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Ouch, why do contractions hurt so much anyway? Not fun, but inevitable and believe it or not, incredibly useful. And when we say rock in the surf during your pregnancy, you say partner! Or do you? Your midwife is at least as important before, during and after the birth of your baby. She is there for you and has the answers to all your questions. Finally, we tell you about amniotic fluid and breaking the water. After reading this blog you know what to do.

Ow! A contraction!

No matter how beautiful the birth of a child is, pain is inevitable. And although pain management during labour is not very common in the Netherlands, there are a number of options to reduce the pain. But first: why do contractions hurt so much? The pain is often the most severe during the dilation phase. During a contraction in the dilation phase, the lower part of the uterus and the cervix are stretched. The tissue of the cervix is usually quite stiff and in this state it is impossible for a baby to pass through. It will therefore first "soften" (Medicinfo). Although most women feel the pain in their abdomen, it is also common for women to experience pain in the back or legs (UMCG). And that pain is there (fortunately) for a reason. Pain stimuli cause the production of endorphins in your body and endorphins reduce the pain. But to do this you must be as relaxed as possible. This is because tension or fear can hinder the production of endorphins. Try to focus as much as possible on the breaks between the contractions and not on the contractions themselves. The breaks often last about three to five minutes and give you enough time to catch your breath. Should your body's own endorphins not be enough for you - and believe us, that's not crazy at all - there are a number of options for pain relief. 

For example, there is TENS. TENS stands for Transcutaneous Electrical Neuro Stimulation and provides a tingling sensation by means of small electric shocks. By means of electrodes on your back and a device that you operate yourself, you receive small electric shocks that can help reduce the pain. Nice, right? 

Acupuncture can also offer a fine solution. By placing small needles in specific places, the balance in the body is restored and you feel less pain. Afraid of needles? Acupressure is similar to acupuncture, but the hands and fingers are used instead of needles. 

If you suffer from lower back pain, sterile water injections can help. Your midwife will place four injections of sterile water in your lower back after which you will experience less pain for up to two hours. Advantage: the midwife can repeat this treatment as often as you want. This method of pain control is not yet very common, so consult your midwife before the birth if you think this is a good way of pain control (KNOV). So there are plenty of things that can make childbirth just a little bit more pleasant. 

Rock solid: your midwife

During and after your pregnancy, your midwife is one of the most important people. But even before you are pregnant you can turn to her for advice about getting pregnant. Do not hesitate to ask her all your questions and worries, she is there to help you. During the pregnancy you will visit the midwife about ten to fourteen times. In week 8, the midwife (or the laboratory) will take blood to check for glucose levels, blood type and sexually transmitted diseases. If there is something wrong, they will be able to catch it in time. From week 36 onwards, the midwife sees you every week because more check-ups take place then. She is also present during the birth and helps you to handle the contractions. If there is a medical indication, she will often transfer you to the gynaecologist and the midwife in the hospital. During the postpartum period - the first eight days after the birth - the midwife will visit you at home a number of times (Service pharmacy). Together with the maternity nurse she gives advice and she guides you and your partner in your (perhaps new) role as parents. After about six weeks the final check-up takes place during which the midwife will discuss a number of things, such as the pregnancy, the birth, but also contraception. She may also do some tests on you or the little one if necessary (The Midwife). After the last check-up you can ask all your questions to the consultation bureau. 

Amniotic fluid and rupture of membranes

Not every birth starts with contractions. In some cases the waters break first. And even if they do, it may still take some time before contractions present themselves. If your water has broken, you will generally give birth within 24 hours. If not, you will be admitted to hospital (if you were not already there). There is still not much wrong with you, but just to be sure, they can keep a close eye on you and your baby. Have the contractions still not started after 72 hours? Then your delivery will be initiated (LUMC). 

Usually amniotic fluid is colourless and clear, like tap water. Sometimes it contains white flakes. And if it is light pink, it means the amniotic fluid contains some blood. Your baby may also defecate in the amniotic fluid. If so, it will be brown or green in colour. It is important that you call the midwife immediately because the risk of complications increases in this case. The majority of babies who defecate in the amniotic fluid do not experience any problems, so there is no immediate need to worry. But let's be on the safe side: your baby will be closely monitored if it turns out to have defecated (The gynaecologist). 

When your water breaks, it doesn't necessarily mean that the amniotic fluid comes out in torrents. At first, women often think of urine leakage as a sign of water retention. So it can be quite confusing. That's why you should look closely at the colour and use your nose. Amniotic fluid, unlike urine, smells slightly sweet. 

When your water breaks, the natural barrier between the uterus and the outside world has disappeared. If it happens at night, you do not have to call the midwife immediately. It can wait. However, extra caution is advised: do not use tampons, do not take a bath, measure your temperature regularly (preferably four times a day) and change your sanitary towel after every visit to the toilet (LUMC). 

Take it!

Discuss everything properly with your midwife. Again: she is there for you! No question is too crazy, you have to go into labour with confidence and a good feeling. Another tip from us: have an escape bag ready around week 36. If unexpectedly you have to go to hospital because the little one cannot wait, then all your stuff is ready. Mum and dad ready, pack it in!

Sources

The Midwife. (s.d.). What does your midwifehttps://deverloskundige.nl/over-de-verloskundige/tekstpagina/45/wat-doet-je-verloskundige/

KNOV. (2014 October). Your birth: How do you deal with pain? https://deverloskundige.nl/uploads/deverloskundige.nl/knov_client_downloads/42/file/Volledige_folder_pijn_herziening_okt_2014.pdf

 LUMC. (2019, December 19). Broken membranes without contractions between 37 and 42 weeks of pregnancy | LUMChttps://www.lumc.nl/patientenzorg/praktisch/patientenfolders/gebroken-vliezen-zonder-weeen-zwangerschap-37-42-weken

 Medicinfo. (s.d.). Accesshttps://encyclopedie.medicinfo.nl/ontsluiting/deafdde5d8a74e5b9f5ab3bfd1b14283

 NVOG. (2020, February 28). Poop in the amniotic fluidhttps://www.degynaecoloog.nl/onderwerpen/poep-in-het-vruchtwater/

 UMCG. (s.d.). Pain during childbirthhttps://www.umcg.nl/NL/Zorg/Volwassenen/zob2/pijn-bij-bevalling/Paginas/default.aspx

 What does an obstetrician do? | Service Pharmacy. (s.d.). https://kennisbank.serviceapotheek.nl/artikel/wat-doet-een-verloskundige