Witsenkade
Verloskundigen.

About Childbirth.

For many women childbirth is one of the really special happenings in their lives. For a partner it is also very impressive to be present at childbirth. Nobody knows beforehand how the delivery will proceed and that makes it a very thrilling occurrence.

We will try to prepare you as thoroughly as possible for childbirth and will adapt our information to your requirements. There are women who like to know about all possible scenarios, but it is also possible that you would like to just let it happen. However, we do think that it is a good thing for everyone to have basic knowledge about the course of normal childbirth. In our experience women (and partner) who know too little about childbirth can be overpowered and it can then become an unpleasant memory. We would like to avoid this happening. We strive to make you look back upon the birth of your child as a wonderful experience.

Bring your partner

Bring your partner to the chek-up when we talk about your birth plan, so he can also ask all the questions he has!

Let him also read ‘when to call us’.

Grote broers wacht op komst van baby.

When you may give birth.

For most women delivery is between 37 and 42 weeks of pregnancy. That is between 3 weeks before and 2 weeks after the due date. If you are having your first baby there is a high probability that your will give birth slightly after the due date.

If you give birth before 37 weeks we call that a premature delivery. The baby is then considered to be too small to be born and will require extra care after childbirth. A delivery before 37 weeks will always be attended by an obstetrician, because an eye must be kept on the baby during birth and the baby must be handed to a paediatrician immediately after birth to be examined.

If you have not given birth by the due date we will discuss with you when the birth should be induced. We know that most births set in spontaneously within 2 weeks after the due date. But in a few cases birth does not start spontaneously and will have to be induced. Birth is not induced after the same period for everyone; this depends on various factors such as, the size of your baby, the amount of amniotic fluid in your womb, how you are health-wise and what your wishes are. We will go through everything with you and then set a date for inducing labour together. Induced labour is always attended by an obstetrician in a hospital. Therefore we will transfer you if induced labour is required.

What causes birth to begin?

It is not yet known exactly what causes birth to begin. We do know that your baby plays an important role in this. The most important hormones during childbirth are oxytocin, endorphins and adrenaline.

Oxytocin

Oxytocin has been called the ‘love hormone’. It causes strong contractions of the uterus.

Endorphins

Endorphins are opiate-like substances found naturally in the body during childbirth. They are very important as they help you to relax during labour and delivery. As you relax and feel more at ease during delivery, more endorphins will be released in your body and make it more pleasant for you. That is why it is so important for you to feel at ease at all times. We will help you with this.

Adrenaline

Adrenaline is also a hormone. It is a hormone that is released if there is anxiety, tension or fear. This hormone stops the delivery hormones and endorphins and therefore the contractions. During the daytime you always have more adrenaline in your body because it is light, there are more noises and more impressions. That is why most women give birth at night.

Tips

In order to release only a small amount of adrenaline during delivery and as much oxytocin and endorphins as possible during delivery:

  • Organise warm surroundings to give birth in.
  • Wear soft and comfortable clothes.
  • Avoid bright light. Dim the lights (this is also possible in a hospital) or light some candles.
  • Turn off telephone, radio and television if you notice that this distracts you.
  • Take a warm shower and fill a hot-water bottle with warm water.
  • Ask someone to give you a massage.

How does childbirth start?

Childbirth can start in two different ways: with contractions or when the waters break.

Contractions

Most births (90%) begin with contractions. These are contractions of the womb that cause the cervix to dilate. In the beginning the contractions come at irregular intervals and are short. Many women describe this as menstrual pain. During these contractions you can talk, laugh and even go for a walk. They don’t feel nice but they don’t hurt very much yet. After a while the contractions will occur more often and last longer. You will also feel the contractions more and they will become more effective.

When your waters break

10% of all births begin with the breaking of the waters before there are any contractions. This usually happens at night. You notice this because you are suddenly losing fluids. Sometimes it is so much that you are certain that the waters have broken. But sometimes it is difficult to determine whether the fluid that you are losing is just fluid secretion, urine or amniotic fluid. The most important difference is that amniotic fluid keeps on dripping. You continue to lose fluid. If you are in doubt as to what it is, you should call us immediately on the mobile (o6) number.

What can you expect when your waters break?

If the waters break, a hormone is released that causes labour/contractions to begin. Usually contractions begin spontaneously within 24 hours after the breaking of the waters. (that happens in 75% of the cases). Sometimes it takes more time. Once the membranes have ruptured there is a small risk of infection in the womb. This is mainly for 24 hours after the waters break. That is why we will wait for spontaneous contractions to begin for 24 hours. However, if there are no contractions after 24 hours we will refer you to the obstetrician. The obstetrician will do various examinations after which he/she will decide together with you when to induce the birth. Sometimes they do this immediately, but if there are no signs of an infection they will wait one or two days more if this is what you wish. If the breaking of the waters was more than 24 hours ago you will always be attended by an obstetrician in a hospital.

You should use the cellulose mat from the birthing-packet to protect your bed against the amniotic fluid.

Did you know that …

You don’t have to be afraid that your baby will have no amniotic fluid anymore after the waters have broken. Your baby, the placenta and the membranes continue to produce new amniotic fluid. So your baby will still have enough amniotic fluid after the waters have broken.

Baby in de handen van de vader.

If the water breaks, you should pay attention to a few things:

The colour of the amniotic fluid

Amniotic fluid looks like thick water with little white flakes in it. Sometimes it is light pink. This is the normal colour of amniotic fluid. If the amniotic fluid is brown, yellow or green, then the baby has defecated in the amniotic fluid and that should not have happened. Your baby should only to defecate after birth. Most babies (80%) have accidentally defecated and that is not serious, but sometimes (in 20% of the cases) the baby has defecated because it is stressed. That can be dangerous. That is why you should always call us if the amniotic fluid is brown, green or yellow. We will then drop by to check on the condition of the baby. After that we will always refer you to the obstetrician who will attend to the birth and will check on the condition of your baby extra thoroughly.

Call us immediately if the amniotic fluid is green or brown or if the head has not engaged in your pelvis.

Has the head of your baby engaged?

If you come to your check-ups we will always, after 35 weeks, feel if the head of the baby is well placed in your pelvis. We call that ‘engaged’. A lot of children position themselves with their head in your pelvis around 35-36 weeks of pregnancy. This is called engaged. There are also children who remain above the pelvis with their head or have their head in the pelvis at an angle. These babies only descend into the pelvis during the contractions. For the delivery it does not matter whether the child is engaged before or during the contractions. However, it is important if the waters have broken. If the head has not engaged there is still space between the head and the pelvis and if the water broke then, the umbilical cord could descend over the head. This can become dangerous at the moment that the contractions begin. If the water breaks and the head has not yet engaged at the last check-up call us immediately on our mobile number (06), even at night. We will then come by to check whether the head has engaged in the pelvis, without the umbilical cord in front of it.

Prevent an infection!

If your waters have broken, a germ can cause an infection in the womb. In order to prevent this it is wise to minimize the risk by not making love anymore and not using tampons. It is also advisable not to take a bath until you have strong contractions. Taking a shower is permissible.

The phases of childbirth

In order to understand what happens during childbirth it is useful to know a bit about the anatomy of the womb.

The womb is a very large muscle that has one opening at the bottom, the cervix. The cervix has the shape of a spout leading to the vagina and is about 3-4 centimetres long and feels hard, like the end of your nose. The cervix is very strong, which is important because during pregnancy it prevents the child from dropping out of your womb.

During delivery, the cervix must first soften, more or less as soft as your earlobe. Then it must become shorter, from 3-4 centimetres long, it becomes as thin as a membrane. During pregnancy the womb leans backwards a bit and during delivery it will lean forwards. Then the cervix will open. This is called dilation. After that the womb and you will push the baby out, and after that also the placenta.

Delivery is divided into five phases:

  1. The latent phase: the cervix will become softer and shorter and begin to dilate
  2. The active phase: the contractions will grow stronger and longer and you will have a cervical dilation of about 5 centimetres
  3. The transitional phase: you will have about 8 centimetres dilation and the contractions are very strong with intense peaks
  4. The delivery: you have complete dilation and you can expell your child
  5. The afterbirth: the birth of the placenta

What you (as) partner can do during the delivery

The most important thing that you as partner can do is remain positive. It is very nice for your wife to hear that everything progressing as it should and that she is doing really well. If you remain positive, your wife will do so too and that it really important during a delivery!

It can be difficult for you to see that your wife is suffering. But do try not to commiserate with her by saying things like: Óh how terrible for you!’ and ‘dear oh dear, you do have a lot of pain!’ But tell her how well she is working at it and that you are proud of her. That will give your wife more strength and energy.

Baby met blauw T-shirtje aan.

Tips

  • Remind your wife to have a drink now and then. Women often forget this during the contractions.
  • Advise your wife to go to the toilet every 2 hours or so. A full bladder can prolong the birth unnecessarily.
  • Try out various positions to lighten the contractions.
  • Massage your wife’s lower back, just above her tail bone. During a contraction it can feel good if someone puts pressure on there or massages it.
  • Keep count of how often the contractions come during the active phase so that you know when you should call us.
  • Don’t discuss anything with your wife. During delivery your wife can be extremely irrational. Try to ignore this. She may say things that she does not mean because of the pain.
  • If you want to touch or hold her, ask her first. During the delivery she is very sensitive. Stroking or a small pat can take her by surprise and irritate her.
  • Try not to break her concentration during the active phase. Don’t make a telephone call for instance or talk loudly in the neighbourhood of your wife during the delivery.