The most important task of the midwife during the pregnancy is to detect problems or possible risks for mother and child. To accomplish this, the midwife will do everything in her power to promote a normal progression of the pregnancy by giving information, advice and psycho-social counseling to the pregnant woman. There are a couple of problems like stomach aches and anemia during normal pregnancies that the midwife can monitor and, if necessary, treat herself. If a problem or complication arises during the pregnancy that the midwife cannot judge or treat herself, like for example high blood pressure, the pregnant woman will be referred to a gynecologist for additional consultation.
After a normal pregnancy, what usually follows is a normal delivery. A normal delivery gives the pregnant woman the freedom to choose the position, manner and place of delivery. The midwife accompanies this delivery at the home of the woman in labor or, if she chooses, in the polyclinic part of a hospital. During the delivery, the most important task of the midwife remains to detect problems or possible risks for mother and child. The midwife will also provide for the most optimum circumstances for a normal delivery. Every woman in labor will have her own circumstances and wishes and the midwife offers personalized guidance and support to assist in a way that suits the woman in labor.
There is a risk that problems will still occur. For the evaluation and treatment of those problems the midwife has a diversity of options, like for example the doptone to monitor the hearttones of the child and medicine to keep blood loss of the mother within acceptable limits. If problems arise during labor that the midwife cannot judge or treat sufficiently, the woman in labor will be referred to the gynecologist.
The gynecologist is the specialist in the field of aberrant obstetrics. He or she has treatments available for those situations where mother and/or child are threatening to be or even are at risk. Pregnant women are often referred back again to the midwife by the gynecologist after evaluation; in other cases it could be desirable to stay under the care of the gynecologist for the remainder of the pregnancy and the delivery.
The first week after the delivery is called the postpartum period (“kraambed”). A normal kraambed is spent at home. During the postpartum period the mother can recover from the delivery and the parents can get accustomed to the new situation with a baby at home. The baby must “prove” him- or herself that week. The baby must keep a regular temperature, drink well and the metabolism gets underway. The “kraamverzorgster” (maternity nurse) will come every day that first week to medically check and nurse mother and child. She will give advice to the parents on how to take care of the baby. The midwife comes, depending on the situation, a couple of times that week. She will recap and talk about the delivery, will monitor the health of mother and child and is responsible for the policy on how to treat problems if they arise. Here, as during the delivery, the midwife takes into account the circumstances and wishes of the parents so they can make a good start together with their child.
If problems after childbirth and in the kraambed arise, it could be necessary that the mother and/or the baby must be hospitalized. After discharge from the hospital the midwife will come to your home to evaluate the situation and, where needed, adjust this situation.
After about six weeks after the delivery the midwife will do a final check on the mother. The emphasis of the check is on the recovery of the woman after her pregnancy and delivery. We will also talk about how the mother has experienced her pregnancy, delivery and the first weeks with her child and how she feels about motherhood.
We hope this text gives a clear image of the role we as midwives play during and after your pregnancy. If you have any questions about this subject, we would love to answer those during our consultation hours.