8 weeks consult, intake

The first check-up takes place around 8 weeks gestation. We record your personal information, ask about the health history of you and the father of the baby, your work situation, any other children and the health of both your families We also give a lot of information about pregnancy and issues around pregnancy. During this first check-up we also assess whether we can continue as midwives or if we should send you to the hospital, for medical reasons.

During the first check-up we also discuss:

• Prenatal screening
  We give you information about various prenatal tests. As a pregnant woman in the Netherlands you have the option to have your child tested to see if your child has an increased risk of Down syndrome, Edwards, or Patau. You can do the NIPT test for this. To see if there are congenital abnormalities in the baby, you can opt for a 13-week ultrasound and a 20-week ultrasound. The tests are briefly described below;
  
  The NIPT
  
  The NIPT is an examination in which the blood of the pregnant woman is examined. The blood sample can be taken from 11 weeks of pregnancy. The laboratory examines the DNA in the blood for chromosome abnormalities and can determine whether the child has Down syndrome, Edwards' syndrome or Patau's syndrome. The pregnant woman's blood contains DNA that comes from the placenta and DNA that comes from the mother. The DNA of the placenta is almost always the same as the DNA of the child.
  
  The laboratory can also find chromosome abnormalities other than Down, Edwards or Patau syndrome in the child, in the placenta and very rarely in the pregnant woman herself. Those are incidental findings. You decide in advance whether you want to know additional findings. Click here for more information.
  
  13 week ultrasound (ETSEO) and 20 week ultrasound (TTSEO)
  
  The 13-week ultrasound is performed between 12+3 and 14+3 weeks. The 20 week ultrasound takes place between 18 and 22 weeks of pregnancy. The screening ultrasound examines any physical abnormalities in an unborn child, such as an open back or an open skull. We look extensively at the development of the organs, the head, heart, abdominal cavity and arms and legs. It is also checked whether the child is growing well and whether there is sufficient amniotic fluid. In most cases, the sex can be determined at the 20 week ultrasound and if you ask, you will be told this. This does not provide complete certainty and is not the aim of the study.
  
  Not all disorders are visible on a screening ultrasound. A 'good' ultrasound is therefore no guarantee of a healthy child. In case of doubt or uncertainty on the ultrasound, it is repeated at the screening center or in an academic hospital. This does not necessarily mean that there is something 'not right' about the baby.
  
  Click here for more information about the ultrasounds.
  
  (https://www.pns.nl/13-wekenecho, https://www.pns.nl/20-wekenecho)
   
• Ultrasound
  In the Netherlands between the 10th and 12th week of the pregnancy the first ultrasound scan during the pregnancy (normal situation). Than the exact date of birth will be established, which is also the first day of your last period. This takes place in our practice.
• Blood tests
  At the beginning of the pregnancy we test your blood: blood type, Rhc antibodies, irregular antibodies (antibodies, you might have made against another blood types or blood components), Hb, MCV (iron), glucose (sugar), HBsAg (hepatitis B), HIV, Lues (syphilis, venereal diseases) and rubella (German measles, if you have antibodies against rubella).
• Nutritional advice
  During pregnancy there are some things you should not eat; no raw meat such as not-well-done steak, steak tartar, beef sausage.
  What is allowed: well-cooked meat and smoked fish, as long as it is not vacuum packed. Also raw fish fresh from the fishmonger, and baked or cooked shellfish.
  Raw milk cheeses are not allowed, this includes the special, soft cheeses made with raw milk.
  Furthermore, you should not eat too much liver, one serving per day as it contains vitamin A. You should not have too much vitamin A during your pregnancy.
  If you eat healthily and varied, than extra vitamins are not required. If you want extra vitamins, take vitamins especially for pregnant women. There is less vitamin A in these and more iron.
• Folic acid
  If you want to become pregnant always think about the use of folic acid before becoming pregnant. It is better to take this at least three months before getting pregnant. It is advised to take it until 10-12 weeks gestation. If the pregnancy was not planned and you only knew around 8-9 weeks after becoming pregnant, then you can still take the pills. The effect of folic acid is then not that large but it’s never bad to take them.
• Sporten
  You can sport during the pregnancy as long as you listen to your body. Do not test your limits. We advise to stop playing contact sports such as hockey, football and handball after 16 weeks of pregnancy.