The pregnancy ends with the delivery and the birth of a child. The delivery usually starts in the period between 37 and 42 weeks, with a peak in the week after the due date. The baby growing in its mothers womb will be born. For all involved this is a big event.
As long as everything goes well with your pregnancy we will await the spontaneous onset of the delivery and you have the choice were you want to deliver: at home in your own surroundings or in the hospital. Everyone will start their delivery at home. Even if you want to give birth at the hospital, you will start with contractions at home. Giving birth in the hospital means that you rent a room there to deliver under our guidance. We will be assisted by the (maternity)nurse of the hospital. We will first check on you at home and when the time has come we will call the hospital to announce your arrival. If you give birth in the hospital there often will be an extra fee. You can look up what this fee is in your insurance policy. On average this fee will be around 400 euro. If you have additional insurance, the fee will often be reimbursed.
The choice of where you want to give birth can be made during the pregnancy, but you can also wait and see how you feel during labour and then decide to stay home or to go to the hospital. In all cases it is good to consider the fact that giving birth often is different than you expected beforehand. The delivery can be a lot quicker than you anticipated, or take a lot longer than you would have thought. Suddenly staying in the shower at home can feel really comfortable while you thought beforehand that you wanted to go to the hospital for the delivery. It can also happen that we deem it wise on medical grounds that you do go to the hospital when you had the preference of delivering at home. Please keep an open mind in all those cases. Prepare for what you expect to be pleasant and retain the possibility that it could work out differently when the time comes.
Around week 36 of the pregnancy we will have talked about when to call us during the delivery. (See also: When to call during the delivery).If you call us, you will get the midwife on duty on the phone. She will come over to your house to evaluate the situation and see in what stage of the delivery you are, what you can expect (roughly) and what will happen from there on. This all depends on how the delivery is proceeding, how you feel during the delivery and what your needs are at that time. For some this can mean that we will visit you several times before the time comes to stay at your home or to go to the hospital. For others this can mean that we stay at home with you from the first time we visit you or leave for the hospital immediately. The agreement with the hospitals is that we go there only when the active phase of the labour has begun. A woman in labour can be very impressionable before the active phase. The hormone flows that provide for the contractions are easily disturbed by distraction or change. It is even possible for regular contractions to come to a complete stop because of (for example) a telephone call. You will be interrupted in a natural process that needs to start up again. In the active phase of the delivery that impressionability is much less and the contractions will normally push on in spite of distractions. This is the reason the hospital prefers that you come during this phase so you will not occupy a room for longer than is necessary. On average this means we will leave for the hospital when you have a dilation of about 4 to 5 cm. You need to arrange for your own transport to the hospital. If you do not have your own transport a taxi is fastest and easiest.
If you give birth at home, the midwife will bring everything that might be needed, including a birthing stool. The midwife will call the maternity nurse to assist during the last phase of the delivery.
If you want to give birth in a hospital, you can choose between the Bevalcentrum West in the OLVG West, OLVG East and the AMC. We have a sound cooperation with these hospitals. If there is no availability, we will arrange a place in another hospital in the Amsterdam region.
Should something happen during the birth causing you or your baby to be more at risk to have problems or complications then we will transfer your care to the gynaecologist. In most cases this means that there will be more monitoring during the delivery, for example by having continuous registration of the heart activity of the baby. The monitoring will be done by the midwife of the hospital or by a junior doctor / resident physician. You will not see a gynaecologist until true problems arise where action is needed like a instrumental delivery or a caesarean section. Our goal is to go with you to the hospital when the care is transferred during the delivery. We will keep guiding you until the delivery is transferred into the care of the hospital staff and everything has been made clear to you in the new situation.
When the child is born it will be put immediately and directly on the bare chest of the brand-new mother. There he or she will be dried off and covered with warm towels. This is important for the child to recover from the birth and to get used to the huge transition he or she is going through. For the parents this is the moment to take the time to observe and to get to know their child. The skin to skin contact is also very valuable physically. It reduces the stress of the birth for the baby and ensures peace. Moreover, it supports the hormonal changes that are responsible for the production of breast milk. We will leave you undisturbed for as long as possible to enjoy this moment. Usually it will take the baby about an hour to start the search for the breasts, to find one of them (often without help) and to start drinking for the first time.
After a delivery we will stay with you for a couple of hours. The maternity nurse will stay longer. How long depends on the time of day and how you all are doing at that moment.
If you had the delivery in the hospital you usually go home after a couple of hours. After arriving home you will call the maternity nurse yourself. When the maternity nurse will come to your house depends on the time of day.