Give birth the way you want

1. The course of the delivery of your child (ren) can hardly be planned. But you can control the circumstances as much as possible. Such as the place that suits you best, the position that seems appropriate to you and the tools you want to use. An overview of possibilities.

1. At the beginning of the pregnancy, 77 percent of all women are monitored by a primary obstetrician and just over 20 percent by a gynecologist in the second-line obstetric care.

Guidance

1. Of the pregnant women who are accompanied by an obstetrician at the beginning of the pregnancy, 30 percent are referred to a gynecologist during pregnancy. Slightly less than half of all women (45 percent) begin labor under the supervision of a primary care midwife. Some of them are still referred to second line during labor.

2. Of the pregnant women who are accompanied by an obstetrician at the beginning of the pregnancy, 30 percent are referred to a gynecologist during pregnancy. Slightly less than half of all women (45 percent) start labor under the supervision of a primary care midwife. Some of them are still referred to second line during labor.

To give birth at home or not?

1. Ultimately, 22 percent of women give birth at home and 11 percent on an outpatient basis under the supervision of a primary care midwife. 67 percent of women give birth in secondary care under the responsibility of a gynecologist. For women who are pregnant for the first time, a percentage of 77 percent applies, with almost 50 percent having to go to hospital during childbirth. In short: if you are pregnant with your first child, the chances are very high that you will be referred to hospital during pregnancy (56 percent to be exact) and if you are one of the 42 percent of pregnant women who are allowed to start labor at home , the chance is almost 50 percent that you will still have to go to the hospital. Home birth benefits Cons of home birth Optimal relaxation. A sense of safety and security. Most control over how you want it. You can try out all postures undisturbed. Less chance of intervention and less risk of infection. In case of complications you still have to go to the hospital. No pain relief possible. You must meet certain conditions (see later in the article). Hospital benefits Disadvantages hospital   A sense of security. In case of complications you are immediately in the right place. Possibility of medicinal pain relief. Less relaxed and quiet. Less freedom of movement. Less participation. More chance of intervention or artificial delivery. Greater risk of infection. Without a medical indication it costs money.

2. Ultimately, 22 percent of women give birth at home and 11 percent on an outpatient basis under the supervision of a primary care midwife. 67 percent of women give birth in secondary care under the responsibility of a gynecologist. For women who are pregnant for the first time, a percentage of 77 percent applies, with nearly 50 percent still having to go to hospital during childbirth. In short: if you are pregnant with your first child, the chances are very high that you will be referred to hospital during pregnancy (56 percent to be exact) and if you are one of the 42 percent of pregnant women who are allowed to start labor at home , the chance is almost 50 percent that you will still have to go to the hospital. Home birth benefits Cons of home birth Optimal relaxation. A sense of safety and security. Most control over how you want it. You can try out all postures undisturbed. Less chance of intervention and less risk of infection. In case of complications you still have to go to the hospital. No pain relief possible. You must meet certain conditions (see later in the article). Hospital benefits Disadvantages hospital   A sense of security. In case of complications you are immediately in the right place. Possibility of medicinal pain relief. Less relaxed and quiet. Less freedom of movement. Less participation. More chance of intervention or artificial delivery. Greater risk of infection. Without a medical indication it costs money.

The maternity care hotel

1. As an alternative to a home birth, there are some maternity care hotels where you can give birth on an outpatient basis or spend the maternity period. Professional maternity care is available 24 hours a day in the maternity care hotel. The delivery, supervision and check-ups are the responsibility of the midwife. The rooms in a maternity care hotel are privately and attractively furnished. There is free reception of visitors. Family members are welcome to stay the night in consultation. You use all facility services of the hotel: meals, coffee and tea in your room, telephone, television and refrigerator. And finally: your baby is in your room. There are only a few maternity care hotels in the Netherlands, including in Rotterdam, Tilburg, Bennekom and Utrecht. The Healthcare Act stipulates that a delivery with obstetric care is reimbursed for 100 percent. The personal contribution for the maternity care hotel amounts to an average of 3.60 euros per hour.

2. As an alternative to a home birth, there are a few maternity care hotels where you can give birth on an outpatient basis or spend the maternity period. Professional maternity care is available 24 hours a day in the maternity care hotel. The delivery, supervision and check-ups are the responsibility of the midwife. The rooms in a maternity care hotel are privately and attractively furnished. There is free reception of visitors. Family members are welcome to stay the night in consultation. You use all facility services of the hotel: meals, coffee and tea in your room, telephone, television and refrigerator. And finally: your baby is in your room. There are only a few maternity care hotels in the Netherlands, including in Rotterdam, Tilburg, Bennekom and Utrecht. The Healthcare Act stipulates that a delivery with obstetric care is reimbursed for 100 percent. The personal contribution for the maternity care hotel amounts to an average of 3.60 euros per hour.

You can give birth at home if ...

1. You are at least 37 and at most 42 weeks pregnant and your pregnancy has expired without complications. Your health status is stable and your previous delivery (s) went without complications. You have not had a previous birth on medical grounds or a caesarean section. There is no question of a breech presentation or multiple pregnancy.

2. You are at least 37 and at most 42 weeks pregnant and your pregnancy has expired without complications. Your health status is stable and your previous delivery (s) went without complications. You have not had a previous birth on medical grounds or a caesarean section. There is no breech presentation or multiple pregnancy.

You give birth on medical grounds under the supervision of a gynecologist in the hospital if ...

1. You have broken membranes for more than 24 hours. You must be initiated, or if the dilation or expulsion is not progressing. Your child is in need or if there is stool from the baby in the amniotic fluid. You need or want pain medication. Your health condition or that of the baby requires additional medical attention.

Horizontal delivery

1. Most women give birth while lying on their bed. The so-called reclining squat position. Advantages  Cons Good control over the child's heart tones. Good view of the vaginal area. Comfortable position between contractions. Back and side position possible. More gradual expulsion. Press against gravity. The head shoots back more easily in the last phase. Less different postures possible.

Vertical

1. The most natural delivery position, which is highly preferred by midwives. Advantages Cons   Lots of variation and variety possible (squatting, on hands and knees, bent over, standing). The pelvic outlet is optimally widened. Strong contraction activity and faster expulsion. Gravity helps a bit. Less chance of tearing. Less chance of intervention. Use of aids is possible Too rapid contractions or expulsion, so that you still end up flat on the bed. Small tears in the labia.

1. What aids are available for childbirth?

The birthing stool

1. This 'half-open inverted bucket with a sitting edge' is an excellent and frequently used aid for vertical delivery. Advantages are a good seat, support and partner involvement. The stool can be used on the bed and on the floor. Disadvantages are poor vision of the vaginal area, delivery can go too quickly and with prolonged use, fluid can accumulate in the pubic area.

The clam shell

1. This is a flat plastic disc with the same function as a birthing stool, without a sitting edge. This allows for multiple vertical postures and gives you a good footrest. The disadvantage is that you have to take your posture on your own.

The romarad

1. A kind of 'swing in tube construction' in which you can give birth both horizontally and vertically. The advantages are a pleasant cradle effect during contractions and many variations in positions and postures. The disadvantages are the limited possibility to sell during pressing; most women still end up in bed. The aid is only available in a limited number of hospitals.

Water delivery

1. You can also give birth underwater in a rented bath, private bath or shower. The advantages of this are that you experience less pain and have a smoother delivery. Your child's transition to the outside world is also more gradual and many different postures are possible. The disadvantages are the difficult work posture for the midwife, the high costs of a rental bath (around 2250 euros) and that you cannot stay in the bath for more than two consecutive hours. [! 168738 => 1130 = 14!] Skippyball

1. A gym ball is a simple, effective aid for vertical delivery (do not over-inflate). Advantages: a wonderful seat to absorb contraction pains and a relaxing massage of the lower back. Can also be used as a prop for back pain. You can buy it yourself for 5 to 10 euros. This article has been checked by Veronique van Dooren, director of the Dutch Obstetrics Gynecology Association. Sources: * Perinatal Care in the Netherlands 2006 (Netherlands Perinatal Registration Foundation) * Wiegers TA, Janssen BM. Monitor obstetric care provision: final report. Utrecht: Nivel, 2006