Baby / Life Abroad / Pregnancy

The Dutch Maternity System, Part 3 (The Birth!)

Now that I’ve completed a full pregnancy and birth in the Netherlands, I wanted to recap how the Dutch handle the end of pregnancy and the delivery and postpartum period, compared to the American system.

The end of my pregnancy was (luckily) fairly uneventful. My blood pressure went up a little, but never hit a level of real concern (140/90 or higher). Even though I wasn’t in “dangerous” territory, my midwives took the rise in my blood pressure seriously and made sure I was coming in weekly for appointments where they would check my blood pressure and run a test to ensure there was no protein in my urine. The week I got my first high blood pressure reading the practice arranged for a midwife to come to my house two days later to measure my blood pressure and test my urine again to make sure everything was ok. Once my blood pressure (thankfully) leveled off, I continued to have weekly appointments, much like they have in the states at the end of pregnancy.

As I mentioned in Lark’s birth story, I did call my midwife once before I was in “real” labor, because I’d been having regular contractions that had lasted all day and were getting closer together. The protocol in the Netherlands is to call your midwife at the first signs of labor, they then come to your house to assess you and determine if or when you should head to the hospital. In the US, you generally call your OB or the hospital at the first sign of labor, and they tell you whether you should go to the hospital just based on hearing your symptoms over the phone.

Having the midwife come to you first ensures that you don’t head to the hospital too early or before it’s really time. So many women end up at the hospital in the US, hooked up to monitors that measure contractions, only to be sent home hours later because they’re not really in labor yet or they’re not far enough along to warrant being admitted to Labor and Delivery. (And what a glorious waste of time and money all of that is.)

Once my labor started and I contacted the midwife, she took the reigns and determined when we would head to the hospital and took care of the logistics of calling the hospital to ensure that there was room for me to be admitted. At the hospital there was no paperwork, no wrist bands, no IV, no continuous fetal monitoring. My midwife stayed with us the entire time I was in labor and would listen to the baby’s heartbeat intermittently with the doppler.

We saw a hospital nurse once during our five hours at the hospital — she came in early on just to say that we should press the red call button if we needed anything and she would contact my midwife if she wasn’t in the room with us. (In the Netherlands, if a hospital is short-staffed in labor and delivery, your midwife will call your kraamzorg company to send over a kraamzorg to assist in your birth and postpartum period at the hospital. It’s customary for your kraamzorg to be present if you deliver at home as well. A kraamzorg from the company I had signed up with came to the hospital and was present for Lark’s birth and took care of me after I delivered.)

At the hospital I was free to walk around, dim the lights, play music, and was generally un-interfered with. My midwife set up the birthing tub for me and monitored the baby’s heartbeat occasionally between contractions, but she basically just let me labor as I wanted until it was time to start pushing. I think if my labor had been longer/harder, the midwife would have stepped in and given more support as needed. As it was though, my labor was very short and, in my opinion, very easy. Once I started pushing my midwife really stepped in and supported me. Pushing during a natural birth is super scary and your body basically just takes over (it’s true what people say about being inside their bodies for pushing — that’s exactly how it felt). In between contractions my midwife was right next to me, literally inches from my face telling me to breathe and what to do during the next contraction. It was so helpful to have her pull my focus between those intense moments because I was able to re-center myself and prepare for the next wave of pushes.

After Lark was born I was able to hold her immediately after (I mean, I pulled her out of the water myself!) and had an hour of skin-to-skin where no one bothered me, other than to ask what I might want to eat. After Prim’s birth in the US, there was a small delay between when she was born and placed on my chest, where the doctor held her and had KC cut the umbilical cord. She was also removed during the first hour to be weighed, wiped down, and given her first set of shots. Having uninterrupted time with Lark right after she was born was so amazing and made me feel so much calmer. She was able to breastfeed successfully and adjust to her new life outside my belly.

After the hour was up, Lark was weighed, given her eye treatment and vitamin K shot, then dressed and returned to us. She never left our room or even our sight while we were at the hospital.

In the US, all postpartum care takes place in the hospital, whereas in the Netherlands it takes place at home. The newborn hearing screen, heel prick and first set of vaccinations takes place at your home during the first few weeks — the local authorities who handle these logistics come to your house and assess the baby’s living situation in addition to taking care of whatever baby-care they are tasked with completing. Your midwife also comes to your home for your first postpartum appointments.

And then of course the most Dutch aspect of the birthing process — the kraamzorg.

A kraamzorg is a postpartum nurse who comes to your home for the first eight days following the birth of your child. You sign up with a company of your choice, and you can opt for anywhere from three to eight hours a day with your kraamzorg for that period. The kraamzorg assesses your healing, helps with breastfeeding, monitors the baby’s temperature, and how she’s eating and generally progressing during the first eight days. The kraamzorg also helps out around the house, by preparing food, entertaining older children, doing laundry and light cleaning.

Since this post is already super-long, I’ll save my own thoughts and opinions on the Dutch birth and postpartum process for another post.