Pregnant? Now what?
You have a positive pregnancy test: our warmest congratulations! You are probably feeling everything – from delight to disbelief to doubts. And plenty of other emotions too. Our team is here ready and waiting to assist you through this special and exciting time in your life.
You can contact us directly, without a referral from your GP. You can register using the registration form. We will then contact you as quickly as possible. Or you can make an appointment by phone. You can call us for one Mondays to Fridays between 9:00 am and 5:00 pm on +31 (0)492-504712.
Examinations by a midwife
This takes place about 7–8 weeks into your pregnancy. As soon as you know that you are pregnant you can make this appointment. We will ask you how you are doing, and how you have felt over the last few weeks. During this first appointment we also do the initial ultrasound scan. We prefer to carry out this ultrasound internally (through the vagina), but if you do not like this we can try to take a look from outside (through your abdomen). If you would like more information about the scans of your unborn baby during pregnancy (prenatal screening) we will discuss this with you.
Intake
The second scan and checkup takes place at weeks 10–12 of your pregnancy. This is an extensive checkup and takes about 60–75 minutes. During this appointment we also do a scan to calculate your due date. This scan is an ultrasound check to set the calculated date more precisely.
To be able to support you properly during your pregnancy, it is important for us to know if:
- you have (or have had) any medical conditions that affect e.g. your heart, lungs, liver, kidneys, stomach, intestines or thyroid.
- you take any medication. Bring details of your medication and the dosage with you.
- you have any habits that could create risks for your pregnancy (smoking, consuming alcohol or drugs).
- there are any (hereditary) diseases or (birth) defects in your family or that of your partner;
During this checkup we also measure your blood pressure and weigh you, and of course answer any questions you may have. At this checkup you will be given information about getting blood tests done, and we review your options for prenatal screening.
Follow-up checks
Each follow-up check takes about 15 minutes. At these checkups we discuss how you are feeling and anything that happened in the previous weeks. We may also discuss the results of blood tests or prenatal screening.
During the course of your pregnancy, we discuss how you want to feed your baby and take time to discuss the birth itself in detail. We plan in some extra time during the appointments to talk about the birth and how you want it to be. in addition, we also do the following (routine) checks: take your blood pressure, weigh you, measure the increase in size of your womb, and listen to your baby’s heartbeat. These checks will be repeated at each of the follow-up check-ups. We carry out ultrasound scans when medically necessary as part of your care plan.
The number of weeks between check-ups will reduce as you advance through your pregnancy. From 37 weeks onward we will check you each week. If you think you will need some extra time during a checkup, please let us know this when you make the appointment. That means we can plan it in.
Blood tests
At your second checkup we will give you the request form to have some blood tests done. The lab will check out your blood for:
- Your blood group and rhesus factors
- Antibodies
- Infectious diseases (syphilis/lues, hepatitis B and HIV)
- Levels of iron
- Additional tests if these seem necessary (for example blood sugar levels)
You can read more about this in the “Pregnant” folder.
NIPT
If you decide to have a Non-Invasive Prenatal Test or NIPT during your pregnancy, we will also give you the form to take to the lab for this.
Prenatal screening
Many expectant parents wonder whether their child will be born healthy. Luckily, a healthy baby is the most likely outcome. If you are pregnant you have the option of having your child tested before he or she is born. This is known as prenatal screening. Prenatal screening is not required. You and your partner can decide whether you would like to do this or not.
There are 3 classes of tests:
- Screening for Down, Edwards and Pateau syndromes (NIPT)
- IMITAS study following a structural ultrasound scan at around 13 weeks (13 week ultrasound)
- Structural ultrasound scan at around 20 weeks (20 week ultrasound)
If you want like to, then we will also discuss this during the checks at the beginning of your pregnancy.
Ultrasound
Most ultrasound scans can be carried out at our own practice. For the Structural Ultrasound scans at 13 and 20 weeks, placenta location or a kidney scan of your unborn baby we refer you to the Peel Prenatal Screening Centre.
A list of the ultrasound scans you will receive during your pregnancy:
Foetal heartbeat ultrasound
Ultrasound appointment
13 weeks ultrasound
20-weeks ultrasound
Position scan
Growth ultrasound scan
A fun scan
Lifestyle recommendations
Nutrition and vitamins
Eating a healthy and varied diet during your pregnancy is important. You do not need to eat for two, but slimming is not sensible. Eat fresh fruit and vegetables to make sure you consume enough vitamins, minerals and fibre. Milk, cheese, eggs, meat, chicken and fish are important so that you get enough calcium, iron and protein.
If you are pregnant and eat a vegetarian diet with no meat, but do eat dairy products, eggs and fish that is fine too. Take into account that you need to consume enough food that contains iron, iodine, calcium, proteins and vitamins B1, B2, B12 and fatty acids (from fish).
If you eat very little or no meat or fish it is important to substitute for these properly, and especially to monitor how much vitamin B12 you consume. Think about maybe taking a B12 supplement. If you cannot manage to eat fish twice per week, then throughout your pregnancy take a omega-3 (fish) fatty acids supplement with 250-450 mg DHA.
If you are pregnant and eat a vegan diet there is a greater risk of you not consuming enough iron, iodine, calcium, vitamin B12 and omega-3 (fish) fatty acids. These elements are important for the development of your unborn child. Think about this and discuss with a dietician how you can manage it, and what supplements you need.
Important nutrition advice:
- Do not eat any (semi-)raw meat (so no steak tartare, salami or similar sausages).
- Do not eat any raw fish.
- Eat fish 2x per week. Eat oily fish once per week, and white fish once per week.
- Eat 4-5 portions of dairy products per day. If you cannot manage this, then you need to take a supplement of 1,000 mg calcium.
- Do not eat cheeses made from unpasteurised milk.
- Do not eat liver or liver products, such as sandwich spread or pate.
- Wash fruit and vegetables carefully.
- Only consume a little sugar, and not too many sweet snacks.
It is a good idea to take enough vitamins not only during, but also before your pregnancy. You can do this by eating a varied diet every day with plenty of fruit and vegetables. You can also use vitamin tablets. Make sure these are suitable to take during pregnancy.
Folic acid
We know that consuming folic acid reduces the chance of having a baby with a defective, exposed spinal cord (neural tube). Before and during the early pregnancy you need to take an extra amount of this vitamin. So start swallowing folic acid as soon as you decide you want a child. It takes about 4 weeks for the increased folic acid to be absorbed into your body. You need to take 0.4-0.5 milligrams of folic acid or folate every day up to the end of the 10th week of pregnancy. You can buy folic acid or folate at a pharmacy without prescription.
Vitamin D
Your body needs vitamin D in order to absorb calcium from your food. This is important for the growth and maintenance of strong bones and teeth. Vitamin D also plays a role in keeping muscles and your immune system in good condition. Sunlight is the most important source of vitamin D. Your body can create vitamin D on your skin when exposed to sunlight. Vitamin D is also found naturally in oily fish. Meat and eggs also contain vitamin D, but at lower levels. In the Netherlands vitamin D is also added to margarine, blended butter/margarine products, and other baking and cooking oil products.
During your pregnancy if you have fair skin, try to expose your hands and face for 15-30 minutes outdoors in daylight to help the production of this vitamin. If you have darker skin, then we recommend 30-60 minutes per day. In addition, we recommend taking a daily dose of 10 micrograms of extra vitamin D during your pregnancy. If you take a multivitamin for pregnant women, make sure to check that it contains the correct quantity.
Calcium
During your pregnancy calcium is important for building the bones in your unborn baby. Having enough calcium during pregnancy can also reduce the risk of high blood pressure or pre-eclampsia. Dairy products are the main source of calcium in your diet. In addition, you will find calcium in wholemeal bread and other whole grain products. You will be consuming enough calcium if you eat 4-5 portions of dairy products per day. This means 4–5 glasses or dishes of 150 – 200 ml. Healthy choices here would be milk, yoghurt or curd cheese and 40 grams of hard cheese (enough for 2 sandwiches). If you cannot manage this, then you can take a daily supplement of 1000 milligrams calcium. Do not take any supplement that contains more than 1,000 milligrams.
If you replace dairy products with plant-based alternatives, then do not consume more than 4 glasses or dishes (150 ml) of soy drinks/yoghurt per day. Also restrict other soya products such as tofu, tempé or soya beans to no more than maximum twice a week.
Iodine
During your pregnancy it is important that you get enough iodine. Iodine is important for your unborn baby’s growth and the development of his/her brain. In the Netherlands, bread is the primary source of iodine because the salt it contains usually has iodine added to it. Iodine ‘s main function is to produce the thyroid hormones (T3 and T4). The thyroid hormones have a variety of roles, including keeping your metabolism running smoothly and the development and growth of the brain as a foetus and during the first 1,000 days of life. By eating a varied diet with 4 – 5 slices of bread each day made with salt that contains iodine, you will have enough. There is also iodine in dairy products, eggs and fish. If you cannot manage to consume enough products containing iodine, then take a supplement each day of maximum 200 micrograms of iodine.
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Medication
If you take any medication it is sensible to discuss with your doctor before becoming pregnant whether these can be continued during pregnancy. Because medicines can remain in your body for a while, it is important to discuss this well in advance. You must also be careful about using any homeopathic treatments or other products you can buy over the counter at a drug-store or pharmacy without a prescription. Always read the accompanying leaflet carefully, and if in doubt, ask the pharmacist or your GP for advice. For painkillers, you can use 1,000 mg of paracetamol without codeine or caffeine without any risk. When you come for your intake appointment with us it is useful if you can bring an up-to-date list of the medication you are taking.
Smoking
Research has shown that people who smoke have an increased risk of a miscarriage, because of the dangerous substances in cigarettes. These substances affect the creation of the placenta that is needed to supply oxygen to the baby. This creates a risk that your child will not grow very well. Children with mothers who smoke often have a (too) low birth weight, and are more often born prematurely. This can make them more vulnerable. During their early years they suffer more frequently from respiratory diseases. There are indications that cot deaths occur more frequently when people smoke around a baby. So the recommendation to both parents is: stop smoking and avoid smoke-filled rooms as far as possible.
Alcohol and drugs
You are strongly advised not to consume alcohol or drugs during pregnancy. Alcohol will affect the unborn child at all times during the pregnancy, including when the mother does not yet know that she is pregnant and when the placenta has not yet developed. Alcohol consumption during the first few weeks of pregnancy also creates a higher risk of a miscarriage. Even small amounts of alcohol (1 glass per day) can damage your baby. Alcohol consumption can, for example, mean your baby does not develop fully, has defects on their face and nerve damage. Our advice is to stop using alcohol and drugs before getting pregnant.
There is an option to follow an online course if you still consume alcohol. This explains the consequences of alcohol consumption and gives you advice on how you can stop or reduce it.
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Please get in touch
For an appointment, or questions or concerns you can contact us by phone.
Please get in touch
For an appointment, or questions or concerns you can contact us by phone.
