Postpartum Depression

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Postpartum Depression also known as postnatal depression or PPD is a type of mood disorder just after the childbirth.

Postpartum Depression (PPD) - Postpartum Depression Symptoms ...

Your body go through many changes during and after pregnancy. After the birth of the child, you and family, everyone want to spend the joyous moments together with the child. At the same time, as a mother, you may feel the mood swings, sadness, emptiness within a few days after the childbirth. These can be called ‘baby blues’.

Baby blues happens almost to every woman especially to the first time moms. If the baby blues does not go away and continues even after 2 weeks, then you may have postpartum depression. This is a very common problem after pregnancy and happens due to the extensive hormonal changes.

What are the symptoms of baby blues?

  • Mood Swings
  • Anxiety
  • Crying
  • Sadness
  • Appetite problems

What are the symptoms of Postpartum Depression?

  • Severe mood swings
  • Loosing confidence in herself
  • Excessive crying without any reason
  • Difficulty bonding with your baby
  • Worrying about not feeling love towards her baby
  • Fear that you are not a good mother
  • Hopelessness
  • Feelings of guilt, shame, worthlessness or inadequacy
  • Severe anxiety
  • Having thoughts of hurting yourself or baby

One may or may not feel all the symptoms at the same time. Some women do not tell about their symptoms as they may feel embarrassed, or ashamed about it.

What can cause the depression?
A lot of hormonal changes are usually the cause of such feelings. But there are many other factors that can contribute to this feeling such as :

  • Tiring labor or delivery
  • Tiredness due to lack of sleep
  • Overwhelmed with the newborn
  • Doubts about your ability to be a good mother
  • An unrealistic need to be a perfect mom
  • Being less attractive
  • Lack of free time for yourself

These feelings are very common to the new mothers.

How can you help yourself?

  • Rest as much as possible. Sleep when your baby is sleeping.
  • Make time to go out, visit friends, or spend time alone with your partner. Even a 15 min free time is also luxury. 😉
  • If you cannot go out, ask your family to take out the baby for the walk etc. to get some time for yourself.
  • Talk about your feelings with your partner or your best friend. It is important to open up with someone.
  • Do not try to do too much or everything by your own. Ask for help or support from your partner or family.
  • Go for a makeover. Be beautiful and feel beautiful.
  • If you are not able to do some task, its okay. Its not realistic to be a perfect mom.

How can you partner help?

  • Listen to her. This is what she needs the most – emotional support. Encourage her to talk to you.
  • Don’t tell her to pull herself together. She would if she could. Instead, tell her that she’s doing a great job of being a new mother.
  • Don’t judge her if she is not able to do something. Instead listen to her freely.
  • Take her out at least for half an hour so as to change the environment around her.
  • Don’t make major life changes just after the childbirth.
  • Take on some of the night feeds or caring of the baby so she can rest a little bit more.
  • Offer practical support such as laundry, cooking, and shopping etc.
  • Remind her that the postpartum depression is common and she is not alone.
  • Do not forget to cuddle her.
  • If you think it is getting serious, with the approval of the new mom, talk to midwife and ask for the right help.

I hope the partners will read these suggestions and put them in action.

Finally a congratulations on having a baby!!

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The day of giving birth

Every child birth is different, every woman experiences it in her own way ! Trust yourself and your body, YOU CAN DO IT !!

Contractions have begun and the labor has started. Most of the time contractions starts with an irregular, short manner and not so painful at first. To see if your contraction are really started, midwife will check the contractions and feel the cervix with an internal exam. This gives her a good impression of the stage of your labor. Soon after, membranes starts breaking and amniotic fluid breaks as little warm water followed by more contractions. Midwife will be there to guide you on every step and help you with the process. When the cervix reaches 10 cm, after which you start pressing.
In the whole process, woman bears a lot of pain. There are some painkillers available so that you feel less pain. The pain medicines are not available in all the hospitals, so discuss this with your midwife in advance and then decide the hospital.

Laughing Gas (Nitrous Oxide)
You will be taking control and give yourself a laughing gas via mouth or nose mask every one minute. Midwife keeps an eye on you. Once you stop inhaling, laughing gas is quickly disappeared from your body. However you may feel sleep, dizzy or sick and you cannot use it during pressing.

Epidural is an injection that will be given in your lower back. The injection will be given under local anesthetic. You cannot walk or feel difficulties during pressing or urinating because of the anesthetic.

Injection of Pethidine
Pethidine is given as an injection into your buttock or thigh.It is similar to morphine. It works with in half an hour and works for 2-4 hours.You can get sleepy with this injection. Sometimes babies can also become drowsy from pethidine. Baby also find it difficult to breatfeed and suck due to drowsiness.

Pump with Remifentanil
Remifentanil is similar to morphine which is infused through a pump. You will take the control to push the button. The pump is adjusted so that you can never give yourself too much. Remifentanil can affect your breathing and the amount of oxygen in the blood. You and your child are monitored closely when using this medicine.

So choose you medicine at the right time and discuss with your midwife on the side effects.
You can also read more on the advantages or disadvantages of each of the medicine here.

Good luck with your delivery !

The Prenatal Screening

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Most child’s are born healthy. However it is possible in the Netherlands to have you unborn baby tested for a number of congenital disorders. This involves the two screening. Both the screenings optional to choose.

1. The screening for Down, Edwards and Patau syndromes
People with Down syndrome have an intellectual disability and their level of development cannot be predicted. Children with Edward & Patau syndrome generally die before or during birth or rarely live past the age of one. You can get this tested by opting one of the two tests as below :

Combined Test
The combined test consists of blood test of pregnant woman between 9 to 14 weeks and an ultrasound measuring the nuchal fold of the child. between 11 to 14 weeks of pregnancy. This test cannot provide any certainity. This test will show the risk of the syndrome. If there is an increased risk, you may also chose to have follow up testing done such as a screening with NIPT test or an option of additional ultrasound check.
If you are living close to Amstelveen, this test can be performed within Amstelland hospital.
The cost of the test is around Eur 177. If there are twins, the cost is double. Basic health insurance does not cover the costs of the test.

NIPT Test (Non-Invasive Prenatal Test)
This is a new test and it tests the blood of pregnant woman from 11 week. The placental DNA will be checked. This DNA is similar to the DNA of the child. Other chromosomal abnormalities can also be determined using this test, these are usually additional findings. You can decide whether you want to be informed of additional findings or not.
If you are living close to Amstelveen, this test can be performed within Amstelland hospital.The cost of the test is around Eur 175. If there are twins, the costs is double. Basic health insurance does not cover the costs of the test.

2. The screening for fetal anomaly
This is a 20 week ultrasound scan.The scan looks at the head, heart, spine, abdominal cavity, arms and legs. The ultrasound checks the overall growth of the baby, the location of placenta and if there is enough amniotic fluid.
It is not possible to see all the anomalies with this ultrasound. This screening is covered by the basic health insurance. The gender of the baby can also be revealed during this test only if you like.

Pregnancy in the Netherlands

First of all Congratulations. The journey of pregnancy is long, tiring yet a very beautiful one !

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You know you are pregnant and you are in the Netherlands. Do not know what are the next steps? Should you call a GP or huisarts or midwife for the questions and checkup?

Well, do not worry at all. Here is our guide on what to expect in the upcoming weeks, once you know you are pregnant.

1. As soon as you know that you are pregnant, Find a Verloskundige(Midwife)
Who is Verloskundige? Midwife in the Netherlands are called verloskundige in dutch. Once you know you are pregnant, immediately call a midwife to take an appointment.There is no referral needed from doctor. You can find the midwife within or near your area here.
The midwife guides you during your pregnancy and perform all the checkups,scans etc and prepare you for the delivery. Midwife keeps an eye on your health and also of the baby.
You can choose a midwife of your choice and call them to register. You will be invited for an Intake and registration. At the intake appointment, general questions about your illness, ailments, use of medications, allergies, height, weight, health of your partner and relatives etc will be checked and details will be added to the file. Just that you know, all midwife practices are organized and work differently from each other. If you have any illness or special condition such as diabetic then you will be referred to specialist or gynaecologists who will then handle your pregnancy journey instead of the midwife.
Tip : You will need at least a basic insurance to cover up the expenses of midwife.

2. Ultrasounds
All the ultrasounds and checkups will be done by midwife and in their facilities. First ultrasound is around 8 weeks. After that checkups will be done every 4 weeks. The appointments are usually not more than 15 min. During the checkup, your blood pressure, growth of the belly and the baby, your health and baby’s heartbeat will be checked. Usually schedule of the checkup’s is as below :
– 1st checkup/ultrasound : 8 to 10 weeks
– Term ultrasound : 10-12 weeks
– 2nd checkup : 14-16 weeks
– 16-24 weeks : checkup every 4 weeks
– 24 to 30 weeks : checkup every 3 weeks
– 30 to 36 weeks : checkup every 2 weeks
– 36 to 42 weeks : checkup every week

3. Prenatal Screening
Decide before or within 8 weeks of pregnancy, whether you want to go for a prenatal screening. Most child’s are born healthy. However it is possible in the Netherlands to have you unborn baby tested for a number of congenital disorders. This involves the two screening. Both the screenings optional to choose.
– The screening for Down, Edwards and Patau syndromes
– The screening for fetal anomaly. This is a 20 week ultrasound scan.

Your midwife will also inform you about these tests. You can ask your midwife on the hospitals where the tests can be performed.

You can read more about it in our next blog here.

5. Apply for an insurance kit (Kraampakket)
Call your insurer and inform that you are pregnant. It is mandatory to have a maternity package from insurance. The package contains everything you need for your delivery and first days afterwards such as medical products, maternity dressings, mattress protectors etc.

4. Arrange Kraamzorg (Maternity Care)
There is no country in the world apart from Netherlands that provides a carer who supports women during or after childbirth. Kraamzorg provide assistance during the first week of the your baby arrival. It is important that you rest to be able to recover and adjust to the new situation. There is a concept of Kraamzorg(Maternity care carer) to help you out with the below tasks during the first week after delivery.
– Checks on you and your baby
– Guidance with breastfeeding
– Supports with everyday household work
– Takes care of preparation of meals(if you like)
– a few other additional tasks
Always register at the Kraamzorg as early as possible(betweek 12 to 20 week of pregnancy) as they are also very busy specially during summer period(a lot of babies are born during summer in Netherlands). The intake usually happen between 30 to 36 weeks pregnancy.
Tip : Always request a kraamzorg with breastfeeding expert during the intake.

5. Arrange a Maternity leave
If you are working, then you need to have maternity leaves arranged. For that you will need a pregnancy statement from your midwife. The pregnancy statement states that you are pregnant and the expected delivery date for you.
You may take leave upto 6 weeks before the due date. However it is mandatory to stop working at least 4 weeks before the due date. The total leave lasts 16 weeks. So you always have atleast 10 weeks after the child birth. You will receive maternity benefits equal to your salary.
If you have a partner, the partner is entitled to upto 5 weeks of leave within 6 months of child birth. This is applicable starting 1st July 2020. Partner will get 70% of salary from uwv.
The first 6 months after giving birth, you are entitled to take additional breaks for pumping.
From next year, the number of leave for pregnant woman and partner is going to be increased.

6. Decide where you want to give birth
Decide early on where you want to give birth? Would it be a home birth or a hospital birth? It is a tradition within Netherlands to give birth at home.
If you plan to give birth at home, the kraamzorg nurse will come to you before the birth to guide and support you. All the costs are covered within your insurance.
If you plan to give birth at the hospital, you will call the midwife. Midwife will come to your home to do a checkup and then assist you to the hospital. Note that full costs of delivery is not included in the insurance.

7. Prepare a bag for your delivery day
Prepare a bag with all the necessary things required for delivery. This must include clothes for your baby, comfortable clothes for yourself, a towel for yourself, Slippers.
You will get a big list from midwife, not everything is important or mandatory.