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 in Summer

How to get through summer more comfortably

Summer has arrived again, a lovely time of year that can be tricky if you’re pregnant right now. A warm summer day just feels a bit different with a growing bump. While others are enjoying 28 degrees and plenty of sunshine, you might be more preoccupied with swollen feet, sleepless nights and searching for ways to cool down. And did you know that with these high temperatures, you now need to be extra careful? Our midwives explain in this blog what you can do to get through the warm days comfortably and healthily during your pregnancy.

Why do you feel so hot when you’re pregnant?

Many pregnant women notice early in pregnancy that they feel warm more quickly. This is because your body produces extra blood, combined with the influence of pregnancy hormones. As a result, you feel warmer as a pregnant woman, even in winter. In summer you may sweat more, get dizzy more easily and have less energy than usual. Your body is constantly working to keep both your temperature and your baby’s temperature stable. That’s why the heat simply costs you more energy than normal right now.

What to do in hot weather when you’re pregnant?

The most important tip: listen to your body. Do you notice that you’re getting tired, feeling light-headed, or becoming short of breath more quickly? Then take a rest.

And follow these tips too:

• Drink enough water spread throughout the day, at least around 2 litres.
• Plan exercise for early morning or later in the evening.
• Stay in the shade as much as possible between 12pm and 3pm.
• Regularly elevate your legs if you’re troubled by swollen feet or fluid retention in your legs.
• Take a lukewarm shower or use a foot bath to cool down.
• Keep your bedroom cool with closed curtains and ventilation.
• Opt for short cooling-down moments throughout the day rather than one big cool-down.

What clothing is comfortable during a summer pregnancy?

Just like in summers when you’re not pregnant, clothing made from natural materials is the most comfortable now too. Choose cotton, linen or bamboo, as these fabrics breathe better and release heat more easily. Loose-fitting dresses, airy trousers with a soft waistband and oversized blouses are more comfortable than tight clothing. Light colours are also nice on warm days. Dark fabrics absorb more heat, causing your body to warm up faster. A lovely linen set or a flowing summer dress can be a real godsend on warm days.

Are you allowed in the sun when you’re pregnant?

Yes, you can simply enjoy the sun when you’re pregnant. But it is wise to be mindful of the heat and UV radiation. Your skin is more sensitive during pregnancy, which means you can burn more quickly and are more prone to pigmentation spots or the notorious pregnancy mask. So apply sunscreen regularly with at least factor 30, and consider wearing a hat or cap if you’re outside for longer periods. Also avoid being in full sun for hours on end. The sun isn’t harmful to your baby as such, but you are at somewhat greater risk of overheating and dehydration right now.

Does your baby respond to heat?

You may have already noticed: on warm days your baby suddenly seems extra active in your belly. This can have various causes, such as you resting a bit more and therefore being more alert to your baby’s movements. But know that a healthy baby doesn’t overheat in the womb. Your body regulates the temperature around your baby very effectively. It is important, though, to keep drinking enough and to seek out cooler spots where possible, to prevent yourself from becoming dehydrated or overheated.

Pregnant during a heatwave: extra caution needed!

At temperatures above 30 degrees, it costs your body even more effort to cool down. During a heatwave in particular, it’s therefore smart to move appointments, errands or exercise as much as possible to the early morning. Recent Dutch studies1 also show that prolonged heat is associated with an increased risk of premature birth and lower birth weight. This doesn’t mean every warm day is immediately dangerous. It does show how important sufficient rest, cooling down and hydration are during extremely hot periods.

Symptoms caused by summer heat?

Are you experiencing one or more of the following symptoms? Contact your midwife straight away!

• Headache
• Dizziness
• Urinating less than normal
• Feeling unwell

It doesn’t necessarily mean anything, but during summer temperatures it’s good to be extra alert.

Summer holidays when you’re pregnant

Good news: most women can simply go on a lovely holiday during their pregnancy too. Just choose your destination thoughtfully. A city trip to a hot city is less pleasant right now than a stay by the sea or a holiday home with shade and a pool to cool off in. Also make sure you schedule enough rest moments throughout the day, drink extra water, and check in advance where medical care is available at your destination. And if you’re unsure whether your condition is suitable for a holiday, discuss it with your midwife.

Frequently asked questions about being pregnant in summer

Can you be in the sun when you’re pregnant?

Yes, that’s fine, but don’t stay in it too long. Protect your skin and make sure to cool down. This helps prevent your body from overheating.

Why do you feel so hot when you’re pregnant?

Due to hormonal changes, a higher blood volume and a more active metabolism, your body can be up to half a degree warmer during your pregnancy.

How can you cool down when you’re pregnant?

Drink enough water, take a lukewarm shower, use a foot bath, wear airy clothing, get enough rest and avoid the hottest hours of the day.

Is heat a risk factor for premature birth?

Research shows that prolonged exposure to high temperatures is associated with an increased risk of premature birth. So take extra good care of yourself during heatwaves.

Can you still go on holiday in summer when you’re pregnant?

Yes, usually you can. Choose a destination where you can find enough rest and coolness, always drink extra water, and if in doubt, discuss it with your midwife.

Enjoying the summer and your pregnancy

Being pregnant during summer requires a few extra adjustments, but you can still enjoy the lovely weather. Listen carefully to your body, get enough rest, drink extra water and be smart about the heat. Do you have questions about this, are you worried about heat-related symptoms, or would you like to know what’s wise in your situation? Ask your midwife in Amsterdam-Zuid.

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?

Early Pregnancy Test

Everything about the early pregnancy test

Want to know if you’re pregnant? Then you can take an early pregnancy test. The result is reliable, but that doesn’t mean it’s always correct. We’ll explain how that works here. Are you simply too curious to wait regardless? Then an early pregnancy test is worth trying!

The regular pregnancy test

You take a regular test on the first day your period is due, which is 28 days after the start of your previous period. Or later if your cycle is normally longer or irregular. In that case, take the longest cycle length from the past six months and count forward from the start of your previous period.

When can you take the early pregnancy test?

So you can take an early pregnancy test sooner, 6 to 4 days before your period is due to start. Do use a different test for this though; a regular pregnancy test can’t yet detect whether you’re pregnant this early in your cycle. These early tests are simply available at the drugstore, pharmacy and online, and are labelled ‘ultra-sensitive’ or ‘early pregnancy test’ on the packaging. Check each test to see from when it can be used, as this can vary by brand.

How an early test works

Every pregnancy test measures the pregnancy hormone hCG in your urine. The amount detected determines the result of the test. This hormone is produced by your body immediately after implantation. In the beginning there’s very little of this hormone, but it quickly increases a great deal, doubling roughly every 2 to 3 days. An early test is very sensitive and can detect the tiny amount of hormone in your urine. A regular test measures an hCG level from 25 IU/L (International Units per litre), while the early test can already measure it from 12.5 IU/L.

Morning urine

To get clarity as quickly as possible, it’s important to take a test with the urine that has the highest concentration of hCG, and that’s your morning urine. Even though you can take pregnancy tests at any time of day, for an early test we definitely recommend testing in the morning.

Is the early pregnancy test reliable?

An early pregnancy test is indeed reliable. But because sufficient pregnancy hormone isn’t always present at such an early stage, the result can be negative even though you may actually be pregnant. So a negative result doesn’t automatically mean you’re not pregnant. The test itself is reliable, but the result isn’t necessarily accurate.

Extra sensitive

Precisely because this test is so sensitive, it’s also more sensitive to other influences. Are you taking medication, have you had fertility treatment or a miscarriage, or is the cup you collect your urine in not completely clean? Then the result may already be inaccurate. Being ultra-sensitive is useful for such an early test, but it also has its downside.

Downside: period or miscarriage?

Another downside of the early pregnancy test is that a lot can still go wrong, precisely because you’re testing at such an early stage. If you hadn’t tested, you would simply have thought your period had started as usual. But if you did take such a test and it came back positive, that period suddenly becomes a miscarriage. And that brings up very different emotions than just the disappointment of a new period. Without wanting to sound negative, it’s important to realise that 60% of conceptions, around the expected period date, still end in an early miscarriage. So ask yourself whether you want to take such an early pregnancy test, or whether you’d rather wait another week until the day you expect your period.

Frequently asked questions about the early pregnancy test

What is the best time to take a pregnancy test?

For the most reliable result, take a pregnancy test on or after the day your period is due but doesn’t arrive. Want to test earlier? Then use an early pregnancy test, and preferably do so with morning urine.

How reliable is an early pregnancy test?

An early pregnancy test is fairly reliable. However, the earlier you test, the greater the chance that the pregnancy hormone hCG is still too low to be measured.

Can an early pregnancy test be negative even though you are pregnant?

Yes, that’s possible. If you test very early, there may not yet be enough hCG in your urine. As a result, the test can be negative even though you are (just) pregnant.

How early can you take an early pregnancy test?

With an early pregnancy test you can often test as early as 4 to 6 days before your expected period. Always check the test packaging carefully, as this can vary by brand.

What is the downside of an early pregnancy test?

The downside is that you sometimes test too early. As a result, you can get a negative result even though you are already pregnant. This can create unnecessary uncertainty.

Midwives in Amsterdam-Zuid: even if you’ve only just found out you’re pregnant

Have you taken an early pregnancy test and was it positive? Then you can of course book an appointment with us straight away. We’re here for you, whether you’re already pregnant or hoping to become pregnant. Come and visit the midwives in Amsterdam-Zuid and ask us your questions. We’re happy to help.

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’.

5 Weeks Pregnant

Answers to all the questions you have this early in pregnancy

Are you 5 weeks pregnant? Then you probably have lots of questions, but perhaps not many people yet to ask
them to. Many people wait until around 3 months before sharing the good news. But of course you don’t want
to wait that long! That’s why we’ve put together the answers to all your questions about being 5 weeks
pregnant below

What happens in week 5 of pregnancy?

The organs are formed in these first weeks. Around week 5 of your pregnancy, your baby is actually still only 3
weeks old. At this point it still looks like a kind of tadpole, with the beginnings of what will become the arms
and legs. The brain, spinal cord, heart and circulatory system are developing during these days.

How big is the baby at 5 weeks pregnant?

During this period your baby is about 2 millimetres in size, so still tiny! In fact, we don’t call it a baby yet but an
embryo. The embryonic stage lasts until 11 weeks, after which we speak of the foetus.

How big is the baby at 5 weeks pregnant?

During this period your baby is about 2 millimetres in size, so still tiny! In fact, we don’t call it a baby yet but an embryo. The embryonic stage lasts until 11 weeks, after which we speak of the foetus.

What do you feel at 5 weeks pregnant?

You won’t feel your baby yet for a while, but that doesn’t mean you won’t notice anything of your pregnancy. You may already be experiencing quite a few pregnancy symptoms, such as fatigue and nausea. You may also be retaining extra fluid and your digestion may be working more slowly. This can cause things like constipation or abdominal pain. You may also have more discharge, heartburn and tender or even painful breasts. And because your blood pressure drops, you may notice that you feel dizzy quickly. Some women also find they sleep poorly, get more headaches, experience heart palpitations and mood swings. You might also suddenly find certain smells very unpleasant or even off-putting. That’s because in early pregnancy your sense of smell and taste become much stronger. So quite a long list of possible pregnancy symptoms. But rest assured, by no means everyone experiences all of these symptoms.

Can you already have a baby bump?

Yes, it’s possible that at 5 weeks pregnant you’re already starting to see a small bump. But that’s not yet due to your baby or your uterus growing. A bump this early in pregnancy is more likely caused by your bowels. These work more slowly during pregnancy, which causes them to become bloated.

How high is the risk of miscarriage at 5 weeks?

Especially early in pregnancy, there is a risk of miscarriage. Between weeks 4 and 6 the risk is around 12%. After that, the risk decreases more and more. You can recognise a (starting) miscarriage by bleeding, severe abdominal cramps, nausea and/or extreme fatigue. Do bear in mind that not all of these symptoms are always a sign of this, as half of pregnant women who experience some bleeding early in their pregnancy go on to have a healthy pregnancy. Do you have one or more of these symptoms? Then don’t hesitate and contact us straight away. 2

Can you already see or hear the baby at 5 weeks pregnant?

You usually can’t hear the little heart until around week 12. Before that, your uterus still sits behind the pubic bone, which blocks the sound. At 5 weeks, an ultrasound doesn’t usually take place yet. Even if it did, this early in pregnancy you would only be able to see whether a gestational sac has implanted in the uterus. A heartbeat might only become visible from week 6 or 7 onwards.

What should I pay attention to now that I’m pregnant?

As soon as you know you’re pregnant, it’s wise to pay attention to your diet and lifestyle. It’s even better to start doing so if you’re trying to get pregnant. But now that you’re 5 weeks pregnant, we advise you to:

• Stop smoking and drinking alcohol
• Eat plenty of vegetables, fruit and fibre-rich food
• Drink enough, at least around 2 litres a day
• Avoid raw products such as meat, eggs, milk and cheese
• Start taking folic acid or bioactive folic acid

You can find more tips on a healthy lifestyle during your pregnancy here on our website.

Can I still exercise?

You can definitely still exercise at 5 weeks pregnant! Generally speaking, exercising regularly makes you feel fitter and also leaves you fitter and stronger for the birth. However, do listen carefully to your body, and be especially careful later in your pregnancy with certain sports such as kickboxing, marathon training or deep-sea diving. Also check out our blog with tips on exercising during pregnancy.

Frequently asked questions about being 5 weeks pregnant

How big is your baby at 5 weeks pregnant?

At this stage, your baby is still called an embryo. At 5 weeks pregnant, the embryo is about 1.5 to 2 millimetres in size. That’s comparable to a sesame seed.

What symptoms can you have at 5 weeks pregnant?

At 5 weeks pregnant you may experience nausea, fatigue, tender breasts, mood swings, a bloated feeling and needing to urinate more often. It’s also possible that you don’t experience any symptoms at all.

Can you already have a baby bump at 5 weeks pregnant?

Some women feel like they’re getting a bit of a bump. This is usually not because your baby is already that big, but because your bowels are working more slowly. This can give you a bloated feeling sooner or more often.

Can you already have an ultrasound at 5 weeks pregnant?

It’s possible, but it’s still very early. If you do have an ultrasound this early, you’ll probably only be able to see whether the gestational sac has implanted in the uterus.

When should you contact a midwife?

You can do this at any time: before you’re pregnant if you have questions, or as soon as you know you’re pregnant. The first appointment usually takes place between 6 and 9 weeks of pregnancy. During that appointment you discuss the pregnancy and the first check-ups are scheduled.

Can I already see a midwife at 5 weeks pregnant?

Yes, even at 5 weeks pregnant you are more than welcome at our midwifery practice in Amsterdam-Zuid. We can well imagine that you have even more questions, or that you’d like to book an appointment for your first consultation already. Call or email us and we’ll arrange an appointment for your first visit to the midwife straight away. See you soon?

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!

Choosing a girl’s name for your baby

How to make a choice that feels right

Choosing a girl’s name for your baby can turn out to be harder than you expected. Maybe you suddenly start doubting yourself, maybe you and your partner have different tastes, or perhaps something that once felt right no longer does. That is not so strange: a name needs to be beautiful and to feel right. But how do you know whether you are choosing the right girl’s name? Honestly, you never know for certain. But if it feels right to both of you, then it is right. In this blog, we are happy to help point you in the right direction.

Choosing a baby name by instinct

Just as with choosing a boy’s name, picking a girl’s name is largely a matter of instinct. You need to find it beautiful and it needs to feel right. Sometimes a name reminds you of someone – in a positive or a negative way. Or you immediately form a certain image when you hear a name. A name can be very powerful, or wonderfully gentle. That is also what makes choosing so tricky: will it suit your baby when the time comes? So start by each making a list of names you personally love, or that give you a good feeling. From there, you go through them together – crossing some out, reconsidering others. A shared top three will naturally emerge, and you can sit with that for a little while.

Doubts when choosing a girl’s name

Are you having doubts at the moment you think you are making your final choice? That is completely normal. Fortunately, you can still change your mind plenty of times for now. What helps in that case is to make a list, as we described above, and then set it aside for a bit. Come back to it later and say the names out loud. You will naturally feel which ones truly resonate and which name keeps coming back. It may take a little time before you notice it, but eventually a favourite tends to emerge for you both.

The influence of those around you

There are few topics as popular as baby names. Others will be more than happy to weigh in. That can be wonderful, but when everyone shares their opinion, it can also become confusing. Feel free to draw inspiration from all the ideas, but make sure you also return to yourself in good time. What felt right to you before everyone else had their say? That is what matters in the end – everyone else will get used to the baby name you choose. Or they will not, and that is fine too.

Practical considerations for a girl’s name

Even though the girl’s name for your baby should above all feel right, it is also worth pausing to consider a few practical questions. Such as how the name is pronounced abroad. And whether the name might carry a completely different meaning in another language. What shortenings can you expect with that girl’s name, and how do you feel about people calling your daughter that? If you give your daughter more than one first name, how do the initials read when placed one after the other? And how does the girl’s name combine with the surname? Give this a quick check now – your daughter can only thank you for it later.

When you cannot agree on the name

Have you already made up your mind about what your daughter should be called? Then it would be lovely if your partner agreed. But sometimes that is not the case. And it gets really tricky when you have both settled on different “final” choices and you genuinely cannot stand the other’s preferred name. You can try to convince each other, but if you are both doing that at the same time, you will get nowhere. What works best in that situation? Start completely from scratch, forget the original names, and begin again with a blank list.

Choose what feels right

The name you choose will grow along with your baby. Perhaps you want to wait until your daughter is born before making the final decision. That is perfectly fine. But know that the name will truly become hers. She will grow into it, make it entirely her own. It does not need to be perfect – if it feels right to you, then it is right. And it does not matter how long it takes. You have until the 3rd working day after the birth to make a change. So take your time, and we would love to hear which girl’s name you end up choosing!