Monday, January 18, 2010

Pregnant in the Land of Windmills, Bikes, Dikes and Tulips

In just a few months time two good friends of mine are going to be first time mommies. But before they get to that, they are now going through the marvel and struggles of pregnancy. Being pregnant is a wonderful yet daunting experience more so if you are having it in another country with a different language and your support system of women in your family more than a thousand miles away from you.

What do I deem as essential in being pregnant here in the Netherlands?

1. Know the basic terms and procedures.

Maternity and health care in general is different here in the Netherlands. Before you can go to a specialist like an Obstetrician (OB)/Gynecologist (GYN) there is the process of acquiring a verwijsbrief (referral letter) from your huisarts (house doctor-general practitioner). It is only when medical intervention is necessary that you even meet with an OB/Gyn. The main person you have appointments with is a verloskundige (midwife).

Pregnant or not one has to be well informed of the various health care system. ACCESS, a non-profit organization servicing the expat community in the Netherlands have published information booklets on various aspects of living in the Netherlands. One such material is the health care information booklet that was updated last August 2009. You can print a copy of it here:

http://www.access-nl.org/our_services/pdf/booklets/health_care.pdf

As for other ACCESS booklets you can check out their website http://www.access-nl.org

Pregnant and don't know where the nearest midwife is in your area? The website http://www.knov.nl/ provides not only substantial information over the role of a midwife but also offers a search engine for midwives in your area. Just type in your address in their midwife locator http://www.knov.nl/midwife-locator/ and you will find a listing of midwives within your specified radius.

It is also important that you arm yourselves with important dutch terms related to pregnancy and labor. Although in most cases you will find an English speaking midwife but it is still important that you familiarize yourself with terms that you will be hearing for the next nine months.

From the article Maternity Matters What to Expect in the Netherlands http://www.expatica.com/nl/health_fitness/healthcare/Maternity-matters-_-What-to-expect-in-the-Netherlands_11936.html by Amanda van Mulligen, she shared her A-Z of pregnancy and birthing terms in dutch. Listed below is her list:

A-Z of pregnancy and birthing in Dutch
Bedverhogers – bed raisers (available from a Thuiszorgwinkel to hire and a health and safety requirement for a home birth and post natal care)
Bevalling – labour, giving birth
Bloedonderzoek – blood test
Borstvoeding – breastfeeding
Breken van de vliezen – waters breaking
Hydrofiel luiers – muslins
Kraampakket – items sent by medical insurer to prepare for a home birth and post natal care
Kraamverzorgster – maternity care assistant
Kraamzorg – maternity care
Kruiken – hot water bottles (metal)
Navelklem – umbilical cord clamp
Poliklinische bevalling – hospital birth
Thuisbevalling – home birth
Thuiszorgwinkel – a national network of shops selling and hiring items for the pregnancy, birth and post natal care
Uitgerekende datum – due date
Verloskundige – midwife
Vruchtwater – embryonic fluid
Wee├źn – contractions
Zwangerschap – pregnancy
Zwangerschapscursus – prenatal course
Zwangerschapsyoga – Prenatal yoga

2. Prepare yourself mentally by reading on what is in store for you for the next 9 months. Internet is such a help in this matter. There are a lot of good sources around to know what is going on with your body for each week or each month. Sign up for week by week updates from sites like:

http://www.babycenter.com/

http://www.ivillage.com/

http://www.parents.com/pregnancy/

http://www.americanpregnancy.org/

http://kidshealth.org/parent/pregnancy_calendar/pregnancy_calendar_intro.html

http://www.whattoexpect.com/pregnancy/week-by-week/landing.aspx


3. Make a list of questions you would like to ask the midwife. Prepare a list of things you would like to know or things you would like to share.
Try not to feel shy about sharing your feelings or whatever you are experiencing. Being pregnant is not a trivial state. All those little aches and pains amount to something far greater- a growing baby in your belly.Your body has to accommodate that little bundle of joy and that is not a simple feat. I'll let you in a realization of mine after giving birth to Katie...it finally dawned on me why being constipated was necessary. Weet jij waarom? (you know why?) because it helps you to know how to push during labor! Isn't that such a grand design? :)

A birth plan is also important. By understanding that pregnancy is a normal process and in most cases does not need too much medical intervention, you would be able to gauge whether you are confident enough to want a home birth or hospital birth. Home births here in the Netherlands is a common practice. Making a decision to do home birth or hospital birth is important because certain preparations are needed. For example, those opting for home births will receive a kraampakket from your zorgverzekeraar (health insurer) that contains all the necessary materials for home birth and after care and with those planning for hospital births it is necessary to enlist yourself in the hospital months before your due date. There are also information sessions (on pregnancy and labor) provided by the hospitals particularly for those who have enlisted. Creating your birth plan means talking with your partner and midwife about the details on how you would like the labor process to be. Pregnancy and labor are such empowering experiences that it would be nice to have a better idea of how we would like it to be handled.

For both our kids I didn't make an elaborate birth plan but I did specify to the OB/Gyn who gave birth to Katie and the midwife who assisted me with Milos that it would be Boris who will cut the umbilical cord. There were also certain details that I wanted like having no epidurals not unless I really cannot bear the pain and opting for a home birth with Milos (which unfortunately didn't happen but this is for another story http://www.mnnetherlands.com/directory/jelenjevfloreslanakristine/101/101_givingbirthinthenetherlan.php).

I am also a proponent for positive labor and not fighting the contractions. In both labors I didn't scream, kick or curse as much as you see in tv. The only times I can be heard were during the coached breathing with my partner and during the pushing. I believe that bringing out a baby is a marvelous occasion that should not be marred by throwing expletives or words of regret for what is going on. For other tips on positive labor a nice reading material is http://www.pregnancytoday.com/gallery/10-steps-toward-a-positive-labor-19/10-steps-toward-a-positive-labor-1/
.
For those wanting to make their own birth plans, you can check out Baby center's birth planner http://www.babycenter.com/100_create-your-own-birth-plan_5235284.bc or from the American pregnancy association http://www.americanpregnancy.org/labornbirth/birthplan.htm. Like what it says there, it might not fit in everything with what you can have but it's worth knowing what the options are from your service provider.

--- to be continued----

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