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Childbirth

Important moment

Your birth will stay with you for the rest of your life. We want to do everything we can to help you make it an experience you can look back on with fond memories. During the pregnancy, we live more and more towards it together and discuss what you would like and inform you about different options.

The first signs

The birthing process

If you are in the final months of your pregnancy, you may have already felt it: your uterus sometimes contracts briefly. The further along you are, the more this can happen. It is due to hormones and is called 'hard belly'. It can be an unpleasant feeling. But most women don't even feel it. The contractions are not (pre-)contractions and they do not yet announce your labour. We often call it "rumbling" or that the body does prepare itself. Later, you will find that labour contractions really do feel different.

The contractions

Pre contractions and contractions
Usually, labour starts with contractions. Sometimes those contractions hurt right away and follow each other in quick succession. But they are usually short, irregular and not very painful in the beginning. Often you can just get on with what you are doing. These 'pre contractions' already make the cervix more supple.

Internal examination
To check whether your labour has really started, we pay attention to your contractions and feel for the cervix with an internal examination. This way, we get a good impression about the stage of your labour. Very early in labour, it is also sometimes difficult to judge whether you have really started. Don't worry: a few hours later you will know for sure! Labour can also announce itself with the breaking of the membranes. Even then, strong contractions are needed to open the cervix. They usually start within 24 hours of the waters breaking.

The unlocking

From 0 - to 10 cm
In a first delivery, the cervix is even stiffer and therefore does not open as easily as in a subsequent delivery. The contractions first make the cervix smoother and thinner. How fast it goes depends, among other things, on the contractions. If they are stronger and come more often, labour usually goes faster. The first centimetres of dilation are usually slower than the last bit of dilation. At 10 centimetres you are fully dilated after which you may push.

Pain in childbirth

Your body usually responds to childbirth pain by making its own painkillers (endorphins) so that you feel less pain. Anxiety or tension hinders the production of endorphins. Therefore, it is important to be as relaxed and comfortable as possible during your labour. There are different ways to deal with pain during childbirth. What works for one person may not work for another. Everyone does it in her own way.

Different methods
There are different methods of pain 'treatment'. Without medication and with medication. We will elaborate on these at our information meeting. Here you can find online information on the subject.

Breaking the membranes

Connected to the outside world
The membranes usually break only after some time of contractions. This is also good, because the membranes and amniotic fluid protect the baby and help open your cervix by the pressure they provide. If the membranes have not yet broken spontaneously, we sometimes break them only at the end of dilation. But sometimes earlier, if the contractions weaken or if your dilation does not progress sufficiently. It does not hurt. You only feel some warm water running. Afterwards, you continue to produce new amniotic fluid so that your baby is never 'dry'. 

Not in the bath
If your waters have broken and you do not yet have strong contractions, you should not take a bath because of the risk of infection. This is because the baby is now in open communication with the outside world. Your temperature is measured after the waters break to detect any infection quickly.

Labour and birth

Push contractions
When you are dilated enough to allow your baby to be born, the dilation contractions turn into push contractions. Through the opening of your cervix, the head has sunk down. At the peak of the contraction, you will then feel an urge to push. This is an incipient push contraction. You can't stop it. It signals that the baby can come out. 

Active co-pressing
The end is in sight. Good push contractions are already doing a lot of work. You may now start actively pushing along. During a push contraction, push with all your strength towards your vagina and anus, as if you had to defecate. In the beginning, you don't always feel where you are pushing. As the head deepens, it will become clearer how you can use such a push contraction to help you push. 

Last piece
When the head almost comes out, you will feel it stretch at the bottom between your vagina and anus. This can be a painful, burning sensation. A cold or warm flannel against your pelvic floor will help. We will outline what you can do to prevent tearing. Once the head is born, we will guide your baby further out. Sometimes you can and may handle your baby yourself. You usually don't have to push hard anymore, the body will follow. The baby is placed on your (preferably bare) belly.

Cutting the umbilical cord

If the baby's heartbeat can no longer be felt in the umbilical cord, it can be cut. 

First breastfeeding and birth of placenta
If you want to breastfeed, the baby will be put on your breast at this stage. This is a natural means of getting your uterus to contract so that the placenta will loosen and be born more easily. It also helps limit further blood loss.

The Placenta

Things calm down in your belly again, as you no longer feel contractions. The uterus does contract to loosen the placenta and to prevent you from losing a lot of blood. We sometimes keep the umbilical cord taut to check if the placenta is loose. If it is, we'll ask you to push again while sometimes giving some counter-pressure on your belly. 

Kind of weird feeling
This is usually when the placenta, umbilical cord and membranes come out. This is a bit of a strange feeling but does not really hurt. The uterus contracts and feels like a hard ball under the navel. If the placenta does not come out within an hour, it has to be removed under anaesthesia in hospital.

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