Since 3 weeks, I started working again and my leave was officially over. Thanks to the presence of Britt, our trainee midwife, I had a quiet start. As Britt is about to graduate, she could already do a lot herself and needed the space to work independently as well. This gave me the opportunity to slowly get used to being on call again in combination with Maas. Of course, we thought early on about taking care of Maas when we were both back at work. After all, that is not so easy when working irregularly. Fortunately, we both still have our parents who were very willing to babysit and Jordy was able to apply for 1 day of parental leave. This leaves my hands free to be there for you!

I myself was and still am happy to be back at work. Because my leave fell during the lockdown, we had little to no visitors and could not go anywhere. So I was ready for a normal rhythm and social interaction with an adult again. It may be that you will feel this differently yourself and that you are not at all ready to go to work yet. Know that it is all normal and also very personal. Make the most of the moments you have with your baby because the cliché really is true: they grow way too fast so enjoy every moment. Try to do this even when you feel like there is nothing to enjoy for a moment. For example, when you're about to leave the house and your baby starts screaming and on top of that, finds it necessary to poop. Sigh. As soon as Maas touches the changing mat, he starts laughing, he loves being on the mat and then the "sighing moment" of 5 minutes earlier is already forgotten.

Breastfeeding and work

This brings me straight to the next challenge: pumping! As a woman, you are entitled to spend 25% of your working time breastfeeding or pumping. In doing so, your employer must facilitate a pumping area that is lockable. So the toilet will absolutely not suffice and neither will the pantry. So, are you breastfeeding and do you want to pump when you go to work? Then notify your employer in time so that he/she has time to arrange a decent space for you. So as a practice owner, I am my own employer and so I have to arrange this myself. During consultation hours, this is of course not a problem. Then I can schedule extra time so I can pump. During childbirth this is a bit more difficult! Nowadays there are pumps that are hands-free (but really hands-free, so no more cables!) You can charge these and put them in your bra. So I can easily pump in the car when I'm on the road! Very convenient.

Do you have questions about your rights as a breastfeeding mother? Then ask them at the consultation hour or visit https://www.lalecheleague.nl/borstvoeding-abc/artikel/256-borstvoeding-werken-en-de-wet

Nine months in the belly-nine months out of the belly.

In 2 weeks, it will be 9 months since you came 'into the world'. And what a beautiful day that was! The months leading up to your birth seem so long ago now. And all the ailments that came with it now seem like peanuts. But the first trimester was a drama; I was exhausted and nauseous all day. No success with a toddler, work and a household. Fortunately, I got plenty of support. And the fact that the check-ups at Lief Leven were always good and you were growing like cabbage outweighed all those ailments. It also helped that I felt at home with the ladies at Lief leven and that every check-up was a party; we got to see you again! The second trimester was enjoyable. Until pelvic discomfort presented itself in the last trimester. Then the party was over.

Apart from Simone and Mayke, I also met Noor, the intern. Together we discussed our birth plan. We hoped for a home birth with birthing bath, nice music, no painkillers, a quiet setting with dad, my mother and the midwife. Not too much fuss. I remember very often saying 'maybe I'm romanticising everything', but Mayke and Simone always gave me back that this was ok and that visualising how I wanted it could contribute positively. That gave me a lot of confidence. When I had another check-up in week 38, Simone still called out on leaving; "I'll see you next Monday, because you'll be exactly 39 weeks then". Our son was also born exactly at 39 weeks, so we joked a bit about this.

Monday morning, exactly 39 weeks pregnant. In the morning, fortunately, I can still visit the acupuncturist. The pelvic pain is unbearable. Climbing stairs is hardly possible and walking is even less so. I ask the acupuncturist whether the treatment can be aimed at inducing labour apart from pain reduction, because I 'can't do it any more'. After the treatment, I lie down on my bed at home for a while. And after 30 minutes, my membranes break. Ohhhh yes, it's about to start. I recognise this feeling from my first delivery. There too, I was allowed to call Lief Leven at 39 weeks and Simone was soon on our doorstep. Only this time she was there faster, because she assumed it would go super fast this time. I turned and moaned away the contractions in the shower. I had completely forgotten what contractions felt like, but bah, these were contractions. In the meantime, dad made sure our little house was made ready to welcome you. The bath had to be pumped up and filled. He just got busy. The music went on, diffuser with a nice scent. I sat at the head of the table on a gym ball puffing away the contractions and an hour after we called, Simone was already there. I remember being so happy to see a familiar face; we are going to do this together!!! Noor was still busy with another delivery, but soon joined us too. My mother arrived half an hour after that. So our birth team was complete. This gave so much peace of mind!

Even though there were still a handful of us, there was a serene calm. Simone and Noor did their preparations in silence, my mother sat on the sofa with her crochet work. I could fully focus on the contractions. And in between, we could have a nice chat. I actually found it cosy. Dad, on the other hand, ran them legs under his body; drinking, supporting, massaging my back, keeping the bath up to temperature, snacking, etc. When the contractions became serious, Simone suggested we go into the bath anyway, so I would relax. At first I didn't want to, as I had no idea how long the birth would take. In my eyes, the bath was my last resort. Yet she convinced me; I could always get out and back in later.

Measuring how far my dilation was was ok I thought, however, I did not want to know the result of this.  

I was afraid that I would be disappointed by this and then find it mentally tough. So that did Simone all right. I went into the bath. How wonderful that was, I should have done it much earlier! I relaxed. But suddenly things moved fast. Was this because I was relaxing? Jeez, those contractions! All this time everyone was still sitting comfortably in place, everything was ready, it was quiet. Just the water and daddy, you and me. You were getting ready for your arrival, that was clear.

Slowly Noor and Simone gathered around the bath and I asked how long it was going to take. I would know when the body was really ready, Simone said. 'Have faith.

That only lasted a few minutes, because I knew: you are coming now!

I just managed to turn into the crawling position and then went into labour. 2 push contractions later, you are launched into the world underwater. You are here! Welcome sweet girl.

I hold you and we are still snug in the warm water. You don't cry immediately, you are a bit miffed from the launch and hard work, but otherwise you are also very relaxed and close.

While dad, you and I recover and get to know each other, my mum takes photos and Simone and Noor are busy. My placenta is still struggling a bit to be born. I am not aware of anything. My job is done, I thought. When it's really taking too long anyway, we discuss options. The hospital is also mentioned. I wasn't waiting for that, but what has to be, has to be. We try one last time and we succeed.

I can see the relief in everyone's eyes. Apparently, it was more exciting than I realised.

Still quietly, the checks are done on our girl and me. I get to shower, put on something easy and cuddle with you again. What a joy this is. We succeeded; a home birth as we hoped, in the bath, without painkillers, in a peaceful setting, with a wonderful birth team around us. A dream if you ask me!

Just before five, Simone and Noor are ready and walk out with their packs. I joke that they worked a good day shift from 9 to 5 on a Monday. Just in time.

Grandpa brought your big brother back home so you too could get acquainted. I was in the mood for Thai, so that was delivered. It really felt like a big party; nice people around us, you finally with us and good food.

In the course of the week, Noor and Myrte came to visit more often to make sure everything was going well. We really enjoyed the guidance, seeing the same faces over and over again and the aftercare.

To be repeated.

Now, meanwhile, we get to enjoy you for almost 9 months, all those months with us.

How grateful we are for that! Welcome sweet girl. How much we love you.

Before I go to a delivery, I go through everything in my head in the car. I think about what I have in my car: my trauma bag with all the essentials for the delivery, my "normal" bag, which includes my blood pressure meter and the baby's scale, and my doptone, to listen to the baby's heart. In my head, I check what is in the delivery plan (sometimes I quickly read it just before I leave). I also think about what possible risks might be and how I can anticipate them.

Not because I am afraid of the risks, but because it can help me act quickly and well, if I have done so in my head before.

So this time, too, I drove to the delivery in the dark night. I was aware of how important it is and how beautiful it is that I can make the birth of Simone and Jordy's baby beautiful and physiological. On the other hand, that's not entirely up to me either. Childbirth goes the way it goes. As long as I monitor this process well, we are at the mercy of how it goes.

All these things go through me as I drive to Simone's.

I was not surprised that contractions were now well underway. I had visited Simone twice that week to strip her. The first time it did something, but not enough. The second time was last night. I could see from Simone's face that this time it was more serious and I was convinced that labour would start shortly after this. Actually, I was waiting for the phone call.

On arrival, Simone is in the living room very quietly sighing away the contractions. The lights are dimmed and there is quiet music on. I put some things ready. And I see that Simone is managing just fine in the meantime. She is already somewhat introverted.

I listen to the baby's heartbeat. The heartbeat is fine.

Some time after entering the room, I ask Simone if she wants me to measure how much dilation she has. She hesitates for a moment, but decides she wants it anyway. I touch her as she lies in the delivery bath: 3 centimeters of dilation she has. And she has been having contractions for hours. Quite a disappointment for her I notice. But experience has taught us that dilation doesn't say much. Because it's just not linear. She may well be holding her baby in her arms in a few hours. The "bubble" of calm has disappeared for a while. But fortunately the focus returns. Simone quietly sighs away her contractions again. She does hint that it is painful, but also that it is going well. Occasionally I listen to the heartbeat. Other than that, I sit on the sofa. I don't do much because I notice that things are going well. That my presence is good. And that nothing else is needed right now.

In the early morning, the waters break spontaneously. Quickly I write down the time and see if I can tell if the amniotic fluid is clear, thankfully it is. I listen to the baby's heart, still good. The contractions are getting a lot more intense now, because the head is pressing on the edge of the dilation rather than the fluid-filled membranes. I can well imagine it's on her mind whether pain relief might be an option, because the pain is incredibly intense. But she doesn't want that, I know. So I coach her through it. She can do this and she is doing super!

Half an hour after the water breaks, she notices pressure sensation during the contractions. And soon after, she gets reflective urge to push. I help her remember that this is good, that the baby is really getting close now. In reflective pushing, it is the uterus itself that pushes the baby out. All you have to do is give in to this, work with your body. That sounds simple, but sometimes it takes some shifting.

When the urge to push starts, things move very quickly. Every contraction I see Simone giving in more to the urge to push. Standing in the bath, she is pushing with her body. I keep an eye on the heartbeat, but otherwise Simone does everything herself.

Exactly how long she pressed, I don't know. After about half an hour of pushing, the head is born. I keep my hands out of the water, because Simone knows exactly what she is doing. And the next contraction their beautiful little man is born, swimming into this world. In the safe hands of his own mother! How beautiful this is.

I got to witness a beautiful birth. A birth as I prefer to witness it, in her own environment and in the way she wanted. And even from such a special woman! What a wonderful profession we have. And what a privilege that I could be part of it.

Another thing that can influence your experience of the maternity bed is the maternity nurse who comes to the house. Preferably, maternity care is requested before 16 weeks of pregnancy, so you can think about this early on. Think carefully about what you expect from a maternity nurse and ask about experiences of people you know. You have "normal" maternity care but also natural maternity care. Read about the differences and make a conscious choice. Furthermore, you can choose to register with a maternity care agency or look for a freelancer. Because there is so much to tell about the maternity period and this story is already getting too long, we will split up this blog into several parts. We will talk about vitamins, the heel prick, nappies and much more!

First of all, of course, we wish everyone all the best, we hope all your dreams come true this year and of course wish everyone a very fruitful year. Meanwhile, this year's first baby has already been born and, like Maas, it was born in a bath. Are you also hesitating about a bath birth and not sure what to imagine? Then read on. Because I am going to take you through the preparations we made for a bath birth at home. We have two birthing baths for rent at the practice, so I didn't have to go looking for one. Besides the delivery bath, you also buy a box containing all kinds of disposables. These include the inner cover for the bath (so the real bath never comes into contact with water), the hose to fill and empty the bath, a submersible pump to empty the bath again, an under sheet for the bath and gloves for the midwife. The bath itself looks like this:

The bath is not yet fully filled with air, otherwise you won't get the inner sleeve over the bath. So in this photo, the inner cover is not yet on top. As you can see, the bath has handles in several places so you can easily assume different positions. Hydration has also been considered, as there is a cup holder in the bath. Furthermore, the bath comes with fittings for the tap, so there is a fitting for every tap, so you don't have to look for one yourself! Very handy. The bath is very easy to set up and actually ready to fill within 10 minutes. Another thing to think about when giving birth in the bath is a place next to the bath where you can lie comfortably. This is necessary for when you get out of the bath after giving birth. It's often too much to walk straight up the stairs to the bedroom at that point, for example, so it's handy to have a place next to the bath too. For us, this was the sofa. Over this we put plastic and a waterproof mattress protector. This is what it looked like for us:

Next to the bath was our kitchen table so Myrthe also had her things easily to hand. Handy to know, we are all prepared for a bath birth, so our doptone is waterproof and we can just listen to the baby's heart in the bath. After delivery, the bath is easily cleaned up again. It comes with a submersible pump with a garden hose, so you can easily empty the bath in a drain in the garden or in the toilet. When the bath is empty, you remove the inner cover and throw it away. The bath is then drained and folded back up to fit into the rucksack. It seems like a lot of work at first, but everything is designed to be very easy. If you have any more questions about bath birth or about the bath itself, feel free to ask at the consultation hour or leave a comment on facebook or instagram.

In the next blog, you can read how together we provided the optimal setting at home to create a nice environment for labour.

You can read more next Tuesday!

Last time, I told you about my adventure with the sugar test. To be honest, I had been quite nervous because I am not a hero with blood sampling ( I know, I am a midwife). Still, it's very different poking someone else than being poked myself. Anyway, I had survived the day and afterwards it was not too bad! So I had worried about nothing. Because my fasting value was abnormal, I had to take my sugar values myself at home. It can happen that during the sugar test the value was a bit higher once but that it usually isn't. That is why you first go and prick your sugar levels at home to see what your sugar levels are during the day. Initially, my fasting value remained on the high side. It should be below 5.3 and I was always around 5.4 or 5.5. I started trying everything to get this value down. I ate less and less carbohydrates and sugars, hoping this would lower the value. The more often I got a wrong reading, the more stressful it became. So I started eating even fewer carbs. Unfortunately, cutting back on carbs too much had the opposite effect and there's a very logical explanation for that! Naturally, I called my colleague Mayke, our nutrition guru. She told me that your liver stores sugar as a supply and that your liver releases a certain amount of sugar in the morning to give you energy to start your day. So the less carbs and sugar I started eating, the more enthusiastically my liver started releasing sugar in the morning. To address this, I started eating more carbs again in the evening and went for a walk in the morning before pricking. Fortunately for my body, this was enough to keep the sugar levels at a good level. I do want to emphasise that this was fortunately enough for my body, but this does not have to be the case for others. Sometimes your body is so upset by the pregnancy hormones that you cannot get your sugar levels under control with just a different diet and more exercise. Then the internist will prescribe insulin to help your body regulate your sugar levels. This is important for your own health but also for your baby's health. For me, it was important to make sure I had done everything I could to help my body get the sugar levels right without medication. Our little man is estimated to be big from the beginning so anything I could do myself to regulate his growth that had to be done. So for me it was quite a stressful period because each time I thought I was doing the right thing, which in hindsight turned out to have the opposite effect. Fortunately, I got the sugars under control and have stayed that way so far. If your sugars are also abnormal, always low-key contact your dietician, nutritionist or an orthomolecular therapist. They can help you see what your body needs to regulate sugar levels properly.

If you guys have any questions for me, please send a pm or leave a comment on facebook or instagram! As long as our little man stays put, you can expect my next blog next Tuesday!