Category Archives: Life Abroad

Life Abroad

A Tour of Our Amsterdam Apartment

May 17, 2017

I finally got around to taking a few photos of our apartment, in case you’d like to see how we’re living out here in Amsterdam!

We have a 3 bedroom flat that spans two floors above a woodworking shop. Not having residential downstairs neighbors is great — the shop is closed in the evenings and on weekends, and they aren’t bothered by the sounds of life with kids (aka Prim running laps around the apartment). We have a private entry from the street, which is awesome because we can store our stroller downstairs (lugging two kids up these Dutch stairs is quite enough).

Up the first flight of stairs is the living space, which includes a living room, dining room, kitchen and outdoor terrace. Upstairs we have 3 bedrooms, a small laundry room with washer and dryer, and a bathroom with separate toilet.

Our flat is located on a quiet street in the heart of de Pijp neighborhood — it’s super close to the city center and tons of great sites, stores and restaurants, but we’re lucky that we don’t live on a loud and crazy main road.Our street at sunset. Sometimes the light here in the evenings is just insane!This is a photo from last June of our front door. The plant out front was in full bloom and it looks like it’s going to be blooming again any day now.This is also an older photo, we’ve since picked up a couple of toddler chairs which we purchased secondhand for €10 — such a steal.Someday I will have a kitchen with more than a small slice of counter space. Not today though.Look at that tiny Prim! This big shelf in the living room helps store and corral all the toys.Our outdoor terrace is so nice on warm days — we felt so lucky to find an apartment with outdoor space.The view from the terrace feels pretty “Dutch.” I love it.Lark’s crib, which will eventually be moved into Prim’s room.Prim’s crib (which is usually full of books and many other stuffed animals. The girl loves her “stuff!”)Prim’s room and the guest room (below) both have these built-in desk things that we tried to get the landlord to remove before we moved in. He didn’t want to remove them which was kind of annoying (they take up so much space!) but the one in Prim’s room actually works well as a changing table at least.Our guest room (slash where we fold clean laundry — ha).Our room (which is so hard to photograph due to it’s A-frame construction).The outdoor terrace through the seasons.View from our front windows.View from our back windows (in winter, obviously).This is the Amstel River, which is just down the street from our apartment.And this is part of Sarphatipark, which is a 5 minute walk away.

We feel pretty lucky to have found such a great flat in such an awesome location. When the weather is nice, I feel like I could live here forever.

And seriously, we have a guest room — what are you waiting for??

Baby / Life Abroad / Pregnancy

Reflections on Giving Birth Abroad

February 26, 2017

If you’ve been following along for awhile now, you already know that there are a lot of differences between how the Dutch and American systems handle pregnancy and birth (if you’d like to get caught up, see parts 1, 2, and 3 here). I’ve also written about Prim’s very “American-style” birth (read: induction, Pitocin, epidural, being forced to wait to push) and Lark’s decidedly Dutch entrance into the world (no drugs whatsoever, born in the water, home less than 3 hours after delivery).

So given the choice, which model would I opt for next time?

The Dutch approach, hands-down. As I’ve mentioned before, I do think the Dutch approach has its drawbacks. I think it’s a tougher model for first-time moms in some ways. If you are struggling with breastfeeding (like I did with Prim), being sent home from the hospital mere hours after delivering could add additional stress to an already stressful and emotional situation. Also, if you’re someone who has a lot of anxiety with pregnancy, the American approach will likely give you more peace of mind than the the sort of “free-range” Dutch model. And if you’re someone who is dead-set on having an epidural for delivery, the American model is going to be your best bet. (Remember that 60% of American births are accompanied by an epidural, whereas only 10% of Dutch births use one.)

The Dutch model is very much based on the natural progression of pregnancy and childbirth; so if you’re into the natural pregnancy/birth thing (which I am), the Dutch model is amazing, in my opinion. I love that there’s not a lot of unnecessary medical intervention in the Dutch model, and that they really focus a lot on your wishes for labor and delivery ahead of time. Not to mention that the model of having your midwife present for the majority of your labor I think helps support the natural birth model, as they can provide valuable support and insight during the labor process.

I loved that my midwives were deeply invested in my birth plan long before I went into labor. I felt very supported in my wish to have a natural birth and labor in the water. Additionally, one of the things that really struck me after giving birth was how much my midwives wanted to discuss my labor and delivery after it was over. I have seen or talked to four of the five midwives in my practice since delivering, and all four have brought up Lark’s birth, saying that they had heard about my delivery (“Delivered in the water — how wonderful!”) and asked me how I felt it went.

In the US, no one asked me about my birth. Even after my postpartum hemorrhage, where I literally almost bled to death, no one — not even my regular OB — asked me about my delivery or its aftermath and how I felt about it.

If you’ve given birth, you know that it’s a huge, life-changing moment. It’s something that you want and need to discuss afterwards. The Dutch seem to recognize this, but the American system does not. Overall, the Dutch seem to recognize that in order to have a “successful” pregnancy and birth, you support the mother personally first and medically second. The American model seems much more based on risk-aversion and doing what the doctor feels is best, even if it’s not what the mother wants.

I love that the Dutch seem to still regard pregnancy and birth as a miracle created by a woman’s body. There is a lot of respect for the woman throughout pregnancy and birthing process, and a lot of weight given to her own wishes and feelings throughout the nine months. A good example of this was after my delivery my midwife and kraamzorg were talking to me about Lark’s birth and I mentioned that the timing was especially fortuitous because my mom happened to be visiting Amsterdam for a mere three days and I had managed to deliver during those three days. Without missing a beat, the kraamzorg said, “Your body knew,” and my midwife immediately said, “Yes. Women’s bodies — they know.”

Isn’t that wonderful? I know it’s a little crunchy-granola sounding, but I think a lot of the respect for the female body has been lost in the American system. So much of the US system is focused on the fetus, rather than the mother. While I agree that the fetus is precious, you don’t get the baby without the mother. Creating and birthing a life is a huge, wonderful thing that should be celebrated. If you’ve been or are pregnant, you know the awesome sacrifice of carrying a life, and I’m here to tell you that what you’re doing — it’s not easy, but it’s amazing.

If you’re considering a birth abroad, or moving to the Netherlands and considering expanding your family, I can’t recommend the Dutch approach enough. As I told my midwife after delivery, I don’t know how I’m going to go back to the American system after this, as I feel like Lark’s birth was about as ideal as it gets.

Baby / Life Abroad / Pregnancy

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

February 24, 2017

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.

Life Abroad / weekend

Snow Day!

February 13, 2017

It snowed over the weekend in Amsterdam! It has snowed here before, but usually the flurries don’t last long and don’t really stick for more than an hour or two, so it was exciting to have a few legit inches throughout the day that stuck around for all of Saturday and Sunday.  Prim was bundled up and spent some time out on our terrace with KC while I was inside dealing with some fun contractions (yayyy for prodromal labor. Not.)  Prim’s outfit was complete with her plastic multi-colored elastic heart bracelet. Obviously.KC built Prim a little snowman, but she was really more interested in just hanging out and eating the snow.Thanks for the awesome snowy weekend, Amsterdam! (And kudos to baby #2 for staying put during the storm since KC is stressed out enough waiting for your arrival 😉 )

Life Abroad / Pregnancy

My Birth Plan

January 11, 2017

Obviously the grammar could be cleaned up a little…

In case you’re curious, here’s what I laid out in my birth plan*, based on the format provided by my midwife (with the specifics being basically identical to what I asked for when laboring with Prim):

  • My expectations regarding my pregnancy and delivery:
    • Give a short description of how you see the course of your pregnancy and delivery
      1. Calm, normal and quick (ha!)
      2. I would like the delivery to be calm, peaceful and supported. I would like to be able to dim the lights and play music in the delivery room.
  • Who will be present during delivery:
    1. Husband, midwife, any necessary medical personnel.
  • Contractions: relaxation and pain relief
    • If applicable, which positions would you prefer to soften your contractions whilst giving birth? (eg: walking, on the birthing stool, showering bathing, etc.)
    • How would you prefer to counter the pain associated with the contractions? (eg: breathing techniques, etc.)
      1. Would like to try all available positions to soften contractions (walking, birthing stool, shower, bath, etc.)
      2. I would like medication/epidural pain relief available, but hope/prefer not to use.
  • Where would you like to deliver:
    1. At the hospital (OLVG Oost).
  • Special treatments/interventions during deliver?
    • Do you have any other wishes or ideas about your delivery not mentioned above?
      1. I had a delayed, massive postpartum hemorrhage following the delivery of my last child due to a large blood clot.
      2. I have had back surgery on L5/S1 and have a bulging disk at L4/L5 — if given an epidural, it needs to be above L4/L5.
      3. Prefer delayed cord clamping, especially if baby is born before 37 weeks.
  • Postpartum period
    • Do you want to breastfeed or bottle-feed (with formula) your child?
    • Do you have any other wishes or ideas about your postpartum period?
      1. Skin to skin immediately following delivery, for as long as possible.
      2. Husband to cut umbilical cord.
      3. Breastfeeding exclusively as soon as possible after delivery.

My midwife reviewed my plan thoroughly and informed me that this is all “very standard” in the Netherlands — including delayed cord clamping (it’s the standard to delay clamping in all births here). Also, you get to eat during labor here (hallelujah!) As I’ve mentioned before, I wasn’t allowed to eat anything for over 24 hours while in labor with Prim and was STARVING, so I’m glad that I’ll at least have the option to re-fuel as needed here, without having to sneak it behind the nurses back (because, yeah, I would this time).

Now, obviously, a “birth plan” is kind of a misnomer in itself because birth plays out how it’s going to play out, no matter how hard you try to control it. The above is more a “birth wish list” of sorts; and just like I did when I was pregnant with Prim, I’m going in with the intention of letting my body do its thing naturally and will re-assess my needs as they come up in the moment.

An interesting note on the hospital and postpartum period here — the standard hospital stay is a mere 4 hours after delivery. That’s right, 4 hours after you deliver you’re sent home with your brand-new baby. Again, if this were my first child, I would probably be freaking out a little bit about this, but since this is my second, I’m ok with it (in principle). Obviously if you have any sort of complication or reason for extended monitoring you stay in the hospital longer, but part of the reason for the short postpartum stay is because you are provided a home health nurse for the first 8 days following birth.

Standard insurance covers a kraamzorg (basically a home postpartum nurse) for about a week after delivery, for anywhere from 3-8 hours a day. The nurse comes and checks your healing, assesses how the baby is doing, assists with breastfeeding, and will also watch older children, run errands, and do light housework.

Amazing, right?

Also, the first health appointments you have following birth (for you and baby) are conducted at home. The midwife comes to you for your postpartum check and the consultatiebureau (which handles pediatric care in the Netherlands) also comes to your house to check the baby. This is partially for your own comfort and also so the consultatiebureau can assess the baby’s living and sleeping situation (so smart!)

Further, when you actually go into labor in the Netherlands, the process is a bit different than the US. Much like the US, you call your midwife (or doctor) when you believe labor has started, but rather than managing it all on your own, here in the Netherlands your midwife will come to your house to monitor and support your labor. She tells you when it’s time to go to the hospital and accompanies you, and while at the hospital she can stay with you during labor if you would like the support. Once you’re ready to deliver, assuming you don’t have any complications, the midwife will deliver your child with assistance from a nurse. This means that if you have a normal, low-risk pregnancy, labor, and delivery, then you won’t actually see an OB or other doctor EVER during your birth or pregnancy. Nuts!

*I also went through a longer-form birth plan here, which is awesome any very comprehensive — but it is in Dutch and the google translate is only about 90% helpful. That said, if you’re looking for a birth plan template, this really covers all your bases!