Post-term pregnancy: what if you’re ‘overdue’?

You’ve reached your due date…. and yet nothing happens. No contractions, no signs. Just that one sentence you keep hearing: “You’re overdue.” But what does that actually mean? And more importantly, what does it mean for you and your baby? In this blog, we’ll gently guide you through everything you want to know about
post-term pregnancy. So that you understand what’s going on and can make a choice that feels right for you, with confidence.

What does post-term pregnancy mean?

Post-term pregnancy means you’ve been pregnant for more than 42 weeks. That’s more than two weeks after your due date. Good to know: your due date is, of course, an estimate. Only a small percentage of women actually give birth exactly on that day. So it’s not at all unusual for your baby to be born a little later.

What if you’re still pregnant after your due date?

Once you’re past your due date, so from 40 to 41 weeks of pregnancy, you’ll have a conversation with your midwife. If it’s medically responsible, you’ll discuss together which next step you’d prefer. You then have two options:

• Wait for labour to start on its own
• Choose to be induced

There’s no right or wrong here. Which choice is best depends on your situation, how you feel, and your pregnancy. That’s why your midwife will discuss this with you personally. If you’re offered this choice, know that at that point both options are medically responsible for you.

Why is it better not to be pregnant for longer than 42 weeks?

There’s no ‘hard limit’ that says you can’t or shouldn’t be pregnant for longer than 42 weeks. But we do know that certain risks slowly increase the longer the pregnancy lasts. That’s why, around 41 weeks, we already discuss which approach you’d prefer. Not to put you under pressure, but to keep you well informed.

What are the risks of post-term pregnancy?

Most pregnancies that go longer than expected simply go well. Still, there are a few points we stay extra alert to:

• Meconium-stained amniotic fluid. This happens when your baby passes meconium (stool) into the amniotic fluid. This is usually
  harmless, but it can sometimes cause breathing problems after birth.
• Slightly higher chance of your baby being admitted. For example, to the neonatal unit (NICU). This chance increases slightly after 42 weeks of
  pregnancy.
• A very small increase in the risk of stillbirth. Fortunately, this remains very rare, but it is still a factor in the decision to discuss the options around
  41 weeks.

Do know: the risks are there, but they are very small. Most babies are also born healthy after 41 or 42 weeks.

Is it true that your placenta ‘ages’?

The idea that the placenta ‘ages’ is a persistent myth. You’re not a carton of milk that goes ‘past its date’. What is true is that as the pregnancy progresses, your placenta becomes slightly less efficient. However, this happens very gradually, and not on a fixed day such as after 42 weeks of pregnancy. But because your placenta works a little less well over time, we do monitor you and your baby closely during this phase. We look at how your baby is moving, how you’re feeling, and if needed, we schedule some extra check-ups at the hospital. Do know that a poorly functioning placenta is genuinely very rare, but we monitor you closely during this phase just to be safe.

Induction or waiting: what suits you?

The most important question with post-term pregnancy is: what suits you, and what is medically the best approach for you and your baby? The answer naturally differs from person to person and situation to situation.

Still, you can ask yourself a few questions:

• How do you feel about a natural start to labour?
• How are you feeling right now, physically and mentally?
• How has the pregnancy gone so far?

Some women are perfectly happy to wait it out calmly. Others prefer to have more control and choose induction instead. But in every case: discuss it with your midwife for expert, personal advice. She knows what options are available to you and will make sure you know and understand those options, and that you can
calmly discuss any questions or concerns you may have.

Frequently asked questions about post-term pregnancy

What is post-term pregnancy?

You’re then pregnant for more than 42 weeks: so more than 2 weeks ‘overdue’.

Is it a problem to be overdue?

No, usually not. Many pregnancies last a little longer without any problems.

When is induction recommended?

This is often discussed around 41 weeks. If it can be done safely, it’s a choice.

Can I wait until 42 weeks?

In some cases, yes, if everything is going well and you’re well guided. Speak to your midwife for personal
advice.

How do I know if my baby is still doing well?

By paying close attention to your baby’s movements and through check-ups with your midwife or at the
hospital.

Trust your body, and ask us if you have questions or doubts

The final days or even weeks of your pregnancy can be intense. You’re looking forward to meeting your baby, and might feel impatient or even a little tense. If you have doubts, questions, or just want to talk things through now that you’re past your due date, you’re always welcome to call us. We’re here for you.

Pregnant After a Miscarriage

Answers to your questions and doubts

Unfortunately, not every pregnancy goes as hoped. Sometimes it ends prematurely in a miscarriage. Even so, it’s normally possible to become pregnant again afterwards. But many women have questions about this, or doubts. That’s completely normal, and you’re always welcome to discuss them with us. Call and book an appointment soon. Or read this blog first for initial information about pregnancy after a miscarriage.
Button: Call us with questions or doubts after a miscarriage

When can you get pregnant again?

After a miscarriage, you can become pregnant again fairly quickly, even before you’ve had a period again. How quickly your cycle recovers does vary from woman to woman. But there’s no medical reason to wait; becoming pregnant right after a miscarriage isn’t dangerous and doesn’t increase the chance of another miscarriage. If your doctor or gynaecologist has advised you to wait for a medical reason that applies to you, then this of course doesn’t apply.

Pregnant again after a miscarriage without a period?

Just as you can become pregnant again after a pregnancy before your period has started, the same is true after a miscarriage. In general, you can assume that your first period will occur between 4 and 6 weeks after the miscarriage. With a regular cycle, you’re therefore fertile again between 2 and 3 weeks after the miscarriage. But before your cycle gets going again, your body needs to be ready for it. How quickly that happens depends on, among other things:

How far along was your pregnancy?

When you’re pregnant, your body produces the hormone hCG. The longer you’re pregnant before having a miscarriage, the longer it also takes for this hormone to leave your body. Only after that can your cycle start again.

How long does physical recovery take?

After a pregnancy, all the pregnancy tissue needs to leave your body, and that’s also true after a miscarriage. This can happen within a few days, but it can also take a few weeks. Your cycle starts up again once all this tissue has left your body.

How regular was your cycle before the pregnancy?

Did you have an irregular cycle before your pregnancy? Then you’ll probably have one again now. In that case, it’s very difficult to say when you’ll be able to get pregnant again.

Is it okay to get pregnant again straight away?

That’s up to you. If it’s physically possible, there’s no reason why you couldn’t become pregnant again straight away. But it’s also possible that you’re simply not emotionally ready yet, and that’s fine too. You decide when you’re mentally ready for a pregnancy after a miscarriage. Discuss it with your partner, take your time, and don’t let anyone rush you. And, very importantly, keep taking your folic acid consistently!

What does it do to your body if you get pregnant again soon after a miscarriage?

A quick pregnancy after a miscarriage can be demanding on your body. This depends, among other things, on the previous pregnancy and how the miscarriage went. If you lost a lot of blood, for example, you may have an iron deficiency. This can make you quite tired or dizzy. Your hormone levels also change temporarily after a miscarriage. This can lead to increased fatigue, and you may find things emotionally a bit harder as a result.

Why your body (usually) actually functions well during a miscarriage

It feels quite contradictory, but having a miscarriage is often a sign that your body is actually functioning very well. In many cases, something isn’t quite right with the embryo. Your body detects this and then ends the pregnancy. However sad, in that situation your body is working exactly as it’s meant to. This, of course, doesn’t apply to miscarriages caused by other factors.

Emotional and pregnant after a miscarriage

After a miscarriage you may experience all kinds of feelings. Anger, grief, loss, guilt, emptiness… all of it can be there, and all of it is allowed. Whether you become pregnant very soon after a miscarriage or only some time later, those feelings can still be present, or suddenly come back completely. And considering that many women are already more emotional during pregnancy anyway, it’s not so strange if the emotions from that miscarriage resurface. If that happens, talk about it, with your partner, a friend, doctor, coach, or with us. Because we’re here for you, even if you’re finding things difficult during or after a pregnancy.

Frequently asked questions about getting pregnant after a miscarriage

When can you get pregnant again after a miscarriage?

After a miscarriage you can often become pregnant again fairly quickly, sometimes even before you’ve had a period again. There’s usually no medical reason to wait.

Can you get pregnant after a miscarriage before you’ve had a period?

Yes, that’s possible. With a regular cycle, you can be fertile again around 2 to 3 weeks after a miscarriage. Your first period usually comes after 4 to 6 weeks. This can, of course, vary from person to person.

Is it okay to get pregnant again straight away after a miscarriage?

If it’s physically possible, there’s usually no reason not to become pregnant again straight away. But you also need to be emotionally ready. So above all, take the time you need.

What does getting pregnant again quickly after a miscarriage do to your body?

This can be demanding, especially if you’ve lost a lot of blood or are still recovering. You might, for example, feel tired or dizzy. Your hormones can also still affect how you feel.

Can you feel emotional when you’re pregnant again after a miscarriage?

Yes, that’s completely normal. Grief, fear or uncertainty can suddenly come back. Talk about it with your partner, a friend, your doctor or your midwife.

Call your midwife in Amsterdam-Zuid

Do you still have questions after your miscarriage? Is there anything you’d like to know before becoming pregnant again? You can always come to us, alone or together with your partner. Will you call us with any questions or doubts?

Pelvic Instability

How to reduce the symptoms

Unfortunately, being pregnant isn’t all roses and moonlight. Your body changes, and in some cases that also leads to complaints, such as pelvic instability. It’s something that can’t be prevented, but there are a number of things you can do to reduce the symptoms.

Pregnancy hormones

Pelvic instability affects almost half of all pregnant women, but it can also flare up only after giving birth. Pelvic instability during pregnancy usually occurs because your joints and ligaments become softer and more flexible as a result of your pregnancy hormones. This leads to greater instability, which can cause pain.

What is pelvic instability?

Your pelvis consists of three parts connected to each other by ligaments. To create enough room for your baby by the end of your pregnancy, your pelvis needs a larger passage. That’s why the hormones make your joints and ligaments softer. The downside is that your pelvis can also start to shift, which we call pelvic instability. Your body automatically responds to this by correcting it, causing your muscles to tense up. This can also feel painful.

Pelvic pain

So pelvic instability can cause pelvic pain. And this is often triggered by very ordinary things, from turning over in bed to walking up or down the stairs, or even just vacuuming. In other words, activities you’ve always done without giving them a second thought. To prevent or reduce the pelvic pain, it’s wise to carry out all your regular daily activities a bit more carefully.

Symptoms of pelvic instability

You can recognise pelvic instability by one or more of the following symptoms:

• Pain in your pelvis: nagging, burning or sharp. This pain can be localised or radiate to your pubic bone, tailbone, groin, thighs and lower back.
• Feeling tired more quickly, especially if you sit, lie or stand in the same position for a longer period.
• Start-up pain: pain you feel when getting up from bed or a chair.
• Bowel complaints, incontinence issues or a bloated feeling.

During pregnancy

Not everyone develops it, but if you do get pelvic instability, during a first pregnancy this usually only happens halfway through. Once you have symptoms, they often get somewhat worse during the last few months. In a subsequent pregnancy, it can occur much earlier. Your joints and ligaments soften more quickly, so you can experience shifting, your body’s corrections and the associated pain sooner.

Or after giving birth

It also happens that pelvic instability only occurs after giving birth. Sometimes you already had symptoms before that, but they only get worse afterwards. Or they only start then. This can happen if your ligaments were stretched too much during the birth.

Tips for fewer symptoms

You can’t prevent or cure pelvic instability, but if you’re experiencing it, there are a number of things you can do to reduce the symptoms:

• When getting out of bed, first roll onto your side and swing your legs out of bed. Then bring yourself to a sitting position using your arms. Once you’re sitting on the edge of your bed, stand up slowly.
• Avoid climbing stairs, lifting and bending as much as possible. If you do have to do this, use the handrail on the stairs and bend your knees when you need to bend down. It’s best to lift using your arms and legs, never your back.
• Walk with small steps and don’t walk too much or for too long.
• Cycle more often than you walk, as this puts less strain on your back. If possible, lower your saddle slightly, this keeps your pelvis a bit more still and lets you pedal more from your legs.
• Lying on your side in bed? Use a pillow between your legs to keep your pelvis as straight as possible.

Pelvis and Pregnancy information session

You’ll get more tips and advice on how to deal with pelvic instability during a workshop especially for our clients: Pelvis & Pregnancy Information Session. Would you like to join too? Check our calendar to see when the next one is and sign up online!

Frequently asked questions about pelvic instability during and after pregnancy

What is pelvic instability?

Pelvic instability occurs because the ligaments and joints in your pelvis become more supple under the influence of pregnancy hormones. This is necessary for giving birth, but can also cause shifting and pain.

What are the symptoms of pelvic instability?

Pelvic instability is often recognisable by pain in the pelvis, groin, lower back, tailbone or thighs. Feeling tired more quickly, start-up pain when getting up, and bowel or incontinence complaints can also occur.

When does pelvic instability develop during pregnancy?

Not everyone develops pelvic instability. If pelvic symptoms do occur, in a first pregnancy this is usually halfway through. In a subsequent pregnancy, symptoms can occur earlier.

Can you also develop pelvic instability after giving birth?

Yes, that’s possible. Sometimes the pelvic symptoms are already present during pregnancy and get worse after giving birth. It’s also possible for pelvic instability to occur only after giving birth.

What can you do to reduce the symptoms of pelvic instability?

You can often reduce the symptoms by moving more calmly. Avoid lifting, climbing stairs and bending as much as possible. Walk with small steps and don’t walk for too long. Cycling instead of walking is often more comfortable. Lying on your side? Then place a pillow between your legs. Targeted physiotherapy exercises can also help.

Physiotherapy or training

You can also do targeted exercises during your pregnancy or after giving birth to reduce the symptoms of pelvic instability and strengthen your pelvis again. This can be done through physiotherapy or various types of training, such as Mensendieck exercise therapy or personal training specifically for pregnant women or new mothers. Check out our site here for a diverse range of trainers in Amsterdam-Zuid. Or feel free to ask us for advice.

Pregnancy Massage

When a massage is and isn’t possible during pregnancy

A massage every now and then is always lovely, even when you’re pregnant! Still, it’s better not to simply book a ‘regular massage’ during your pregnancy. Your body is different and responds differently too. A genuine pregnancy massage takes this into account. That’s not only pleasant, it also has many benefits for your pregnant body and helps avoid the risks that a regular massage during pregnancy can carry.

What’s different about a pregnancy massage?

A pregnancy massage is similar to a regular massage, but less firm. The masseur won’t massage the pressure points that are connected to your uterus. This is because doing so could stimulate your uterus, which could cause it to start contracting. And that’s obviously something you want to avoid! A certified pregnancy masseur knows exactly where you can and can’t be massaged during pregnancy. So choose a practice run by such a specialist while you’re pregnant.

Massage table for pregnant women

The massage table can also differ from a regular table. Some massage practices have special tables for pregnant women, with a cut-out for your belly and breasts. If there’s no such table? Then you lie on your side, with your belly and legs supported by cushions so you’re still very comfortable. A chair massage is possible as long as you can still sit comfortably in the chair and the masseur knows which pressure points to avoid. If the chair masseur isn’t a pregnancy massage specialist, it’s best to skip it for now.

If your body reacts differently

Because your body is changing, you may also respond differently to a massage. You might suddenly feel hot or very cold, become nauseous, or find the massage too intense. If so, let the masseur know straight away. The massage can then be adjusted so it’s still a relaxing moment for you! It’s also better to avoid a heat massage, such as a hot stone massage, during pregnancy. This is because of the reaction you may have to the heat, but also because a lot of waste products can be released during such a massage.

Benefits of a pregnancy massage

Besides being relaxing, a pregnancy massage has many benefits, such as:

• Less pain: if you’re struggling with, for example, your back or shoulders, a massage can offer a lot of relief.
• Less fluid retention: especially during the last few months, many pregnant women retain fluid in their legs. A pregnancy massage can help drain that fluid.
• Better blood circulation: the massage helps waste products be removed more effectively and quickly.
• Better resistance: a massage helps you sleep better, stimulates the production of oxytocin, the happiness hormone, and reduces feelings of stress and the production of stress hormones. It also improves your blood circulation. As a result of all this, your immune system is strengthened.

When is it not allowed?

A pregnancy massage really is highly recommended, unless you have certain conditions such as high blood pressure, thrombosis, heart problems, varicose veins or a fever. Not sure whether a massage is a good idea? Then discuss it with your midwife first.

Massage after giving birth

A massage is also highly recommended after giving birth. The birth was already tough on your body, and the first months with a small baby can also feel physically demanding. A massage can then help you relax again for a moment and recover more quickly. And are you breastfeeding? Then you may well be experiencing shoulder and neck tension. It goes without saying that a massage alone can be very welcome for that reason too.

Frequently asked questions about pregnancy massage

What is a pregnancy massage?

A pregnancy massage is a massage specifically tailored to the body of a pregnant woman. The massage is less firm than a regular massage and takes into account the changes that occur during pregnancy.

How do you lie during a pregnancy massage?

During a pregnancy massage you usually lie on a special massage table with cut-outs for your belly and breasts. If that table isn’t available, you often lie on your side, supported by cushions.

What are the benefits of a pregnancy massage?

A pregnancy massage can help you relax better, sleep better and reduce pregnancy-related complaints such as back, pelvic and neck pain. It can also help drain fluid and stimulate blood circulation.

When is a pregnancy massage not recommended?

A pregnancy massage is not recommended if you have high blood pressure, thrombosis, heart problems or varicose veins. If you have a fever, it’s also wise to consult your midwife or doctor first.

Can you also have a pregnancy massage after giving birth?

Yes, this type of massage can also be pleasant after giving birth. It can help you relax and recover more quickly from the birth.

Midwives in Amsterdam-Zuid, for all your questions

As your midwives, you can come to us for a great many things during your pregnancy. A great many, because of course we don’t do the massages ourselves. But we do know where to send you for a lovely pregnancy massage! So feel free to ask us. Or discuss your doubts with us if you’re not sure whether a massage is possible during your pregnancy. We’re here for you and all your questions.

Weight gain differs per trimester

Weight gain usually isn’t spread evenly across your pregnancy. You gain the most during the second trimester, often around 6 kilos (at an average BMI).

In the first trimester, weight gain is often fairly modest, around 1 to 2 kilos. Some women actually lose weight during this period because they suffer
a lot from morning sickness. In the third trimester, weight gain is usually around 3 to 4 kilos.

How the kilos are distributed

So the extra weight you’re carrying around by the end of your pregnancy says nothing about your baby’s weight. But rest assured, it’s not all fat either. With an average gain of around 10 kilos over your entire pregnancy, those kilos are roughly distributed as follows:

• Baby 3 – 3.5 kg
• Uterus 1 kg
• Placenta 0.5 kg
• Amniotic fluid 1.5 kg
• Extra blood 1.5 kg
• Breasts 0.5 kg
• Fat 2 kg

Dieting during pregnancy? Don’t!

Are you shocked by the extra kilos despite everything, and thinking about going on a diet? Don’t! Dieting during pregnancy is very unwise. Your baby and your body need nutrients, so make sure you eat enough, well and healthily. Eating for two, by the way, is a myth, so that’s not necessary either. You may find that you’re hungrier though. Just listen to that, but make healthy choices. Still worried about your weight? Then try to exercise a bit more, if your body allows it. Working on your fitness is always good for you, and can even help you lose the extra weight more quickly after giving birth.

There are also risks if you gain too much weight

So can you eat and snack freely for these nine months? That’s definitely not advisable either. In fact, gaining too much weight during pregnancy can even carry risks. You could develop high blood pressure, pre-eclampsia or gestational diabetes. On top of that, it’s obviously nice to be fit before giving birth and not feel hindered by the extra kilos if you want to try different positions during labour. What’s more, a very substantial weight gain on your part during pregnancy also affects your baby’s weight; this can increase significantly too, with the possible risk that your child may be overweight later on. None of this needs to happen, of course, but the best approach is to keep eating healthily, with variety and in a responsible way throughout your pregnancy, adding a few extra vitamins and supplements.

Frequently asked questions about weight gain during pregnancy

How much weight do you gain during pregnancy?

How much weight you gain differs from woman to woman. Your BMI before pregnancy serves as a guideline: the lower your BMI was, the more weight you’re expected to gain.

How many kilos do you gain at an average weight?

At an average weight, with a BMI between 18.5 and 25, weight gain during pregnancy is (indicatively) around 11.5 to 16 kilos.

In which trimester do you gain the most weight?

You usually gain the most weight in the second trimester, often around 6 kilos at an average BMI. In the first trimester that’s around 1 to 2 kilos, and in the third trimester around 3 to 4 kilos.

What does the extra weight during pregnancy consist of?

The extra weight doesn’t consist of your baby alone. Your uterus, placenta, amniotic fluid, extra blood, breasts and some extra fat also contribute to the weight gain.

Is dieting during pregnancy advisable?

No, dieting during pregnancy is unwise. Your baby and your body need nutrients. Eating for two isn’t necessary, but eating enough, well and healthily is.

Discuss your concerns or questions with us, or join the workshop!

During your pregnancy your body changes, and you’re also dealing with a whirlwind of emotions. Do you feel uncertain about that? Feel free to discuss your concerns or questions with us. We can give you plenty of answers and, if needed, refer you to a nutritionist. Or join the workshop we offer free of charge at our practice: ‘Nutrition during your pregnancy’.

4 Weeks Pregnant

Everything you need to know and arrange when you’ve just found out you’re pregnant

If you’re 4 weeks pregnant, you’ve probably only just found out yourself. So it’s only natural that you’re full of questions! You might be wondering whether what you’re experiencing right now is normal, or whether everything’s going well. Know that you can already book an appointment with our midwifery practice in Amsterdam. We’ll see you very soon and discuss all your questions, as well as what you can expect over the coming months. In the meantime, you naturally want some answers already, so below we discuss a number of the most frequently asked questions we receive from women who have only just found out they’re pregnant.

Pregnancy symptoms in week 4

Even though you’ve only just become pregnant, you may already be experiencing certain pregnancy symptoms. Typical pregnancy symptoms associated with week 4 include fatigue, nausea, tender breasts, abdominal pain or bloating, headaches and frequent urination. Some women also notice mood swings. Many of these symptoms are caused by changes in your hormones. Don’t have any symptoms at all? That’s perfectly normal too, and it doesn’t mean anything about whether your pregnancy is going well or not. So enjoy it!

A baby bump at 4 weeks pregnant?

You may notice that you already have a bit of a baby bump, even though you really wouldn’t expect that at 4 weeks pregnant. And that’s correct; if you already have a bump now, it’s not because your baby has grown that much. Your bump is most likely caused by your bowels being upset. This gives you a bloated feeling and may also cause flatulence.

Embryo: the size of your baby

At this stage of your pregnancy, your baby is still called an embryo. At a size of 0.5 to 1 mm, your baby is now as small as a pinhead. Tiny indeed. But that won’t last long, your baby is now growing very fast and this week the first body parts are forming. In about a week or two, your baby will already be around 6 mm and will then grow 1 mm a day. That’s hard work, which is why it’s so important to take good care of yourself already.

4 weeks: how your baby is developing now

Every week of pregnancy is important, but the period from week 4 to week 12 is a truly crucial phase, during which your baby is formed. In weeks 4 and 5 of your pregnancy, the foundations of your child are laid: the neural tube closes, the nerve cells that regulate bodily functions form, and the brain and heart begin to develop.

Folic acid, especially at 4 weeks pregnant!

Once you know you’re pregnant, and you’re in this early stage such as week 4, it’s essential to live healthily. If you weren’t already taking folic acid, we recommend starting straight away. Folic acid plays an important role in the development of your baby’s nervous system, which, as you can read above, is currently in its crucial phase. 2

What you should and shouldn’t eat right now

Eating healthily and varied is of course also very important. We’ve already described elsewhere what you can and can’t eat during pregnancy. But we also know that, due to fatigue among other things, you may have no desire at all for elaborate cooking or healthy eating in these first weeks. So in these weeks, mostly just follow your gut feeling when it comes to food. And as soon as you have the energy for it, you’ll gradually start eating more healthily. Of course, it’s still important to avoid harmful things such as alcohol, cigarettes and drugs.

Bleeding at 4 weeks pregnant

Are you experiencing bleeding at 4 weeks pregnant? This can be caused by the cervix being very well supplied with blood, which means it can bleed easily. It could also be implantation bleeding, where the fertilised egg implants itself in the uterine wall, which can cause a small amount of bleeding. So even if this has given you a fright, it doesn’t necessarily mean you’re having a miscarriage. It is important, however, that the bleeding isn’t accompanied by abdominal pain or cramps. If the bleeding is very light and you have no pain, you can safely wait and see. If the bleeding is heavier, so much so that you regularly need to change your sanitary pad, it’s wise to call us, either during the day or first thing the next day. This also applies if you’ve never been to see us before. Just let us know straight away that you’re bleeding. We’ll then ask you a few questions and tell you what to do next.

Frequently asked questions about being 4 weeks pregnant

What symptoms can you have at 4 weeks pregnant?

At 4 weeks pregnant you may experience fatigue, nausea, tender breasts, abdominal pain, bloating, headaches and/or frequent urination. It’s also perfectly normal if you don’t have any symptoms yet.

Can you already have a baby bump at 4 weeks pregnant?

Some women already notice a bit of a bump at this stage. This isn’t because your baby is already that big. It’s more likely that your bowels are upset, which can give you a bloated feeling and cause flatulence.

How big is your baby at 4 weeks pregnant?

At this stage, your baby is still called an embryo. The embryo is about 0.5 to 1 millimetre in size, roughly the size of a pinhead.

Why is folic acid so important at 4 weeks pregnant?

Folic acid plays an important role in the development of your baby’s nervous system. Because the first weeks of pregnancy are crucial for your baby’s development, it’s recommended to start taking folic acid straight away if you haven’t already.

Is bleeding at 4 weeks pregnant always a miscarriage?

No, not necessarily. Bleeding can also be caused by the cervix being very well supplied with blood, or by implantation bleeding. If you have heavy bleeding along with abdominal pain or cramps, contact your midwife.

4 weeks pregnant? Get to know your midwife in Amsterdam-Zuid!

Are you 4 weeks pregnant? Call or email us straight away to book your first appointment with your midwife in Amsterdam-Zuid. Or schedule your first appointment with the midwife yourself, via this sign-up form. Our practice has two locations: on the Churchilllaan and on the Willemsparkweg. We’ll arrange an appointment with you right away for your first consultation. See you soon!

Exercising During Pregnancy

5 Tips from a Pre- and Postnatal Trainer

Almost every pregnant woman wonders: can I still exercise? And if so, what is safe and sensible? The short answer is: yes, in almost all cases you can keep exercising! And in most cases, during the first phase of your pregnancy, you can continue with the sports you were already doing.

Yet online you will find a great deal of contradictory and confusing information. That is why Fenna Wüst of The Workout Lab wrote this blog for us. Fenna is a qualified movement scientist and experienced personal trainer, specialising in training pregnant women and postnatal recovery and rehabilitation (postpartum).

She shares the following 5 practical tips on how to stay safe and fit during your pregnancy.

Tip 1: Keeping Active Is (Almost) Always a Good Idea!

We start with the most important tip – even though it is certainly not easy with all the pregnancy-related ailments. Continuing to exercise has many benefits for you and for your baby. It obviously helps you stay fit, but it does much more than that. It also helps with common pregnancy complaints and discomforts, improves your sleep quality, and improves the condition of your baby both in the womb and after birth.

A useful tip if you really have no energy or feel very nauseous: start with just 5 to 10 minutes of movement. If that goes well, extend the session a little longer. If it really is not working, then that is your exercise done for today. Every moment of movement counts, however small.

If you are feeling good, there is nothing wrong with continuing to challenge yourself – especially if you were used to doing so before your pregnancy. But can you ever overdo it? Absolutely – read tip 2 to find out which signals to watch for so you can stop in time.

Tip 2: Listen to Your Body (and Your Midwife)

In today’s world, we are used to always pushing on. We are always busy and try to do everything at once. We often ignore the signals from our bodies – and yet our pregnant body gives us an enormous number of signals when we are doing too much.

Learn to truly listen to these signals and avoid telling yourself “things will calm down from next week onwards”.

The signals to watch out for:

• Braxton Hicks contractions (tight abdomen)
• Dizziness
• Sudden headache
• Nausea (different from the nausea typical of the first trimester)
• Extreme fatigue (exhausted on the sofa for the rest of the day)
• Pain complaints (lower back, coccyx, pubic bone, a heavy feeling in your pelvis, urinary leakage)

Each of these is a reason to stop your exercise session. And if the symptoms do not subside quickly, contact your midwife.

If you experience pain or extreme fatigue after your workout, you should make adjustments to your next training session. For example: shorter sessions, lower intensity, or choosing a different form of exercise. Also have your technique and posture checked by a specialist trainer. Small adjustments in these areas can make a big difference to how your body handles the physical demands of exercise.

Tip 3: Take It Easy

This is advice you will often hear, yet in practice it can be difficult to apply – or it gets misunderstood as meaning “I should stop exercising”.

Taking it easy means taking it easy in everything you do in life. Work, 10,000 steps a day, taking the stairs, cycling, cooking, keeping the house, your social life, and your relationship. Try to cut back by 10% across the board rather than sacrificing only sport and physical activity.

Pain and discomfort are almost always the result of multiple contributing factors. Exercise helps you stay fit and strong so that you can manage everything else.

Tip 4: Which Types of Exercise Are Suitable During Pregnancy?

The sports you were doing before your pregnancy can, especially in the first trimester and early second trimester, simply be continued. If you did these sports regularly, your body is well adapted to that level of exertion. If it no longer feels right, if you experience any of the signals mentioned earlier, or if you have not been able to exercise for a while, then it is wise to adjust your workout or activity.

Sports with a high risk of falling, contact sports, exercising in extreme heat, or in conditions with large pressure differences are less suitable during pregnancy. Choose controlled forms of movement instead. And if you are not yet doing strength training, I would recommend starting. Strength training helps keep your rapidly changing body strong and gives you literal physical support during your pregnancy.

Tip 5: Learn How Your Core Works

A question we receive very often is: “Can I still train my abdominal muscles?” And the answer is: yes, but probably in a different way from what you are used to – and with guidance. Because if you train your abdominal muscles in the usual way, the rectus abdominis muscles shorten and can stretch less easily alongside your growing bump. This can increase the risk of diastasis after birth.

When training your abdominal muscles during pregnancy, it is better to approach it differently, because your core does not consist solely of your abdominal muscles – it works together with your pelvic floor, your breathing, and your diaphragm. Together, they provide stability by regulating the amount of pressure in your abdomen. Exertion and effort create intra-abdominal pressure. When this pressure is very high, it places a great demand on the pelvic floor and abdominal muscles – and these muscles are already being significantly challenged by pregnancy itself.

For pregnant women who do want to train their abdominal muscles, we often teach a simple rule: exhale just before the hardest moment of an exercise – “blow before you go”. The pressure in your abdomen and on your pelvic floor is especially high when you hold your breath. By paying close attention to your breathing and performing the exercise correctly, this helps regulate the pressure and supports your core and pelvic floor.

Find Your Balance

Exercising during pregnancy is a journey of discovery – finding a balance in what is still possible. At The Workout Lab, the specialist pre- and postnatal trainers are happy to help you with this. During the Workout Mama group classes or the 10 Weeks Workout Mama programme, they focus on building strength, posture and technique, breathing, core engagement, and the pelvic floor. With the right guidance, you will not only learn to move safely, but also understand how your body is changing and how to respond to it. This keeps you strong and fit – and gives you a head start in your postnatal recovery.

Frequently Asked Questions About Exercising During Pregnancy

Can you keep exercising whilst pregnant?

Yes, in most cases you can continue exercising during pregnancy. Do listen to your body and your midwife.

What signs mean you should stop exercising during pregnancy?

If you experience symptoms such as a tight abdomen, dizziness, pain, or extreme fatigue, stop immediately.

Which types of exercise are safe during pregnancy?

Walking, swimming, yoga, and adapted strength training are often excellent choices.

How intensively can you exercise whilst pregnant?

That depends on your fitness level and how your body responds during pregnancy.

What are the benefits of exercising during pregnancy?

Staying active helps you keep fit and can reduce pregnancy-related complaints.

Want to Know More About Exercising During Pregnancy? Ask Your Midwife in Amsterdam-Zuid

Do you have questions about exercise or a healthy lifestyle during your pregnancy? You are welcome to bring all your questions to your midwife in Amsterdam-Zuid. Our practice works with several specialist partners and we are here to help you.

Iron deficiency during pregnancy

Have your ferritin (your iron stores) checked!

When you are pregnant, you are often tired. You might be told “that is just part of it” or “try to get some more rest.” But what if that does not help? What if you notice that you are extremely tired and no longer feel like yourself? In that case, you may be dealing with an iron deficiency. Even if you have blood tests done and your Hb level is normal. Ask to have your ferritin checked, your iron stores. Thanks to new insights, we now know that this is often where the real issue lies. You can be tired because you truly have an iron deficiency, even when your Hb does not show it.

Symptoms of iron deficiency during pregnancy

Symptoms of iron deficiency often start subtly. Pregnancy is intense by nature, so feeling more tired is not unusual. However, there is a difference between normal pregnancy fatigue and exhaustion. And that exhaustion is exactly what happens with iron deficiency: you deplete your reserves. And you feel it. If you have iron deficiency during pregnancy, you may experience some of the following symptoms:

• Severe fatigue
• Shortness of breath more quickly during exertion (such as climbing stairs)
• Dizziness
• Difficulty concentrating
• Hair loss
• Pale skin
• Restless legs

Are you not pregnant but do you have these symptoms? Then you may also have an iron deficiency. In that case, have your blood checked as well and ask specifically for a ferritin measurement. Why that matters is explained below.

Ferritin or Hb? Here is how it works

When blood tests are done because of fatigue, the focus is usually on your Hb level, hemoglobin. This is the protein in your blood that transports oxygen. If that value was “normal,” no further testing was done in the past. The conclusion then was: no iron deficiency. And you were advised to take it easy. We now know better. Even if your Hb is fine, a low ferritin level still means iron deficiency. Here is why: ferritin shows how much iron you have in storage. Those stores are depleted first, before your Hb starts to drop. Only when Hb drops do we call it anemia. But a low iron store already has noticeable effects.

Wallet and bank account

Hb and ferritin are closely connected. We often explain it like this: “Hb is your wallet, ferritin is your bank account.” As long as there is still some money in your wallet, things seem fine. But if your bank account is already empty, you will notice sooner or later. A shortage in iron stores, ferritin, is therefore felt earlier than it shows up in your Hb level. In addition, the lower limit for ferritin in women used to be 10, while for men it was 30. An unexplained and unjustified difference. Today, more and more general practitioners and laboratories set the lower limit for women at 60. We do as well. If you come to us with fatigue complaints, we always check your iron by also measuring ferritin. And if it is below 60? Then we advise treatment with supplements.

Iron tablets

If your ferritin level is too low, we will advise iron tablets. You may experience side effects at first. That is unpleasant, but know that for most women these side effects decrease after about 1 or 2 weeks. After that, you will notice you have more energy and feel more like yourself again. However, just as Hb is the last to drop, it is also the first to rise again. So you may start feeling better fairly quickly while your ferritin stores are not yet fully replenished. That is why you should not stop supplementing too early. First you refill the wallet, only then the bank account.

During pregnancy, even with daily iron supplementation, Hb and ferritin levels can remain stable or even decrease. Your body simply uses much more iron during pregnancy. You produce about an extra liter of blood, and your baby and placenta also require iron. Another reason to correct iron deficiency with iron tablets when anemia is present.

Iron-rich nutrition

Of course, iron-rich food during pregnancy can only help. In fact, it is beneficial. With enough iron-rich foods such as red meat, whole grain products, legumes and green leafy vegetables, you can support your body to some extent. But if your ferritin level is too low, diet alone is not sufficient. You will also need supplements to effectively correct the deficiency.

Consequences of iron deficiency for you and your baby

If you deal with iron deficiency for a long time, it can have consequences. For you, it may mean having fewer reserves during childbirth, leading to a longer recovery and prolonged fatigue. For your baby, low iron stores can also have an impact. Your baby is fully dependent on your iron supply and will receive less iron if your ferritin level is too low. In cases of long-term, severe iron deficiency, there may be a slightly increased risk of low birth weight or preterm birth. This is not a reason to panic. But it is a reason to take ferritin seriously and inform your midwife if you have symptoms.

How much iron can you take during pregnancy?

You need more iron during pregnancy than usual. However, the correct dosage depends on your Hb and ferritin levels. Do not experiment with dosages yourself. Always consult your midwife or general practitioner.

Iron and vitamin C: good teamwork

Did you know that iron from supplements or food is absorbed less effectively when taken together with coffee, tea, milk or other calcium-rich products? It is better to take your tablet with water or a vitamin C-rich drink. Fruit itself contains little to no iron, but vitamin C helps your body absorb iron more efficiently. Oranges, kiwis, strawberries or mango are great options. You can also eat a piece of fruit with your iron tablet, whatever you prefer.

Frequently asked questions about iron deficiency during pregnancy

What are the symptoms of iron deficiency during pregnancy?

Severe fatigue, shortness of breath, dizziness, palpitations and concentration problems are common.

What does low ferritin mean during pregnancy?

It means your iron stores are low. You can already feel tired before your Hb drops.

Is iron deficiency dangerous during pregnancy?

Usually not. A mild deficiency is easy to treat. Severe or long-term iron deficiency can affect both mother and baby.

How do you correct iron deficiency during pregnancy?

With iron supplements tailored to your blood values. Your midwife or general practitioner can prescribe these.

How much iron can you take during pregnancy?

This varies per situation. Always consult your healthcare provider about the correct dosage.

Symptoms that may indicate iron deficiency? Visit our midwifery practice in Amsterdam-Zuid

At Verloskundigen Amsterdam Zuid, we do not stop at your Hb value. We listen to your story and we also test ferritin. Are you feeling extremely tired or do you have other symptoms that may be caused by iron deficiency? Contact us and we will discuss the options with you.

Anxiety or stress during pregnancy

What you can do (and why you’re not alone)

Being pregnant is beautiful, but it can also be overwhelming. It’s a special time filled with expectations, emotions, and changes. But let’s be honest-it’s not always a pink cloud. You may feel tense, worry a lot, or notice that you cry more easily than you’re used to. Anxiety or stress during pregnancy is more common than you might think, and it says nothing about how well you will care for your baby. In this blog, we explain where these feelings come from and what you can do about them. And remember: you don’t have to carry this alone.

Why you may feel more anxiety or stress during pregnancy

A lot changes during pregnancy. Hormones such as estrogen and progesterone can make you more emotionally sensitive. That’s completely normal. On top of that, many questions may arise: Am I ready for this? Will the birth go well? Is my baby okay? These kinds of worries are very common. Your life and your body are changing, and your brain is preparing for that. Sometimes, however, these feelings take over-and then it’s important to do something about them.

What to do if you experience anxiety during pregnancy?

The most important thing when you feel anxious during pregnancy: talk about it. With your partner, a friend, or of course your midwife. It is not weak or wrong to worry-it is very human. Writing things down can also help, as well as consciously seeking relaxation through breathing exercises, yoga, or walking. Structure in your day, getting enough sleep, eating well, and being kind to yourself all make a difference too.

Mental wellbeing during pregnancy

At our practice in Amsterdam South, we always take time for you-and that includes conversations about your worries or fears. We know how important it is to feel mentally well during pregnancy. If we notice that you may need some extra support, we can refer you to a coach or psychologist who has experience working with pregnant women dealing with anxiety or stress.

Is anxiety or stress harmful to your baby?

Everyone experiences stress from time to time. It’s completely normal to feel this way during pregnancy as well. And rest assured: occasional stress during pregnancy is not harmful to your baby. However, if you experience intense stress or tension for a longer period of time, it’s wise to talk about it-not only for your baby, but especially for yourself.

What if you experience panic or depressive feelings?

Some women experience panic attacks during pregnancy or develop pregnancy-related depression. This can happen in any trimester, though emotions are often more intense in the first or third trimester. The signs? Constant worrying, feeling low, lack of motivation, and poor sleep. Here too, the same applies: you are not alone, and it’s important to talk about it. There are effective and safe treatment options, sometimes with the support of a specialized psychologist. Are you experiencing panic attacks or depressive feelings? Tell us-we are here for you and will refer you if needed.

Medication or supplements? Always consult first!

Do you want to take something for anxiety, panic, or depressive feelings? Never do this on your own-always consult your GP or midwife first. Some medications or supplements are safe to use during pregnancy, while others are not. A healthcare professional will always look with you at what can help you and what is safe to take during these months.

Frequently asked questions about anxiety and stress during pregnancy

What can you do about anxiety during pregnancy?

Talk about it with your midwife, do breathing exercises, or find relaxation through walking, yoga, or meditation. And above all, be gentle with yourself.

What does stress do to your baby?

Occasional stress is normal and not harmful. Try to avoid prolonged stress. Relaxing in time or talking about it is therefore important.

What can you safely take for anxiety during pregnancy?

Never take supplements or medication without consultation. Always talk to your midwife or GP. There are safe options, but only when medically indicated.

Can pregnancy cause panic attacks?

Yes, it can. The combination of hormones, tension, and fatigue can lead to panic symptoms. This is treatable, and you are not alone.

What is the difference between anxiety symptoms and pregnancy depression?

Anxiety symptoms often revolve around worry, panic, or loss of control. Depression is more about feeling low, exhausted, and losing interest. Sometimes they occur together-both deserve attention. Talk to someone if you recognize these symptoms.

Remember: you don’t have to do this alone

When people think of pregnancy, they often imagine a happy, carefree time. But that is not everyone’s reality. Doubts, fears, and tears can be part of it too. And by recognizing them and taking action, you show strength. So if you feel anxious, tense, or simply not yourself, come visit our midwifery practice in Amsterdam South, call us, or send us a message. We are here for you-always-with care and without judgment.

Sleep problems during pregnancy?

Tips for better sleep during pregnancy

Trouble sleeping during pregnancy? You’re not alone. Especially in the second and third trimester, many women lie awake at night. Fortunately, there are ways to improve your sleep without resorting to sleeping pills or other tricks. Why you may be sleeping worse right now, what you can do to fall asleep more easily, and which sleeping position is best during pregnancy-we explain it all in this blog.

Why you sleep poorly during pregnancy

Many women struggle with sleep during pregnancy. For some, this starts halfway through pregnancy, while others experience sleep problems as early as the first trimester. This is often hormone-related, and unfortunately there is usually little you can do about that. Physical discomfort can also disturb your nights, such as pressure on your bladder, leg cramps, or an active baby in your belly. On top of that, your mind may be racing with worries or ideas about the birth, the nursery, or your to-do list. And don’t forget the dreams-during pregnancy they are often more intense, vivid, and sometimes so realistic that they wake you up. All of this happens because your body is preparing for a major change, and you tend to notice that most at night.

7 practical tips to sleep better during pregnancy

Fortunately, there are several ways to get through the nights more comfortably. We previously wrote a blog about sleeping positions during pregnancy. In short: if you are comfortable and sleeping well, that is the best sleeping position for you at that moment. If you are experiencing sleep problems during your pregnancy and could use some tips, here are a few:

1. Create a bedtime routine
   Go to bed around the same time every evening and build in a moment of calm. A warm shower, reading a few pages, or gentle breathing exercises help your body relax.
2. Sleep on your side with support
   Sleeping on your side with a pillow between your knees and/or under your belly relieves pressure on your lower back and helps you stay comfortable.
3. Eat lightly in the evening
   Heavy meals or sugary snacks before bedtime can disrupt your sleep. Choose a light meal or snack instead, preferably with enough protein, such as a handful of nuts or a boiled egg.
4. Move during the day
   Regular movement helps your body release tension and promotes healthy sleep. Take a relaxing walk after dinner or join a gentle prenatal yoga class. You’ll notice it helps you sleep better.
5. Sleep, don’t scroll
   Checking your email or binge-watching your favorite series in bed may sound tempting, but it undermines your sleep quality. Use your bedroom for sleeping, not for scrolling or channel surfing.
6. Write it down
   Is your head full of plans or worries? Write them down before going to bed. Or keep a notepad next to your bed and jot things down if they wake you up.
7. Get up if you can’t sleep
   If you’re still awake after 20 minutes, get up for a bit, drink some water, read something calming (preferably not on a screen), and then return to bed. Lying awake and worrying often has the opposite effect.

Natural remedies for sleep problems

Sometimes you want a little extra support for your sleep. But be careful: not all natural sleep aids are safe during pregnancy. Avoid melatonin supplements unless your doctor or midwife explicitly approves them. Generally safe and often effective are:

• Chamomile or lemon balm tea
• Warm milk with honey
• Magnesium (always discuss this first with your midwife)
• Breathing exercises or mindfulness via an app before bedtime

If you want to use a natural remedy to sleep better, always consult your midwife first.

Sleeping less? You’re not alone

Even if you’re sleeping less, your body is working hard to help your baby grow, adapt, and prepare for birth. So if you’re sleeping poorly or waking up frequently at night, it’s frustrating-but not necessarily harmful. The key is to be kind to yourself and focus on what does work.

What if you continue to sleep poorly?

Despite all the tips, it’s possible that you continue to struggle with sleep during pregnancy. In that case, try to find practical solutions to make your days feel less heavy. Discuss it at work, for example. Being able to start later and catch some extra sleep in the early morning can already make a big difference. Looking for a practical solution for your sleep problems? Ask us-we’re happy to think along with you.

Frequently asked questions about insomnia during pregnancy

What is the best sleeping position during pregnancy?

The best sleeping position is the one in which you are comfortable and sleep well. As long as you don’t experience discomfort, any position is fine.

Why do you sleep poorly during pregnancy?

There are often multiple causes: hormones, physical discomfort such as bladder pressure or heartburn, and worrying. Sleep quality tends to decrease especially in the third trimester.

What can you do to sleep better during pregnancy?

Create a consistent bedtime routine, stay active during the day, and limit screen use in the evening. Breathing exercises, relaxation, and a comfortable sleeping position can make a big difference.

Are there natural sleep aids you can use during pregnancy?

Chamomile tea, warm milk with honey, or magnesium (after consultation) are usually safe. Avoid melatonin and supplements without consulting your midwife.

How much sleep does a pregnant woman need?

On average between 7 and 9 hours per night, but sleep quality matters most. Rest moments during the day are also valuable-listen to your body.

Less sleep during pregnancy? Ask the midwives in Amsterdam South!

Are you pregnant and finding that your nights are becoming increasingly restless? You are always welcome to contact us to explore solutions for your sleep problems. We’ll discuss what you’re currently doing and what you can do to sleep better-or at least get more rest. Call or email us and we’ll quickly schedule an appointment at our practice in Amsterdam South.