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A day in the life of a Dutchy midwife

25 May 2017 by Elinor Abramson Leave a Comment

It’s 20.00pm on a Thursday evening and I’m ready to go on call. My colleague will arrive shortly to hand-over, unless she calls me first to take over from her if she’s busy.

A bit later and no phone call and no colleague yet. Not unusual though – it’s a very relaxed team and this team mate I know will usually arrive a bit later.
And yes, indeed she rolls up just when I’ve got the pot of tea ready (because some British things cannot be left behind..!)

So, we settle in for hand-over with a mug of Yorkshire Tea as this particular colleague actually likes our strong tea with milk. Just as I have learned to drink hot water in a glass that has seen a swift dip of a flavoured tea bag (at best), so we all adapt to new cultures and challenges!
I hear all about her day, the postnatal visits she has done, the extra check-ups and the quick birth in the afternoon. How she took a young high school student on work experience with her and was able to show her a real birth due to the generosity of the birthing mother. A future midwife? Maybe..!
Then we go through my scheduled visits for tomorrow, I haven’t got many which is a nice relaxing start to the shift. Only two visits, a luxury! Normally we have 5 or 6 postnatal visits as a standard, sometimes up to 8 or 10 if it’s busy.
We chat about clients, things that are going on in the practice and time ticks on. We chat about our children, how they’re getting on and mine appear intermittently to get snacks and drinks from the kitchen.
It’s all part of normal life, routine. My children come and sit with us regularly, interrupt proceedings and demand a little time and attention of their own. So hand-over can often include hilarious stories from friends or school, home-made cookies that are produced while we’re chatting or a spontaneous fashion show of new clothes!
Eventually we exhaust our hand-over, several hours later…!

yorkshire teaThe on-call phone rings and I’m immediately ready for a baby on the way. Not this time though, this is a new mum with some breastfeeding questions which I am happy to answer despite the hour. I hang up after the call and think about how wonderful it is that our clients have access to a medical professional on the end of a phone 24 hours a day. The amount of calls we take and reassure worried parents (to-be) really makes me proud of the system I work in. Small things often, but to the worried clients, absolutely paramount.

Then as I’m still wide awake I decide to work on some IT for the practice, which is usually a big mistake as I’m busy for hours…which is of course what happens. Now I decide to go to bed as it’s quiet so far. Then after a fairly short sleep the phone goes again…

A papa on the phone; ‘Hello, I’m Mrs. T’s husband and she’s having some contractions now and the waters seem to have broken..’

‘I’m going to PUSH!’ I hear in the background…

I JUMP out of bed, throw on my clothes and run down the stairs. I’m still on the phone as I’m pretty sure the baby’s coming and I need to instruct papa. He sounds a bit scared but not panicked so I tell him what he needs to do with one arm in my coat and the other pulling on a snow boot.

‘I’ll be there in 5 minutes!’ I assure him as I dash out of the door. Thankfully they live very close by and I’ve been to their home before for an extra check-up, so I know exactly where I’m going.
It’s -5 outside, so I get into the frozen car and start it up as fast as possible. I’ve got the blowers going full blast and leap out to de-ice the windows. I scrabble an area on the windscreen enough to see through and jump back in.
But it’s all steamed up and frozen on the inside! ‘Oh bugger it!’ I’m thinking as I open the window and stick my head out to see.

So here I am, at 05.50am – 3 minutes after leaping out of bed, driving through the ice with my head stuck out of the window, wearing a bobble hat… I’m hoping no one sees me!

I arrive at 05.54, looking at the clock to see how long since I spoke to Mrs. T’s husband. It’s taken me 7 minutes in total to get here, not bad. The building is being renovated so there is scaffolding and temporary structures all around the entrance. I stop the car (stop, not park!) right in front and throw my ‘Midwife Emergency’ notice on the dash board. Leaping out, I grab my visiting bag and run to the boot to get my kit out. I sling the huge orange rucksack on my back, slam the boot and run like the clappers…

The bloke waiting to be collected for work follows my movements with a look of slight alarm on his face…

SkylineThe wonderful sunrise from the 12th floor after a super fast home birth!

Up the stairs to the second floor, then to the lift – up to the 12th floor… running down the balcony and into the house. The front door is open as instructed thankfully.
As I dash into the hall, papa is coming out of the bathroom.

‘Oh hi’ he says. ‘he’s here already..’ then calmly leads me into the bedroom…

I do a swift sweep of the situation. This is a 5th baby for this mama, so she’s laying like a professional with her baby on her chest. Baby’s fine, mama’s fine.
Papa comes and stands next to me. ‘I was a bit scared’ he tells me.
I tell him he is amazing and that he deserves his midwife’s diploma! I can see he’s proud, but relieved that I’m here.
I sort everything out and then we have a proper look at the little one, who turns out to be a she and not a he. Little curious faces are starting to appear and after mama is settled the older children are allowed in with their wide, sleepy eyes. I look over and see this new little one surrounded by her siblings and grab a phone to take some pictures.
The maternity nurse arrives, breakfast commences and all the children get ready for school. I sit with the family and eat some toast while I’m bombarded with questions! There will be a tale to tell at school today, that’s for sure.

I leave the family when the children have gone to school and mama can get some sleep. It’s a bit early for my visits so I decide to catch some sleep myself before carrying on. After the adrenaline ebbs away, I realise I’m knackered!

So I re-pack my bag, lay my clothes ready and climb into bed. Not long after the phone rings, it’s the hospital with a message about a client. I note it down and go back to sleep. The phone goes again, it’s the assistant from the practice with a question about a client, I deal with it, note it down and settle down again. The phone goes again, it’s a maternity nurse to discuss the baby she’s caring for, I deal with it, note it down and settle down again.

Then I hear squealing and laughing from downstairs. My daughter is home with a friend. So I give up trying to sleep and get up again. After a pot of Yorkshire Tea (of course) and early lunch, I get ready to go out and do my visits.

I can’t find the car key anywhere? I search and search. Empty every pocket, bag and retrace my steps from this morning. I even look in the car! Then I remember my husband ran to get cash this morning and call him already dreading the answer to my question… Yes, the key is in his pocket. And yes, he’s the other side of Rotterdam via public transport… No transport, no equipment! What now…??

Damave midwife illustrationColleague! Brainwave – my colleague is running clinic at our midwifery centre and she has her car and equipment with her (I hope). I call our assistant quickly and confirm I can borrow the car. Then, I jump on a bike of course! Now I’m truly rocking the ‘Call the midwife’ look. Visiting bag in the basket and off to work I pedal. (Thankfully I only live 5 minutes from the centre).

DashboardI arrive at work and my colleague is royally wetting herself at my predicament. Charming! She hands me her keys and I climb into her teeny tiny Fiat 500  and off I go! I am almost immediately called by another papa whose wife has been contracting since yesterday evening on and off and now regularly. It sounds pretty serious so with google maps to help, off I drive. And drive, and drive until I’m around, under, over and into the fields where I finish up at a farmhouse. After greeting the three dogs I’m allowed in to see what’s going on.

There is a busy mama in the sitting room, swearing occasionally at the strength of her contractions. We go upstairs to check progress and it turns out to be a good time to go to the hospital where she has chosen to give birth. I arrange to meet them there after I’ve done my 2 visits (that I was so relieved about!)

Visit 1 entails driving into the city centre which involves a back up of traffic and massive road works due to rebuilding in Delft around the train station…which seems to be never ending. After finally parking I walk through the city to find the house down a little side street, up 4 flights of stairs and into a sauna of an apartment. It was a bit hot in there! I do the speediest heel prick test in history, chat to the parents, note everything down and arrange a new appointment for them. Then hurry back down the stairs, back through the city and down into the car park. Where I receive 3 phone calls I’m sure just because reception was so bad! I get in the (teeny tiny) car and note down the details of the calls. Then off to visit 2. Out of the city, down towards Rotterdam and onto the caravan camp. Into the caravan where I’ve been before to see this client twice already. I knock and stick my head in as there are no doorbells here. No answer. I open the inner door to find an empty caravan. Then mama comes in behind me. ‘I was over at my mother-in-laws’ she tells me. It’s one big family here, a good support network is a given thankfully. I run through all the final visit points and wish her well with her little family.

Then off to the midwifery centre I go. I need to swap cars back again before I go off to the hospital. My wayward husband has returned with the key, brought the car to the centre and biked off home in shame…!

So, car swapped I thank my colleague (who is still amused) and head off to the delivery suite. Finally. I get to the birthing room where mama is sitting under the shower and papa is coaching her. They’re doing really well and don’t need me to stay with them just yet. I check if they need anything and go to grab a drink and a quick sandwich. I just manage to drink my tea and the bell goes.

She’s starting to feel pressure. So out of the shower and I check progress, it’s going really well but not quite there yet. 20 minutes later and the situation has clearly changed. I check again and it’s time for baby to come. I call the nurse in to help and we get everything ready. Pushing starts and it’s hard to switch to an active phase so it takes a while to get the hang of it. Mama’s back is really uncomfortable so I suggest the birthing stool. The nurse sets it up for us and we transfer from the bed. This works much better, the pressure is off the back and pushing goes amazingly. Baby is born in just 35 minutes!

We settle mama and baby back onto the bed and I deliver the placenta. I’m just checking it over and explaining what I’m doing when mama pipes up ‘Oh, I do that with my animals too!’. Brilliant.

I round off proceedings, check baby over and write the birth up in our system. I’ve called my colleague to come and take over from me as it’s already 20.00pm. She’s waiting for me in the coffee room when I’m finished and we hand-over with a cup of Dutch tea with a whiff of tea bag! I’ve been here so long I I can even eat beschuit met muisjes 😉

This was both a normal and an unusual day all in one.

As Dutch midwives we have the privilege of being close to women and their families during a very important life phase. We also have the luxury of autonomy in our work so we can decide how we organize our care and can provide professional maternity care that is also personalised. We know our clients, we have the benefit of a relationship that has developed during the months of pregnancy and this works well for the clients but also for us. We can deliver better care, more individualized and tailored to specific needs.

I knew the lady with the super fast home birth really well. I had seen her numerous times, been to her home before and as a result knew exactly who was on the phone, where she lived and how best to support them in the situation. I would just like to add that this is only the second baby I’ve been too late for! But a phone call at 05.47 and a baby 05.48, I challenge anyone to get to that birth on time!
And this was the first and I’m hoping the LAST time I’m left stranded without my car!!!

Filed Under: Birth, Hospital, Midwifery

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Enjoy this special unique celebration today. Doul Enjoy this special unique celebration today. 
Doula Sophie welcomed a baby into the world in the early hours of this morning. A couple who hired her after following the Confident Birth course. Congrats to the new parents.
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If you choose to formula feed your baby from the b If you choose to formula feed your baby from the beginning then the baby will need a small amount of formula in the first two hours after birth. 

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A healthy period to give birth is between 37 and 4 A healthy period to give birth is between 37 and 42 weeks pregnancy. Within this time frame it is absolutely fine to have your baby. ⁠
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About half of all pregnant people will go into labour on their own by 40 weeks and 5 days (for first-time mothers) or 40 weeks and 3 days (for mothers who have given birth before). The other half will not. (evidence based birth) ⁠
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Many of the expats and internationals we work with Many of the expats and internationals we work with have a mother (or both parents) come over from their home country to help around the birth period. 

The question often wrestled with is if the mother should be at the birth or not. 
The answer is always explained when we talk about hormones and what adrenaline does to the birth process. Usually the mother-to-be immediately knows the answer of how the mother(in law) would affect her stress levels during the birth. 

Its actually unusual that having your mum beside you during the birth is a helpful thing. It is possible and i have seen some amazing mums who know how to be and can separate themselves from their daughters experience but not many.

Was your mother around during your birth? 
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Midwifery in the Netherlands is unique and we need Midwifery in the Netherlands is unique and we need you desperately to help us keep it that way. 
The proposed integrated tariff for financing our maternity system will bring the primary care midwives under a monopoly controlled by the hospitals. This will bring an end to freedom of choice for pregnant women and an end to professional autonomy for midwives.

Gone will be your choice of caregiver. Gone will be the professional freedom to deliver the best care to our clients in an evidence based, excellent quality system. 

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No, no, never will a doula replace the partner unl No, no, never will a doula replace the partner unless that is your specific request for some reason. 

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Do the doula test! 2 questions to help you see if Do the doula test! 
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Doulas continue support during the first hour afte Doulas continue support during the first hour after birth and usually stay around 2 hours afterwards.
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Do you know what ‘the doula effect’ is? Studi Do you know what ‘the doula effect’ is? 
Studies have shown that the continual support of the same one person during the whole birth process improves outcomes for mother and baby. 

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At Birth in Holland we are all about doula’s. Th At Birth in Holland we are all about doula’s. This week is World Doula Week and we will be highlighting some of the benefits of doula support and answering your questions about doulas. 

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We cover all elements of fundamental first aid in We cover all elements of fundamental first aid in our ‘First Aid For Babies & Children’ course & also cover CPR.

CPR is an accredited, certificated workshop given by trained Nederlandse Reanimatieraad teachers and gives a certificate that is valid for 2 years.

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We get asked this question often: is it safe to ke We get asked this question often: is it safe to keep working out when pregnant?

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Having a good physical condition helps for an easier labour and good recovery after birth. 

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