Category Archives: Life Abroad

Life Abroad / Pregnancy

Planning a Dutch Birth

January 10, 2017

One of the things I’ve noticed being pregnant in the Netherlands is how attentive my midwives have been to my birth preferences. The conversation about my “birth plan” literally started at my very first appointment. Home births are very common here, with somewhere around 30% of women delivering at home, as many insurance plans will only cover a hospital birth with medical necessity. When I signed up for insurance here I knew we wanted to have another baby, so I opted into a higher-priced plan which covered hospital birth without medical necessity (though I’m pretty sure that my history qualifies me for a hospital birth either way).

I’m not against home birth in principle, but I personally prefer to deliver at the hospital, so I informed my midwife that I would be planning on a hospital birth. She had consulted an OB-GYN about my medical history (as I had brought my medical records from my previous pregnancy and ER stay) and felt that my decision to deliver there was a good one.

Once I reached 20-something weeks I was given a form to fill out with my birth preferences. I filled it in and brought it to my next appointment where my midwife reviewed it thoroughly and we discussed my wishes.

This whole process was such a departure from my experience in the US, where any discussion of my “birth plan” was completely lead by me — not my doctor. I prepared a birth plan all on my own in the US and brought it to an appointment with my OB where she stuck it in my folder without even glancing at it. And since I ended up going to the hospital to be induced without any warning, I didn’t have my birth plan with me to give to the nurses so I just told them what I wanted verbally.

Luckily, I had some great nurses and doctors who were very supportive of my wish to labor naturally, and I was well taken care of during Prim’s birth. I have spoken to many friends who have not had such positive experiences trying to labor and birth without drugs or additional medical intervention in the US.

Here in the Netherlands, birthing without drugs is the norm. Only about of 10% of women receive an epidural here. This is partially because fewer women deliver in hospitals here than in other modernized countries, but also because anesthesiologists do not work the way they do in the states. Here, anesthesiologists often aren’t available after-hours, and if you request an epidural and the anesthesiologist is busy, it’s highly likely you won’t receive one. (I’ve also heard that if your nurse thinks you don’t need an epidural that you won’t get one.)

Since the Dutch treat pregnancy and birth like such a normal process that the body is designed to handle, this approach isn’t all that surprising. I have spoken to women who have received an epidural here — one of my midwives had almost exactly the same experience I had during her birth, where she labored as long as she could on pitocin after having to be induced and finally gave in and was given medication when she became too exhausted — so the epidural-assisted birth does indeed exist here, it’s just much rarer than in the US. C-section rates are also considerably lower here.

Here’s a comparison by the numbers between the US and the Netherlands:

  • Births via C-Section:
    • US: 32.7%
    • Netherlands: 7.7%
  • Epidural use during labor/delivery:
    • US: 60%
    • Netherlands: 10%

Coming up tomorrow: my birth plan and the Dutch postpartum approach. Stay tuned!

Life Abroad / weekend

This Weekend Was

August 24, 2016

KC took last Friday off work and it was raining, so we decided to take Prim to Tun Fun — a sort of Chuck E. Cheese-type place set up in an old abandoned subway station. I can see it being much more fun for a kid who is a little older — one who can run and climb things, but Prim had a great time parked in the ball pit meant for the little ones. 
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She was mainly interested in throwing the balls out of the ball pit, which she was surprisingly good at. There was a solid pile of balls outside the pit by the time we headed out (sorry Tun Fun staff…) img_9632

And of course I couldn’t resist the child-in-a-cage photo op.

After Tun Fun we hopped on our bikes and rode in the rain to get some burgers for dinner. I managed to ride into one of the inlaid subway tracks in the street and almost ate it on my bike, so that was fun. Luckily Prim was on KC’s bike and not mine. Definitely not one of my better moments. (Also, the things that come out of my mouth in moments like this are so not kid-friendly.)

We also hit up this local carnival/film festival thing called Parade. It was… interesting. I thought it would be a little more kid-friendly, like carnivals in the states, but this was more geared toward adults and only had one ride (a particularly terrifying set of swings that went in a circle and had a guy who would stand and swing you around viciously as you would pass by — no thanks). img_9630 Prim had a good time wandering all around the grassy areas while we were there, at least. (Prim’s Canadian tuxedo/denim-on-denim look was my fault because I couldn’t find her other sun hat before we left the house.)

Afterward we biked to a local restaurant I had spotted the week before and got a milkshake. (Because milkshakes are my favorite thing these days.)  img_9635The rest of the weekend was spent running errands and doing other usual weekend things. Prim spent some time breaking in her new floaties and getting used to the headphones we bought her for flights. It was quite the look. img_9628 img_9627

Here’s hoping that she loves those headphones enough to sit still for at least part of the flights back to California in a couple weeks… img_9626

How was your weekend?

Life Abroad / Pregnancy

The Dutch Maternity System

August 19, 2016

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Given that I’ve already experienced one pregnancy in the US, I thought I’d write a post about the Dutch maternity system. It’s pretty different from the US — much more hands-off. A friend of mine recently referred to it as “free-range pregnancy,” which I think is a pretty apt description.

When I was pregnant with Prim, here’s how the first trimester was:

  • blood test at 5 weeks to confirm pregnancy and measure HCG levels
  • blood test 2 days later to confirm HCG levels were at least doubling
  • doctor appointment and ultrasound at 6 weeks to confirm pregnancy with heartbeat
  • blood test to screen for antibodies, Rh, iron levels, etc.
  • doctor appointment at 10 weeks
  • ultrasound at 10 weeks to confirm due date
  • early glucose test due to family history of gestational diabetes
  • blood test for NT scan
  • NT scan ultrasound at 12 weeks
  • doctor appointment at 14 weeks

Here’s the first trimester in Amsterdam (omitting all the hospital crap I had to do due to the Hyperemesis Gravidarum):

  • doctor appt at 6 weeks to establish relationship with midwife
  • 6 week ultrasound to confirm pregnancy with heartbeat 
  • 10 week ultrasound to confirm due date
  • blood test for NT scan/blood test to screen for antibodies, Rh, iron levels, etc.
    • these tests are done together so you only have to go in for one blood draw
  • NT scan ultrasound at 12 weeks
  • midwife appointment at 13 weeks

The three things in italics above are things that are not customary in the Dutch system. We opted into these and paid out of pocket for them. If you went “straight Dutch” you would have two midwife appointments, the dating ultrasound and one blood test during the first trimester — that’s it!

Also, when I would go in for a routine doctor’s appointment in the US they would weigh me, have me pee in a cup, take my blood pressure, measure the height of my uterus, and listen to the baby’s heartbeat on the doppler. Here a standard midwife appointment is getting my blood pressure taken, having the midwife feel how my uterus is growing, and listening to the baby’s heartbeat on the doppler. That’s right — THEY DON’T WEIGH YOU. I’m kind of into it.

It’s also not customary to do the glucose/gestational diabetes test here. They apparently only test you if you have some sort of risk factor. And aside from the GD test (if you’re required to take it), there is no other blood work required after the single test done in the first trimester. Bananas!

I’ll fill you in on the delivery planning here on a later date, because that’s a whole other animal. But yeah, if you’re into hands-off pregnancy, maybe plan your next one to be here in the Netherlands!

Life Abroad / weekend

Watch Out, World!

August 18, 2016

img_9526Serious Dutch mama comin’ through!

We got a child seat installed on my bike last week so I got to take it for a spin this weekend after a delicious Sunday brunch at Omelegg. I’m not going to lie, I was totally nervous taking Prim out on my bike. It’s not like I’m not a competent bike rider or anything, but I think taking any kid out for the first time is kind of nerve-wracking.

Luckily everything went well, and P would even pat my back whenever we would come to a stop, as though she was saying “good job, mama!” (Although it was probably more like, “Let’s get going! What’s the hold up??”)

KC and I are now all set up to ride around the city together with Prim in tow. I think it’s going to be a little while before I’m fully comfortable traversing the streets with a small child sitting behind me, but practice makes perfect! And thank goodness they have serious bike lanes here and bikers very clearly have the right of way in almost every situation, which people really respect. 

Please note that P’s helmet is soooo not Dutch — no one wears helmets here, even the kids! Girlfriend is gonna look like a tourist though because it took me 9 damn months to grow that brain. img_9525

Oh, and just ignore my amazing Sunday morning hair in those photos… Sometimes pregnancy is like, “I’m so starving I’m just going to throw on pants and who even cares because get me food and put it in my face IMMEDIATELY.” I’m basically a newborn. I have to be fed every 2-3 hours or I turn into a screaming crying mess.

That pregnancy life, it’s a glamorous one.

Life Abroad / Travel / weekend

A Trip to Zaanse Schans

August 17, 2016

img_9529This weekend we took a quick trip to Zaanse Schans. It’s only a 20-minute drive from Amsterdam and such a cute small town full of windmills and that classic Dutch charm. 
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When we left the house it was sunny, so of course by the time we got to Zaanse it quickly turned overcast and then started raining. Luckily Prim didn’t seem to mind, even though we’d neglected to bring the rain cover for the stroller. (That bag in front of her was my jerry-rigged attempt to keep her lower half sort of dry.)img_9534

My Tom’s shoes were not the smartest footwear choice for the sudden downpour either, but oh well. We still managed to have a great time. We saw sheep, goats, ducks, and huge swans. img_9531

img_9533The only bummer of the trip was that the town is home to a Cocoa processing plant so the entire town smells like chocolate. (You’ve heard of Dutch-process cocoa, right? Well, they make it here.) Let me just tell you that parading a pregnant women around a town that smells like freshly baked chocolate chip cookies is TORTURE. The smell seriously made me want to swim in a chocolate river à la Charlie and the Chocolate Factory.img_9532

 

We stopped at a local pub on our way out for a quick drink and a snack. It wasn’t the swimming pool full of chocolate that I really wanted, but a glass of orange juice and a plate of bitterballen was fine. (Heartbreak. Pregnant heartbreak.)

We also happened to share a table with an older couple who were visiting from Arizona and who had met working for KC’s company back in the states a super long time ago. The guy even knew a partner in KC’s office — such a small world! img_9535

And don’t let P’s serious face fool you, she had a great time.