Information about maternity care You are pregnant During pregnancy you can start making early preparations for the birth of your child. It is a reassuring feeling to know everything has been arranged. It means you can get greater enjoyment out of your pregnancy. Registering in good time, preferably before the 16th week, can help in this regard. In most cases you will need to inform your health insurance company and let them know clearly from which organisation you would like to receive maternity care. If this is not the case you can telephone us and we will register you directly. Tel: (0)88 – 77 77 666. Intake consultation As soon as you have registered with us, you will receive written confirmation. If after registering you move or change health insurance companies, please let us know as soon as possible. During the second half of your pregnancy one of our assistants will contact you and make an appointment for an intake consultation. Whether this interview takes place over the telephone or at your home depends on your health insurance company. It is important that you take good care to check the terms and conditions of your policy. During this interview we will make arrangements which we lay down in a care agreement (zorgovereenkomst). It could be that following the birth your personal and/or family circumstances are different from what you had expected beforehand. If so, we then modify the care we provide. Obviously we take into account the advice of others, such as your obstetrician or general practitioner. During the intake consultation the assistant will also talk to you about having safe and properly functioning equipment available, and the importance of proper working conditions. Referred to as a ‘working conditions (arbo) check’, the details of it are described in the file you are given during your intake consultation. 1 Meetings, courses and maternity information markets During your intake consultation you can ask many practical questions about pregnancy and the period after that. Our assistant will also tell you about other sources of information. Naviva Kraamzorg also has its own Internet site ‘www. naviva.nl’, which itself provides information and contains a number of interesting links. Naviva also lays on various activities for expectant parents throughout its operational area. These deal with issues such as breast-feeding, treatment and care of your baby, safety, and the birth itself. Other bodies organize courses and meetings on haptonomy and yoga. There are also large numbers of classes offering antenatal exercises, some of them organized by your own home-care provider, others by independent therapists. If you would like more information at this point, please call Naviva Kraamzorg’s Customer Service on (0)88 – 77 77 666, or go to www.naviva.nl Preparations What items do you need? There are certain things you will need whether you give birth at home or in a hospital. Ensure that you have all items listed around the 7th month of pregnancy. Also if you give birth in hospital and spend your maternity period at home you will need some items at home. This concerns: • Bed blocks (these are absolutely necessary in order to prevent the nurse and maternity assistant having back problems. See also the Conditions of Service below. You can borrow up to 8 bed blocks from the Thuiszorg (home care) shop; • Chamber pot with lid. You can borrow these items from your local Thuiszorg shop about three weeks before your due date (and sometimes even earlier). You should also buy a rubber/plastic bed-sheet from this shop. Our consultant can also arrange that these items will be delivered to your home and collected again free of charge. What do you need? For giving birth at home you will need a set of items including the following: • Towels and face flannels; • 2 sheets or duvet/comforter and 2 mattress covers or 2 under sheets; • 4 pillowcases; • A jug or bottle for rinsing; • 1 large plastic basin or 2 new buckets (for your own care) • 4 packages of sanitary towels (without plastic); • Pedal bin bags; • Garbage bags; • 1 roll of soft toilet paper; • 10 washed and ironed nappies/diapers packed into a clean plastic bag • 1 roll of aluminium foil in order to maintain the baby’s temperature. You will need a maternity package. Various health insurers provide coverage for these packages, or issue them free of charge. An alternative is to buy a maternity package at a Thuiszorg shop or general care shop. Each Thuiszorg or general care sop sells different maternity packages. At least the maternity package should contain the following items and quantities. • 15 under sheets 60 x 90 cm: • 2 boxes of wound compresses (8,5 x 5 cm and 16 x 16 cm); • 2 packages of sanitary towels/napkins, 12 to a box • 1 navel clamp (sterile) • 1 100ml bottle of 70% alcohol • 1 package of nappy/diaper liners, 15 to a package • 1 mattress protector, 80 x 160 cm; • 1 maternity mattress, 60 x 90 cm, with an additional insertable strip of cloth; • 1 roll of nappy/diaper tape; • 1 disinfectant soap pump dispenser; • 1 100g package of zigzag cotton wool. You should preferably have all the above items available by about the seventh month of pregnancy. 2 PLEASE NOTE Not all items available from the shop are to be used during the maternity period. Many items may come in handy after the maternity period. This includes special mats, baby sleeping bags and hot-water bottles. Requirements for the baby: Your baby also needs a set of items: • Cot or crib without head protection (preferably with adjustable slatted base); • Firm mattress and 1 or 2 mattress covers (moltons); • If necessary, a mattress protector (between mattress and slatted base); • Dressing table (height 90 – 105 cm); • 1 dressing cushion; • 4 under sheets and 2 over sheets; • 2 blankets; • 4 molton under blankets (onderleggers); • 2 large 1 liter hot water bottles; without seam and having screw-top equipped with rubber seals (the hot water bottle can be wrapped in a nappy/diaper) • or alternatively buy 2 flask bags made of cotton, flannel or melton. Important: Before using the hot water bottles, make sure they do not leak! • 2 baby caps; • 4 to 6 cotton or flannel undershirts or rompers; • 1 cardigan, sweater or coat; • 4 to 6 cotton or terry cloth (badstof ) baby sweaters and trousers or babygrows (boxpakjes); • If you use disposable nappies/diapers: approx. 18 water-absorbent (hydrofiele) nappies/diapers (including the 10 diapers used at the time of the delivery). These nappies/diapers are also to be used for drying the baby); • If you only use cloth nappies/diapers: 42 nappies/diapers of which 18 water-absorbent ones and 24 with eyelets;3 to 6 large safety pin (for multi purposes) or a roll of tape; 6 baby bibs; • 6 facecloths (water-absorbent); • 1 nappy/diaper basin – or, if you use disposable nappies/diapers, 1 pedal bin – and a bucket • • • 1 baby bath with stand; 1 comb and hairbrush; 2 feeding bottles, 2 dummies/pacifiers, feed and bottlebrush if you do not breastfeed; • 2 digital thermometers (one for the mother and one for the baby to avoid infections); • Baby soap or a bottle of liquid soap; If you wish to massage your baby during the maternity days or after, we recommend that you buy soft, vegetable oil. You do not have to buy double quantities of many of the items listed above if you are expecting a multiple birth. If you have any questions about this please call Naviva Kraamzorg. Tel.: (088) 77 77 666. The Consumer and Safety Foundation [Stichting Consument en Veiligheid] has published a brochure entitled “What to look out for when buying or using something” [‘Waar let je op als je iets koopt of gebruikt?’]. It gives excellent information on what to be aware of when buying major items for babies and children. You can order the brochure from the Consumer and Safety Foundation, telephone (020) 511 4567. You can also visit the site: www.veiligheid.nl. Giving birth in hospital Make sure you have a bag ready around three weeks before the calculated due date in case you (still) have to go to the hospital unexpectedly. This ensures that you have everything ready. 3 Items to be included in the bag • Insurance papers; • Hospital’s patient details card (ponsplaatje); • This information booklet and the associated Maternity Care file (to fill in yourself ); • Toiletries; • 2 t-shirts or night gowns; • Slippers and warm socks; • Bathrobe or housecoat; • Stretch underpants; • Clean clothes for after the delivery; • photo camera, video camera; • (breastfeeding) bras; • list with important telephone numbers of family and friends; • 1 set of baby’s clothes (undershirt, sweater, • pants, romper or plastic pants (luierbroekje), coat or baby cape, cap, Bib); Coins for the wheelchair and parking meter, if applicable (€ 0,50,€ 1 of € 2). Allergies Allergies can be hereditary. Allergies can be hereditary. If you or your partner (or someone else in the family) has an allergic affliction, then you would be well advised to take this into account in preparing the baby’s room. Materials least likely to cause allergic reactions are: • synthetic blankets; • Synthetic mattress not containing wool, kapok or sea grass; • Bed on bed legs equipped with a slatted base to ensure sufficient ventilation; • smooth flooring, which you can wipe with a damp cloth; • Bed clothes washable at 60°; • Perfume-free soap; • Cuddly toys washable at 60°; If allergies occur in your family, your baby could also have a reaction to components in its feed. Research has shown that babies are more resistant to allergies if they are breastfed for the first few months. Our staff will be happy to advise you after consulting with the obstetrician. The nurse of the childcare clinic (consultatiebureau) will also be glad to answer your questions. Baby room Wash the baby clothes you buy in advance and ventilate the baby room several times, particularly if it is new and/or freshly painted. In connection with any allergies that may occur we recommend that you wash all washable items in the baby’s set of items beforehand. To avoid a possible allergic reaction in your baby we advise you not to use any laundry softener. The baby’s cot: • has a smooth finish: no protruding parts, knobs, sharp points or edges; • Has, if it concerns a collapsible cot, a proper shutting mechanism that cannot be opened by a child; • • • • • • • Has a firm base that can be properly ventilated; Both the slatted base and the bed base be fixed firmly in various positions; Has at least 2 side panels with an open structure, e.g. posts or a properly ventilating fabric; This also applies to a foldable cot (campingbedje); Is between 90 – 140 cm long and preferably at least 55 cm wide; Has side panels of 60 cm high, measured from the top of the mattress; Has a distance between the posts of between 4.5 and 6.5 cm; Has a smooth, properly fitting and firm mattress; Has a mattress that fits in the bed properly; Has a mattress that leaves no space between the mattress and the cot. Bedclothes: • The weight and material of the blankets you buy have no effect on the baby’s safety. • Buy sheets and blankets. Pay attention to the following: the blanket should not be too thick. the thicker the warmer. • The blanket, mattress cover (molton) and sheet are large enough to be tucked under the mattress. The dimensions should be at least 100cm by 80cm. • There are special baby sleeping bags available for newborn infants. Make sure that the neck and arm openings of the baby sleeping bag are not too large for the baby. The baby sleeping bag has a zip fastener that runs from the level of the baby’s lower legs up to the top of the bag. The baby sleeping bag is stitched with cotton. If you have a padded sleeping bag then other bedclothes are generally unnecessary. It can be used after you stopped using the hot-water bottles. If you use a blanket inserted in a duvet/ comforter, then the cover must fit properly be big enough to tuck in (at least 10cm under the mattress). 4 Our advice: do not purchase a: • Mattress with a plastic cover • Duvet/comforter • Head protection • Rubber/plastic bed sheet (zeiltje) • Stabilizing rollers • • Sleeping bag girdle Padded baby sleeping bag in combination with blankets Preparing the bed/cot. Recommendation. The under layer: • Spread a mattress Melton over the mattress. Spread the under sheet smoothly over the Melton and mattress. Place a Melton under sheet or flannel nappy/diaper in the area of the baby’s bottom; • The baby’s head should rest on a nappy/diaper. This will catch any saliva / regurgitated food. Depending on the shape and size of the bed, the ‘head nappy/diaper’ should be folded. Fold a chequered nappy/diaper in three, the open end facing away from the baby, in such a way that the baby is not irritated by any seams, and tuck it properly under the sides of the mattress; Or fold the head nappy/diaper into a triangle, the points laid on top of one another facing away from the baby, and tuck the points it properly; At the end of the maternity period you should remove the head nappy/diaper from the bed for safety reasons. The top layer: • Make the bed ‘short’, the baby’s feet reaching the bottom-end of the bed. This will prevent your baby from getting completely covered by the blankets; • One blanket is sufficient if you use a thin sleeping bag; • The upper sheet should be folded about 10cm over the blanket; • If you use small blankets lay the lower one crossways and the upper blanket lengthways. This will keep the mattress firmly in place; • If you use a blanket inside a duvet/comforter cover, it is important that it fits well and can be tucked under the mattress properly (at least 10cm under the mattress); • • • • 5 If you use a large blanket you should tuck it under the mattress as smoothly as possible; Should you decide to use a duvet/comforter, tuck it under the sides of the mattress so that the baby cannot slide underneath it. Tuck in the top layer tightly (but not too tightly). There should be no loose-lying plastic in the cot or playpen. This could be dangerous if the baby sucks on it. Arrangements to be made just before giving birth There is nothing more annoying than realizing you have forgotten something just before you are due to give birth. We therefore have a number of practical tips: • Should you move house or switch to another health insurer, please let us know as soon as possible; • If you have an outside light, make sure that it is switched on; • Make sure that the number of your house is clearly visible; • We advise you to heat the room in which you will give birth as well as the baby’s room to between 21°C and 23°C; • Put an additional table, good-size bedside table or ironing board in the room in which you plan to give birth; • Have two buckets ready, lining one of them with a garbage bag; • Make sure there is enough space to move around. You should also have emergency lighting as well as spare fuses at hand; • A torch/flashlight is useful in the event of a blackout; • Cover your mattress with a rubber or plastic sheet several weeks before you are due to give birth. This will protect it if your waters break prematurely; • For the birth we advise you to cover the under sheet with a rubber/plastic sheet. This you should then cover with a sheet folded double and a fibre mat; • Place the blocks under your bed about three weeks before the anticipated due date; • Place the pot already under your bed; • Make up the baby’s cot/crib in advance and, just • before the baby is born, warm it with a hot-water bottle, wrapping its clothes around it; You should have all the necessary equipment for the birth ready about three weeks in advance. When you are about to give birth …. When your contractions begin, contact your obstetrician or gynaecologist. Following consultation, call your obstetrician for assistance during delivery on (088) 77 77 600. (Telephone this number only for assistance during delivery). The maternity period Feeding on demand Whether you decide to breastfeed or bottle feed, it goes without saying that our staff will respect your choice. They will provide help and support during your maternity period, whatever your needs and situation. Naviva endorses the ten basic rules of the World Health Organisation (WHO) and UNICEF. These rules were drawn up to ensure that nursing mothers are given the best possible help, wherever they are in the world. If you are still in doubt about whether to breastfeed or not, make sure that you are properly informed. It is worth all the effort! Feeding on demand is an important aspect of feeding your baby. Feeding on demand means allowing the baby to drink (from breast or bottle) whenever it is hungry. We would advise you not to wait until it is so hungry that it starts crying, as this will put you under stress, make your baby restless and might even cause it to lose its grip on the breast or bottle. If your baby does not ‘ask’ to be fed itself, then you should be sure to feed it every three to four hours. A feeding routine usually starts to emerge during the first week. It is normal to feed your baby 8 to 12 times in 24 hours. In theory, babies have enough reserves to survive the first 24 to 48 hours without extra feeding. How … do I give my baby the breast? Find a position that is relaxed and comfortable for both of you. • Support your breast gently, using four fingers underneath and your thumb on top next to your nipple. • Wait until your baby opens its mouth wide and check that its tongue is lying flat. • Bring the baby to the breast. • Make sure that the baby has taken the nipple and the surrounding area (the areola) fully into its mouth. • Is the baby’s mouth still open wide while feeding and is its bottom lip curled outwards? • Is its tongue under the nipple and above its lower jaw? • Press the baby’s chin, lips and nose gently into your breast. • You should hear the baby swallowing. • The baby will let go when it has had enough. If the maternity nurse is not present at feeding time, make a note of how the baby drank in the maternity care file. If there are any problems, the maternity nurse will contact our breastfeeding expert. Please note; you might be charged for this, although some insurance companies cover the costs. Check your insurance policy for details. Tel (088) 7777 680. Bottle feeding If you decide to give your baby the bottle, you will have to buy the equipment, choose the brand of formula and make thorough preparations. The first bottle will be given after talking to the maternity nurse. You will have spoken to her during your pregnancy about the type of formula and the equipment you will need. 6 How …do I prepare bottles? • Hygiene is very important. • Get everything ready and lay it out on a clean and ironed tea-towel/nappy. • Read the instructions on the formula, paying special attention to the use-by date. • Fill the bottle with the prescribed amount of tap or mineral water. • Heat the water to hand temperature in the microwave (always without the teat), bottlewarmer or in a pan. Warm water from a geyser or boiler is also all right. • The formula should never be warmer than 30 to 35ºC. If you heat the water in a microwave, shake it before you feel it to distribute the heat properly. • Scoop the prescribed number of measuring scoops of formula into a jug. • Add the water and stir well with a fork. • Pour the formula back into the bottle and check the temperature against the inside of your wrist. • Use the bottle of formula within an hour. • Close the packet or tin securely and store it in a cool, dry place, but not in the fridge. • Wash the measuring scoop and store it in a clean place outside the packaging. You can prepare formula up to eight hours in advance. Store ready-made formula in the fridge at a maximum temperature of 4ºC. How… do I give my baby the bottle? • Change the baby before the feed and always wash your hands before giving the bottle. • Place a bib under the baby’s chin. • Find a position that is relaxed and comfortable for both of you. • Prop the baby up and support its head in the crook of your arm. • Keep changing arms while feeding the baby to avoid it developing a preference. • Check the temperature of the formula every now and then. • Hold the bottle so that the teat is always full to prevent the baby from swallowing air. • Stroke the baby’s cheek with the teat if you want to encourage it to take it in its mouth. • Place the teat on top of the baby’s tongue. • Make sure that the teat is far enough into the baby’s mouth. • Your baby might swallow too much air while drinking, particularly if it drinks greedily. Make sure to wind your baby every now and then to avoid colic. • Once the baby stops drinking, wind it. Hold the baby upright with its head resting against your shoulder and pat its back with the flat of your hand. Don’t forget to place a bib over your shoulder first! If the maternity nurse is not present at feeding time, make a note of how much your baby drinks in the maternity care file. If there are any problems, you can always call the bottle feeding helpline [Flesvoedingslijn]: (088) 77 77 656. Heel prick When the baby is three to five days old, it will be given a heel prick. This will often be done by your own maternity nurse. The blood that is taken will be tested for a number of congenital and hereditary illnesses. This is done because many of these rare illnesses are much easier to treat if spotted early. For more information, refer to www.rivm.nl. Hearing test On day five, a specially trained member of Naviva maternity care staff will visit your home to test your baby’s hearing. This test is part of the screening process, which you can read about in the special leaflet enclosed with this brochure. For more information, please refer to www. nsdsk.nl. In some areas, the heel prick and the hearing test will be carried out by a nurse from your local childcare clinic. She will also come to your home. After thematernity period Your period of maternity is over. The maternity nurse will help you to look back and decide how the past few days have been for you, your baby and the family. Are you satisfied, are there any further questions…? The maternity nurse has done her best to make sure that you and your partner have enjoyed the first few days and has provided you with help and advice. From now on, it is up to you to take over the care of your new baby and your family. 7 The childcare clinic One week after your maternity period, you will be visited by a nurse from the local childcare clinic. . If this is the same person who carries out the hearing test and heel prick in your region, she might have made an appointment with you already. She may call you during your maternity period. You and your baby will be given an appointment to visit the childcare clinic. You will find a telephone number to ring if you want to contact the clinic yourself in the ‘GroeiOp/ GroeiGids’ booklet or at the back of this magazine. The childcare clinic has a walk-in weighing session and a telephone helpline. Depending on the region in which you live, the maternity nurse will take you through the information you will need to pass on to the local childcare clinic. More and more of this process will become digitalised and arranged via the so-called Electronic Child Dossier (or EKD in Dutch). About maternity care Details and scope of maternity care Maternity care is designed to help give mothers and babies the best possible start in this special phase of their life. This is very important, which is why here in the Netherlands we work according to a national needs assessment protocol. The protocol aims to make an objective and transparent allocation of the available hours of maternity care. On the basis of this protocol, an assessment officer will decide how many hours of maternity care are reasonable in your personal situation. This indication will not include the hours that the maternity nurse is in attendance during a home birth. After the birth and/or during your maternity period, another assessment will be made to make sure that the number of hours you have been allocated still corresponds with your situation. If not, together with the midwife, we will decide on a new number of hours. This is called a reassessment (herindicatie). You are free to buy in more hours of maternity care yourself if you think you need more than the maximum hours allocated in the assessment or by law. When providing maternity care, Naviva makes use of a maternity file. Naviva will give you this file, which is useful for recording and discussing the details of the care you receive after the birth so that you will be able to take on the responsibility for caring for your baby after your maternity period. Furthermore, the file makes a nice memento for later. What does maternity care cost? You will have to pay a statutory personal contribution for the hours you are allocated according to the assessment. Some insurance companies refund (some of ) this personal contribution depending on the details of your policy. You can always ask for more If you would like more maternity care than you have been allocated, you can buy extra hours of care at the prevailing rates. Some homecare organisations give extra discount on our hourly rate. Our customer service staff and consultants will be able to tell you all you need to know. Maternity care after a stay in hospital Even if you give birth in hospital, you may still be entitled to a certain number of hours of maternity care at home. This will depend on the length of your stay in hospital, but in general, maternity care is available until the 8th day after the birth. Maternity care if your baby is in an incubator If you are allowed home while your baby has to stay in hospital, it is sometimes a good idea to arrange maternity care for yourself. After all, you have just given birth. Depending on the conditions of your insurance policy, some mothers are also eligible for a number of hours of maternity care once their baby comes home. This care is nearly always aimed specifically at the baby and designed to inform and instruct the mother. Once again, this will depend on the details of your insurance policy. Information is available from your insurance company or the Naviva maternity care customer service line. Telephone: (088) 77 77 666. 8 Clear arrangements; better service In order to be able to provide you with good service, we need to know what you expect from us. When your maternity is over we would like to know whether our care has lived up to expectations. Naviva Kraamzorg and its personnel respect your privacy as well as your religious and philosophical convictions. At the same time Naviva expects its clients to treat its personnel with respect. We also make arrangements with you about the working conditions of our personnel (under the Working Conditions Act). They are guests of your family, and your home is their workplace. We also like to be clear about the conditions under which we provide care. These are governed in part by the Working Hours Act, which provides for compulsory rest times for employees in the Netherlands. In addition, most maternity assistants work according to a roster system. Although you will most likely be assigned just one maternity assistant, it sometimes happens that a maternity assistant is replaced by another one during maternity. This may be the case if a maternity assistant has worked for another family for several days before coming to you. If a maternity assistant is replaced, the original one will ensure that she transfers her responsibilities properly to her replacement, based on the file. We also advise you to read the conditions of service elsewhere in this brochure. At Naviva Kraamzorg, it goes without saying that we make solid arrangements in advance and establish afterwards whether everything was satisfactory. Happy? Unhappy? Naviva Kraamzorg stands for good care. Nevertheless, it might be the case that you are not satisfied with the care we provide. In that case do not wait until our work is finished, but rather talk to the person looking after you. If this does not help, then you can always get in touch with Naviva Kraamzorg’s management. Should you still not be satisfied with the outcome, however, then there is another possibility: the so-called complaints scheme. You can read about it and also about the avenues open to you in a separate folder. This is available from Naviva Kraamzorg’s Customer Service, telephone (088) 777 7666. We will send you an evaluation form. We would like to know about your experiences and perceptions of Naviva Kraamzorg. Please return the form as soon as possible after we have ended our care in the designated reply envelope. Your comments are important because we are always striving to improve the service we provide and, where possible, adjust it to your wishes. If you have any comments, please do not hesitate to write them down on the evaluation form. In this way you will be doing our future customers a service. Naviva Kraamzorg Terms and Conditions of Service www.naviva.nl/leveringsvoorwaarden Home care Membership of the Thuiszorg Members’ Service/Health Service Many home care organizations have their own Members’ or Health Service. There are a lot of benefits to being a member. You receive a discount on courses and other services organized by the organizations and you receive discount on purchases in the Thuiszorg shop. Some even give a discount on hourly rates for maternity care. This could be interesting if you wish to purchase additional hours of maternity care. For detailed information on the benefits of a membership please contact your local Thuiszorg provider. (Telephone numbers and websites are listed at the back of this brochure). You can register as a member on the home care organisation’s website. Thuiszorg shops There are Thuiszorg shops located in various parts of our operational area. They stock a solid and reliable range of articles such as the maternity package, recommended items, scales, breast pumps, childproof items and nappies/diapers. You can buy, rent and/or borrow articles from Thuiszorg Shops and Service Locations. Members of the Members’ or Health Service receive discount on all items purchased. For this they must be able to produce a membership card. If you wish to borrow anything, you will be asked to show an identity card. 9 Addresses of the home care organisations Carinova Phone: 0900 – 8662 www.carinova.nl Carint Phone: 088 – 367 70 00 www.carintreggeland.nl Livio Phone: 0900 – 92 00 www.livio.nl Zorgaccent Phone: 0900 – 0678 www.zorgaccent.nl Vérian Phone: 0900 – 9255 www.verian.nl Zorggroep Oude en Nieuwe Land Phone: 0521 – 53 99 99 www.zorggroep-onl.nl This is a publication of: Naviva kraamzorg Post bus 2190 7420 AD Deventer Visiting address: Keulenstraat 19 7418 ET Deventer Tel.: 088 – 77 77 666 Fax: 088 – 77 77 699 Internet: www.naviva.nl June 2013
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