Childbirth

Every woman experiences childbirth in her own way, every birth is different. However, most deliveries follow the same steps. Good preparation is half the battle: look for information, ask us questions. And most importantly, trust yourself and your body. You can do it!

For a visual summary click here.

The time has finally come

Labor usually starts with contractions, but not every contraction means you are in labor.  It can also be a false alarm.

False alarm:

In the last months of your pregnancy, your uterus sometimes contracts for a moment, you may have felt that before. This can happen more often as the pregnancy progresses. These contractions are called false labor contractions or Braxton hicks. It may be an unpleasant feeling of your womb being hard and tense for a short while. But some women don’t even notice it. These contractions are not (pre) contractions and they do not announce your delivery.

The following signs usually indicate that labor has not yet started:

  • The Braxton hicks are irregular – they can be long or very short.
  • They do not get consistently longer, stronger and closer together.
  • These contractions fade and disappear when you lie down.
  • You will feel these contractions mostly at the top of your womb.

The real thing:

Labor usually starts with contractions (90%). Sometimes these contractions immediately are painful and come in quick succession. But usually they are short, irregular and not that painful at first. Often you can just continue what you were doing. The contractions can feel like waves that build up to a peak intensity   then gradually decrease. These contractions soften the cervix. To see if your labor has really started, we will observe your contractions and examine the cervix with an internal examination. This will give us a good impression of the phase of your delivery. Very early in labor it is sometimes difficult for us to assess whether the delivery has really started. Don’t panic: a few hours later you’ll be sure!

Childbirth can also be announced with a rupture of the membranes  or breaking of the water(10%). Even then, strong contractions are needed to open the cervix. They usually start within 12 hours of the water breaking.

Childbirth can also be announced with a rupture of the membranes  or breaking of the water(10%). Even then, strong contractions are needed to open the cervix. They usually start within 12 hours of the water breaking.

Contractions

A contraction is a cramp of the uterine muscle. This cramp in your abdomen comes on slowly, gets more intense or severe and then subsides. Between contractions your womb is relaxed and pain free. The contractions get stronger, come more frequently, more regularly and are more intense as the delivery progresses.

Dilation contractions:

Some women find the pain of the contractions quite tolerable, other women find it very intense. Most women have pain in their (lower) abdomen during the contractions, but some women feel the pain mainly in their lower back and / or their legs. Contractions mostly felt in the lower back region, are often more difficult to deal with than abdominal contractions.
The true labor contractions cause your cervix to open wide enough (10 cm) for the baby to be born. The opening of the cervix  is called “dilation”. We will check this regularly to determine the progress of the delivery, but of course this is always done in consultation with you. Strong contractions are needed for dilation. They last long (50-60 seconds) and are regular, every 3 to 5 minutes.  The contractions become more powerful and painful as the dilation progresses. They are most intense during the last centimeters of dilation (8-10 cm). This is a difficult period for many women. Fortunately, you are nearly there! And of course you can count on our coaching abilities especially during this last hard part.

Dilation

During the first delivery, the cervix is ​​stiffer and therefore opens less easily than during a next delivery. The contractions first soften the cervix and make it thinner and more flexible. The time frame of this process depends on the contractions. If they are stronger and very frequent, the delivery can proceed faster. The first  5 centimeters of the dilation usually progress slower than the last part of the dilation. At 10 centimeters you have full dilation, to start the next fase: the pushing fase. In which you feel the urge to push.

Rupture of the membranes

The membranes usually only break after you have been in labor for some time. That is good too, because the membranes and amniotic fluid protect the baby and help to open your cervix due to the pressure they exert. If the membranes don’t spontaneously rupture, we will suggest to rupture them at a certain point. Always in consultation with you and when we think that is useful. For example, if the contractions weaken or if you do not continue dilating enough. The procedure of rupturing the membranes doesn’t hurt, you just feel a little warm water running out. The placenta continues to produce amniotic fluid, so the baby still has amniotic fluid around him.

If your water has broken but the contractions are not strong yet, we advice you not to take a bath because of the slightly increased risk of infection. After all, the baby is now in open connection with the outside world. We therefore ask you to measure your temperature every 4 to 6 hours to quickly detect an infection.

 

Pushing contractions

When you have 10 centimeters dilation, the dilation contractions change to pushing contractions. You then feel a strong urge to push at the height of the contraction.
Sometimes that urge already occurs at 8 or 9 centimeters, but you should not give in to that. We will often first do an internal examination to make sure that the dilation is complete, whether the baby’s head has dropped nicely and whether you can start pushing.
The contractions usually come every 5 minutes. They are very strong but mostly not experienced as painful.

 

The birth

When you give birth for the first time, the pushing stage for a first child takes 1 to 1 1/2 hours, so it often takes a while before you see the head. It progresses bit by bit with each contraction. The baby is busy turning its head through the birth canal.

With a second child you usually do not need to push as long, because the birth canal has already been made flexible by the first child. A second or subsequent child is sometimes even born in a few contractions.

When the head is almost coming out, you feel it stretch enormously in your vagina and anus. This can be a painful burning sensation. A warm washcloth against your pelvic floor helps. During this last part we will tell you exactly what is happening and will of course continue to coach you.

When the head is born, we gently develop the baby as it is born. You usually don’t have to push anymore. Sometimes you yourself can help the baby being born, or maybe dad wants to do this? The baby is quickly placed on your (preferably bare) chest, for the sacred hour. During this hour the baby can adjust to aerthly life and gradually start showing an interest for nursing. If you want to breastfeed, we wil try to latch on the baby for the first tima. This is a natural way to make your uterus contract and prevent further blood loss.

 

The placenta

After the birth of your baby, the uterus continues to contract to release the placenta and to prevent you from losing to much blood. We will check whether the placenta is loose and if it is, you can push once more. The birth of the placenta is a bit of a strange feeling, but it doesn’t hurt. If the placenta is not born within 30 to 60 minutes, it must be removed under anesthesia.

Cutting the umbilical cord:

When the umbilical cord has stopped pulsating, it can be cut. This is a special task for the father. It doesn’t hurt the baby as there are no nerves in the umbilical cord.

Requisites for the delivery and the baby

Bedbloks and a bedpan

The bedbloks enable you to raise the bed to provide the midwife and the maternitynurse (“kraamverzorgster”) with a more workable height. We advise you to place them under the bed legs from the 37th week. In case you have “kraamzorg” with “Zorgmed” the bedbloks and bedpan will be delivered at your home. In all other cases you can borrow the bedbloks and bedpan free of charge at the “Thuiszorg winkel” (Kastelenplein 168, Eindhoven). You do need to bring your ID in order to borrow these items.

Maternity parcel (“kraampakket”)

Depending on your insurance this parcel will be provided for. If not provided you need to buy the following items (for instance at “kruidvat”):

  • 6 underpads (“celstofmatjes”)
  • 1 bottle of alcohol 70%
  • 1 box of sterile gauze (10X10)
  • 2 suits maternity dressing (“kraamverband”)
  • 1 soap dispenser/ baby soap

In case you choose to deliver at home the following items are also required:

  • 2 big underpads (“celstofmatjes”)
  • 1 zigzag cotton wool package

For a home birth it is advisable to have a roll of grey garbage bags, two household buckets and a portable laundry basket. Emergency lighting (flashlight).

Baby supplies

  • Metal warm water bottle+ cover (“kruik + kruikenzak” to be bought at for instance “Hema” )
  • Digital thermometer (not an ear or forehead thermometer)
  • 1 Cotton cap smallest size (“mutsje”)
  • 6 cotton bodysuits / onesies (“rompertje”) size 56/62
  • 3 sets of clothing size 56/62
  • 1 or 2 bath capes (“omslagdoek”)
  • 3 hydrophilic washcloths
  • 6 hydrophilic towels (“hydrofiele luiers” used to dry the baby after bathing)
  • Diapers (washables or disposables)
  • 6 burp cloths (“spuugdoekjes”)
  • 2 flannels (used as an under blanket in the babybed)
  • 3 blankets or fitted sheets (“hoeslaken”)
  • 3 top sheets
  • 2 blankets (wool or cotton but not a comforter!)
  • 1 changing mat

When planning for a hospital birth we advise to pack the following items.

Mommy bag:

  • Underwear
  • 1 (nursing) bra
  • 1 set Nightwear
  • 1 Bathrobe
  • 1 Easy shirt ( preferably not a long shirt ) for childbirth
  • 1 set easy clothes for traveling home
  • Toiletries ( toothbrush, tooth paste, hairbrush, soap, skincare)
  • Slippers or flip-flops (for the shower)
  • ID and insurance card
  • Phone & Charger
  • Camera to make pictures (or phone)
  • Keys of the house.
  • Eventual: your glasses of contact lenses
  • 1 set of clothes for yourself to wear when you return home after the delivery.

Baby bag:

  • 2 sets of Clothes size 52-56 ( long-sleeved onesie, jumpsuit or long trousers and sweater, socks)
  • Jacket and hat
  • Blanket to cover the baby in the car seat.
  • Car seat

Daddy bag:

  • Night wear
  • Toiletries
  • Slippers or flip-flops (for the shower)
  • 1 set of clean clothes
  • Some snacks
  • Phone & Charger