bring all the information that you need to know.
Ladies (and significant others are also welcome), in order to go through the pregnancy in a peace and a tranquil way (as the Dutch know how to), we will do our best to supply you with information on hospital’s policies, midwives, tests, check ups, natural birth and more.

Let us start with some background on pregnancy and birth in the Netherlands:

The Netherlands is known for its, somewhat different approach towards its citizens (especially women), pregnancy and birth. The Dutch women are considered to be strong mentally and physically, and with good reason.

In the past, many women gave birth at home with a midwife. Nowadays, the number of women that choose to give birth at home, has decreased drastically.

The reason for that is not certain. Here are but a few explanations:
-A new generation that is more aware of the benefits of hospitals

-More foreign women that did not grow up in the Dutch mentality

-A large number of medical students.

To the foreign women, the approach of the Dutch towards birth may seem extreme and unrealistic. Many women can not understand how is it possible to give birth at home, with no equipment, no authorized doctor, no Epidural – just a midwife.

Home birth is a controversial topic that attracts a lot of attention to it. The approaches towards the subject are so diverse and different, that we would like to shed some light on the subject.

Studies that were conducted in the Netherlands and also elsewhere, show that the number of life threatening incidents that occur during home birth, is not higher than the ones that occur in hospitals. The causes of such incidents depend on many factors, and therefore it is impossible to determine which is
a better choice.
Midwife A woman that is professionally trained, either by a school or by another study programs (theoretical studies as well as practical).

A midwife is qualified to practice medicine that only involves giving birth, and under no circumstances, is she trained to practice anything else.

The problem begins for us women, who do not believe in the natural way of giving birth.

Who should we go to the midwife, a private doctor or the hospital?
We come from a society where a midwife is considered to be someone who is not qualified to handle the complications and problems that may arise during
child’s birth and afterwards. For any kind of problem that we have, we immediately go to the doctor whether it is a family doctor, a skin doctor etc.
It is no wonder, given our background, that the Dutch approach to medicine makes our life a little harder.

In many places around the world, the medical approach is medical and can not be interpreted any other way.    What exactly does it mean?
The regular checks during the pregnancy are conducted by a qualified doctor and not midwife.
The gynecologists and other doctors, believe very much in giving birth in the Hospital, where you have all the necessary equipment. They encourage endless tests (such as ultrasound, AFT) and by that, sucking us in to a whirlpool of stress and pressure. We ignore our own judgment and strong female intuition, and allow others to decide what is best for us and our baby.

When it comes to tests during the pregnancy, it is important to stay rational and not to get out of proportion. It would be not a bad idea to go back home to conduct the tests. If you choose to pass your pregnancy period here in the Netherlands, it is very important that you get all the information you need. Be
sure to ask every kind of question that comes to mind, even in the risk sounding too nagging. It is important that you feel secure and confident, and the only way to do that is by getting as much information as possible
concerning the procedure.

Supervision by a midwife:
A midwife’s supervision can be a very different experience than a doctor’s. It is my personal belief, that it is different for the better. The midwife’s supervision during the pregnancy puts the woman’s needs in first place. The midwife, is a woman, who is aware of the needs, fears and worries of the pregnant woman. She is familiarized with her raging hormones, her over emotionality, and being a woman herself, she can understand and relate.

When coming to meet a midwife (whether it is your first pregnancy or your first pregnancy in the Netherlands), you are allowed and even encouraged to ask all the questions that you like. The midwife escorts you from then on, all through the pregnancy. She familiarizes you with the medical bureaucracy, gives you instructions (sometimes even on a piece of paper) on what to do during night labor (when they are not 5 min apart), phone numbers, what to do when your water break etc. The clinic of the midwife is usually a very cozy and welcoming place. There are children’s games lying around, e bed equipped with devices that can hear the baby’s heart and more. Some women that go to a midwife find the presence of such devices comforting and it gives them a “like hospital” feeling.

The main advantage of going to a midwife, is the fact that you have someone who is available to you 24hrs. It does not necessarily mean that you will give birth at home. Should the need arise, they will come with you to the hospital and deliver the baby there.

How to find a midwife:
The midwife’s organizations usually have 4 midwifes. There are a number of sessions through out the pregnancy. Each session is held by all four midwifes in rotation, so that you will get to know all of them. In the beginning, the sessions are held every month and during the last trimester, they can be weekly sessions and sometimes even every 2 days. At the end of the pregnancy the most available midwife, would be the one to escort you to the hospital or to deliver your baby at home. Home or hospital - it is your choice.

Registration
You call up and set an appointment. The secretary will ask you all the necessary details (how far ahead are you, personal details etc.) and will set up the appointment. The first session is where you get to know your midwife. This is the time and place where you voice all your concerns and wishes regarding the pregnancy (your background, mentality, where you would like to give birth and also to which hospital would you like to go. If you wish to use epidural it should be mentioned If you choose to have your baby at home, it is much easier – you just call an emergency number and a midwife will come to your place within a short while.

Below you will find the websites of the midwife’s organization:
knov.nl
nvog.nl


When looking for a midwife, it is also recommended to get in touch with one of the companies that provide service and care at home for the mother after birth.

What is “home care
”?
There is another advantage to giving birth in the Netherlands – the new mother receives a nurse at her home from the very first day. The nurse explains the new world of baby’s care to the new mother – the right temperature of the water, how to give a bath, breast-feed and even cleans the bathroom in order for it to stay sterile. The nurse will usually stay at your home between 6 to 8 days (depending on the kind of insurance you have and whether you had a C section, natural birth etc.).

In order to get that service, you need to register at the ”After Care Centre”. You need to specify the kind of treatment you would like to have and also ask for a kit to be sent to your home (Kraamzorg). The kit should be asked up to 2 or 3 month before delivery. It contains bandages, disposable underwear and other products that can be very handy right after giving birth.
www.particura.nl
(it is also possible to ask the insurance company about other companies that supply that kind of service).

Hospitals
In the Netherlands you can not come to the Hospital if you did not “book a room”, and that is where the midwife is very handy. She is responsible on the day of birth, to call the hospital which you asked for, and to make all the necessary arrangements.

In the Netherlands there aren’t that many delivery rooms, and the new mother is released from the hospitals with in a few hours after delivery. It is possible to stay one night in the hospital, but it needs to be asked, since it is not customary. Being released after a few hours after delivery, is not necessarily a disadvantage – the new mother can recover quietly at home with out having non stop visitors or noise and turmoil around her (The women that truly feel the difference are the ones that have to stay in the hospital after a C section for 5 days).

Since women do not stay in the hospitals after giving birth, there is a very good chance that you will get your own private recovery room (In some not so lucky cases you might be in the same room with one other mother). It is especially good for women who have to stay in the hospital for a few days (women after C section) that way, they can recover in peace with out any loud babies around her.

The hospital is a quiet place where nurses are available for the mother to feed, bath and check upon, every 3 hours. There aren’t any nurseries in the hospitals. Right after birth, the babies are placed by the mother’s side in a small incubator equipped with blankets and a warm bottle.

So good luck to you!

Other relevant website:

Parenting in the Netherlands
motherhood, the Kraamzorg kit, child care and more 
www.kraamenco.nl
www.zuider-amstel.nl/

Lamaze class 

Yoga during the pregnancy

Doule

Lamaze class in English (also good for couples)

Massage for mother and baby during the pregnancy

*warm bottle
It is a special metal bottle that can be bought in every baby store such as Hema or Parental. You fill the bottle with water and wrap a towel around it. You place the water bottle in the bed. You place the baby in the bed on his side so that the water bottle is placed against the baby’s back ad the baby is leaning on it. The warm bottle is very common in the Netherlands to help to keep the baby warm
.

Pregnancy Tests
 
that are conducted in the Netherlands are not necessarily the same as in other countries. Below you will find the most important Pregnancy tests:

Type of Blood tests
It is possible to ask to do this test.
The test tells you your blood type and also your RH (existent - positive or non-existent - negative) which is important to know during birth. It is important to see what is the RH type in both parents. If the mother has a positive RH then there is no problem, but if she has a positive and the father has a negative, this is something that should not be ignored.
The problem arises during, either, a blood transfusion or birth – where there is a mixture of blood. During birth, the mother’s blood mixes with the baby’s blood which, at times, can have critical results. A mother’s body with an RH negative, recognizes the baby’s RH as an intruder and begins to produce antibody’s to attack the red blood cells of the baby – an attack that may result in the elimination of the baby’s red blood cells (especially from the 2nd pregnancy an onward). The child may be born with a severe anemic condition and at times may even result in death in the womb.

*This situation is treatable during the pregnancy and can be done so by vaccinating the mother.

Blood sugar:
You are to fast the whole night before the test.
During the test you will be given a glucose fluid to drink.
the test is used to diagnose various types of diabetes but not for gestational diabetes

It is very important also for women who are not diabetic, because the consequences during pregnancy can be irreversible.
*it is possible for a woman to be diabetic with out her knowing it

In the Netherlands it is not customary to do this test.

Urine tests

Urine culture and sensitivity:
The test is used to diagnose urinary tract infections.
Infection of the urinary may result in kidney diseases that are very dangerous during pregnancy.

Urine tests through out the pregnancy are used to measure protein level in the body.

*In the Netherlands it will not be offered to you and therefore needs to be asked specifically.

Nuchal translucency test
The test is used to diagnose the risk of Down-syndrome in the fetus.
The scan is carried out at 11–13 weeks and 6 days of the pregnancy, and assesses the amount of fluid behind the neck of the fetus.
The test can not be carried out after the 14th week.
The test is carried out only by a physician who is qualified for it.
This test is preliminary to the tests of the first trimester.
If you are above 36, then your medical insurance covers the test. If you are under 36, then you have to pay 140 euro’s for it.
*in the Netherlands if the result of the Nuchal test are in tact (1:350), then there is no need for an Amniocentesis.
 
The Combined Test = First Trimester Screening
The test is made out of the Nuchal test and the 1st trimester blood test.
It is a more thorough test used to better assess the chances of a Down baby.
The test is conducted at your local clinic, private doctor and ultra-sound institutions.

The test can be done separately from the ultra-sounds test, but not after the 13th week and 6 days.

The results of the ultra-sound, the mother’s age and the results of the first trimester test, are calculated together in order to predict whether the baby has a Down syndrome or not. The results are given with in a few days after it is conducted.
*The test has 85% accuracy.
The payment for this test is done separately and it would be wise to check with your insurance company whether you can get it back.

After the combined test, it is highly advised to do also the triple test!!

First trimester screening (Triple test)
First trimester screening is a combination of fetal ultrasound and maternal blood testing performed during the first trimester of pregnancy. This screening process can help to determine the risk of the fetus having certain birth defects.
Screening tests may be used alone or in combination with other tests.
The test can only be carried out at laboratories that are authorized to conduct this test.
**Every pregnant woman must do this test.

The test checks the following;
-HCG level
-UE3 level
-Protein level in the fetus (the protein that the fetus secretes to the mother, placenta and amniotic fluid).

These 3 parameters together with the mother’s age, have 70% chance of predicting Down syndrome.

On the basis of this test, many women decide to do / not to do the amniotic sac test.

It is important to remember that the test cant give a 100% prediction.
It is always advised to consult with a physician or a genetic counselor about these kinds of tests.

The fetal protein test is not conducted in the Netherlands.

Glucose tolerance
A glucose tolerance test, usually, conducted in the 24th to the 28th week of the pregnancy, measures levels of sugar (glucose) in the mother's blood. Abnormal glucose levels may indicate gestational diabetes.
*There is no need to fast prior to the test.

1st & 2nd trimester screening
Both tests are ultrasound tests and are done by physicians that are qualified to perform them. The tests come to check fetus development, body parts and the amniotic fluid. The 2nd trimester screening checks the development of all of the above in relation to the 1st screening.
1st trimester screening is done between the 13th weeks and 6 days and the 17th week and 4 days.
2nd trimester screening is done between the 23rd and the 25th week.
The cost of such tests is expensive and it is partially covered by the insurance.

In the Netherlands the only screening that is done, is on the 20th week. On that screening, the couple is being told the sex of the fetus.

Amniocentesis
This test is used to diagnose any genetic abnormalities in the fetus.
The amniocentesis is a controversial test. Some may say that the test can not really predict genetic abnormalities such as Down syndrome while others might say exactly the opposite.
The amniocentesis is carried out after the triple test where the chances of Down syndrome are being considered.
Women over 36 are considered to be in a risk group for Down syndrome, therefore, the insurance covers the costs of the test.
*The insurance covers the test if there is a good medical reason for it (over 35 or a bad Nuchal test).

The test is conducted by specialized ultrasound doctors.
Prior to the test you need to consult your physician.


How to choose a stroller?
It is the 28th week, and it is time to fulfill your dreams of buying an orange Bugaboo or a green Quinny. Why so soon? you might ask. In the Netherlands if you don’t order the product 12 weeks before delivery, it is very unlikely that you will get it.
Also here, as in every Dutch action, the name of the game is Agenda and time tables.

Any product that you would like to order, take under consideration lead time. In most cases the products are not in stores and need to be ordered in advance, a long time in advance. There are no delivery or birth kits for the new mother, and all is bought 3 months in advance.

So where do we store all the baby products?
The stores are not equipped to keep merchandise for the customer for a period longer than 10 days. Therefore, you need to make room at your home or garage, for everything that you buy.

The stroller is the most important thing that you will buy before the new baby is born. It will be with you for 2 years at least and in some cases even longer.
The stroller is a beautiful product, with magnificent colors, shapes and texture that its appearance alone is enough to make you drool.

A stroller is made out of 2 parts:
The carrycot – a spacious and padded cradle like box, where the baby can
lie down with out being strapped.

The stroller- This is the most important part of the stroller, since this is
where the baby spends most of his first years.
This part of the stroller has seat belts / straps, and the baby
can be placed in a sitting position.
*There are some strollers that have the stroller already
built in them and are made of many parts.
This kind of stroller, is not so easy to operate due to the many parts it has. Most new parents prefer after the first year, to buy a stroller that is only one part and therefore easier to operate.

Infant carrier It is a part that can also be used in the car as a safety harness
during the first months of the baby’s life. The enfant carrier
has a handle that makes it easy to carry around while the baby
is safely lying in it.

So how do we choose?
Let’s ponder on this question for a minute, especially if we are living in the Netherlands, where there are so many brands to choose from (BUGABOO, QUINNY, STOKKE, MUTSY but to name a few) and it is easy to daydream about the little one and his new mean of transportation.
The strollers in the Netherlands are perfectly equipped for the winter weather, and you can buy them in a variety of colors and materials.

If you do not travel by car most of the time, and your main means of transportation are either your feet or the trams, then the strollers are highly recommended. They are strong enough to carry your groceries, purse and bags at the same time.

The wheels are made of thick rubber and not plastic, which makes
them easier to push around on any kind of surface.
Personally, I prefer the one handle trolley since it is easier to operate.
It leaves your other hand free to carry the groceries or the dog and so
on.

Also important to notice when buying a stroller, that the stroller part of it has a back rest, that way it supports the baby and also prevents him from skidding out.

If you do not have a big trunk, then it is not advised to buy these big strollers. They are big, cumbersome, with big wheels, and usually very expensive (can go up to 1000 Euros).

On a more personal note – notice the size of the stroller when it is disassembled, to see if it fits your car.

When buying a stroller, you need to also consider the carry cot:

BUGABOO – the carry cot is not effective while the baby is still lying down. It is hard to operate with it, or even to use it to put stuff in.
STOKKE – the carry cot is not big and spacey, but is very easy to operate.
MUSTY – the carry cot is very easy to operate but it is an open carry cot and most
of the time you need to buy an extra bag for the extra stuff that you
take.

Position of the baby:
Till about the age of four months, the baby lies in a 180 degrees position. In most babies’ strollers, the baby can be placed lying down. Some of them, can even fold upward and have a carry on that detaches from the stroller and allows the baby to be in a 180 degrees position.
*it is a good and recommended to buy a stroller with a carry on.

From a health point of view, the baby can be in another position than lying down, while strolled around (it can only be more comfortable for him when he is tired).

Byproducts
:
sleeping bag- It is absolutely essential especially if your due date is
during the winter. It can be used as a very warm blanket while and is especially good for traveling around Europe during the winter time.

Rain cover- usually comes with the stroller and there is no need to ask for it, since the Netherlands has an abundance of rain.

What is the perfect baby’s stroller?
- A baby’s stroller that weighs 7 Kg. and is made out of 3 parts - carry on, carry cot, stroller
- easy to operate, fits in your car/trunk with out too much hassle and has a long pushing handle that you can hang your bags on it
- the carry cot is in 180 degrees and is made out of soft and gentle material
- a transparent blind that protects from the sun and allows you to see the baby
- a safety harness to prevent the baby from slipping out
- a lower stroller means a more stable stroller
- should cost no more than 1500 – 1800 Euros

and again on a personal note – choose a beautiful and designed stroller, but remember that it needs to be as comfortable as a Mercedes.

lots of success.

Registration 
With in 3 days of delivery, the child needs to be registered at the city hall. Only the parents can register the child. If for some reason, the parents can not come, then a person that was present during birth or an authorized person from the hospital, can do that. When coming to register the child, it is important that you know his/her name. Once the child is registered you get a birth certificate. There is no registration fee unless you ask for a copy of the registration.
Necessary documents: A valid ID of the person who comes to register the new born.
A marriage certificate (if the parents are married)
Details of date and hour of birth

*if the child is already registered with in another city hall, or a legal civil notary, then you need to supply the city hall with a document stating just that 

Bureaucracy
With in 3 days, you need to notify the city hall (where your hospital is located) of the new born baby. This can only be done by one of the parents. You need to arrive with your child’s birth certificate which you get at the hospital.
When registering the new born, you register him/her under his/her new name, so with in 3 days, you need to know already the child’s name.

ID
An identity card needs to be issued to the new born baby..
In order to do that that, you need to call to make an appointment with the IND. There you will get further instructions.
* The IND and your local municipality are not synchronized with each other, so this procedure needs to be done by you.

Flying with out ID
Once you start the procedure of applying for an ID may travel with your infant
outside the Netherlands. You will be supplied with a document stating that you
have started the procedure (the document will have a number on it that will be
enough for the authorities at Schiphol).
Usually the document will not be asked for, but better be safe than sorry.

Passport
Every person, big and small needs to have a passport.
A passport can be issued to the new born at the embassy of his home country. 

Zwangerschapsverlof – Pregnancy Leave 
In the Netherlands, women have the right to 16 weeks paid leave. This may be initiated between 4-6 weeks prior to the estimated due date. The law states that you may not work from 4 weeks before, until 6 weeks after, delivery. When you take up your actual leave should be determined together with your employer.
During pregnancy leave you receive 100% of your normal wages – either directly from the social security office or via your employer. If you were self-employed, until this year, there was no such arrangement. However, the parliament has decided on a motion to introduce the Zelfstandig en Zwangerregeling (Self-Employed and Pregnant Regulation), which gives self-employed mothers a right to a 16-week pregnancy leave. If all goes well, this regulation entered into force on July 4, 2008.
 
Kinderbijslag – Child Benefit 
If you are living in the Netherlands and/or are employed and pay Dutch wage taxes, then you are entitled to kinderbijslag. This holds true not only for your own children, but also for either a step or foster child (in case of legal guardianship). Payment is made on a quarterly basis directly into your bank account up until your child is 18 years of age. The amount paid out is based on the age of your child and is currently set at € 236.77 for children aged 6-11.

In sorrow dost thou bear children” and happily you will look for a circumciser

Some information for the people who do the ritual circumcision:
You gave birth to a beautiful baby boy and now it is time for the ritual circumcision.
When looking for a suitable circumciser in the Netherlands, there are several possibilities:
- first you need to decide if you would like a circumciser that has medical training
or not (There are circumcisers that come only from a Jewish religious background, while others are certified doctors).
- in the Netherlands there are two Jewish circumcisers that come from Belgium :
Rabbi Weiss - 262086 – 32 - 32 +
Rabbi Ackstein - 3319041 – 32 – 32 +
• Both are known through out the Netherlands in their reputation and different methods of cutting. There is no need to book them in advance (unlike other things in the Netherlands).
When you realize that you are about to be the proud parents of a new baby boy, it is important to make the call to either one of the two. There is no need to book months in advance, but just to make sure that they are available around the time of the birth. They come to where ever you would like them to come – either the hospital or your home.
You can also call rabbi Yitshack West at Beit Chabad at 6411402 – 020, to inquire about other circumcisers. If you wish the circumciser to come from a medical background and with medical training, you can ask that when calling to Beit Chabad.

It is possible to perform the ritual circumcision at the hospital, but it is not so popular. If you choose to do that, make sure that you know exactly who the doctor is. Try to find out what is his method of performing the incision and if possible, ask for references.

The ritual circumcision
Before this ritual, there are a few things that need to be prepared. Call your chosen circumciser and ask him what needs to be done. He will tell you exactly what to buy and organize prior to the ritual circumcision (diapers, special brush, cotton balls etc.).

After the ritual circumcision, the circumciser will come to check on the incision. Both circumcisers that are mentioned above, will come to your house to do just that.They will check if the incision is healing nicely and that there aren’t any special problems. 

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