This page is meant to give you important information about our practice, the pregnancy, the delivery and the maternity period.

                                             
APPOINTMENTS
Please bring a towel with you for every consult.


OUR NAME “SIFRA”
Our name “Sifra” is the name of a midwife from ancient Egypt.
The story about the midwife Sifra takes us back more than 2000 years to the time of the pharaohs in Egypt. The king of Egypt ordered the midwives Sifra and Pua to murder all the newborn boys. By doing this, he hoped to eradicate a nation.
The midwifes, however, refused to murder the children. They protected each life, risking their own lives.
Sifra means beauty. This is a fitting name for the women assisting in the birth process, they make sure that both mother and child can continue their life in a beautiful and shining way (meaning of Pua).

INTRODUCTIONS
Dear expectant mother, welcome to our midwifery practice Sifra.
Our practice is run by four midwifes:

• Irena Veringa
• Anneloes Berkhoff
• Sanne Sneeuw
• Wilma Smits

During holidays or other circumstances like courses, congresses and illness we work with one or sometimes more substitutes. At the moment these midwifes are:

• Bahareh Goodarzi
• Willemijn van Hoogdalem

We collaborate closely  to give you the best possible care during your pregnancy, labour and maternity period.
You will get acquainted with all of us during your pregnancy .
We provide midwifery care in the areas: Leidschendam-Voorburg, Leidschenveen, Ypenburg, Mariahoeve and Bezuidenhout
Our practice is a member of the Koninklijke Nederlandse Organisatie voor Verloskundigen (KNOV), ie. Royal Dutch Organization of Midwives. All the midwifes are registered in the BIG-register and the Quality-register for Midwifes.
During consultation hours, the practice assistant Jolanda Fredriksz is present. She will help you with rescheduling or making appointments, answering questions about non-midwifery issues and practical questions and administrative dealings.
Our practice supervises students from the school for midwifes “Verloskundige Academie Amsterdam”. This means for you that you may meet a student during midwifery care.

CONTACT INFORMATION

Our practice is located at:
Zaagmolenstraat 81
2265 XH Leidschendam
Phone number: 070-3010197
E-mail: info@sifra-verloskundigen.nl
Website: www.sifra-verloskundigen.nl

Sifra’s other consult locations:
Loudonstraat 118
2593 WB Den Haag
Gezondheidscentrum Leidschendam

Harriet Freerzerhof 195
2492 JC Den Haag

In case you have any questions, or you whish to make or reschedule an appointment, you can reach us at the practice during our consultation days until 14.30 o’clock.
Should you have AN EMERGENCY QUESTION, for instance inexplicable pain, blood loss or less or no movement of the baby, you can reach the midwife on call through our emergency phone number: 06-43029073.
If your call is not answered straight away, try again, a few minutes later. If your call is still not answered, you can reach us through our pager: 06-65130715. Choose option 2, dial your phone number and finish with #. We will call you back.
We make every effort to contact you as soon as possible. Do not call us with a private phone number, in that case we can not call you back!

Never leave a message on the answering machine in the case of an emergency!!!

CONSULTATION HOURS at 3 locations

Zaagmolenstraat 81 2265 XH Leidschendam		maandag dinsdag vrijdag		08.30 - 12:00 uur 13:00 - 16:00 uur 08.30 - 12:00 uur
Loudonstraat 118 2593 WB Den Haag		dinsdag donderdag of vrijdag		08.30 - 12.00 uur 08.30 - 12.00 uur 12.00 - 16.00 uur
Harriet Freerzerhof 195 2492 JC Den Haag		maandag dinsdag vrijdag		13:00 - 16:00 uur 08:30 - 12:00 uur 13:00 - 16:00 uur

Laboratory
Every Monday and Friday at 08.30 a.m. there is the possibility to give blood at the Zaagmolenstraat for the blood tests.
This is a walk in service, the lab worker will stay until everyone present has been helped.
You will need a blood test form and identification to be able to give blood.

COOPERATION
To be able to give you the best midwifery care possible, we have a few cooperation partners. With these partners we have regular meetings.
They are :

• De Verloskundige Echopraktijk
  Ultrasound scans
  www.echoscreening.nl
  

• Haags-Rijswijks Artsenlaboratorium
  Laboratory
  070-3360714

• Take Good Care
  Maternity care
  www.takegoodcare.nl

• Bronovo Hospital
  www.bronovo.nl

• ‘t Lange Land Hospital
  www.langeland.nl

• Florence
  www.florence.nl

Welfare centre

• Centrum jeugd en gezin
  Centre for youth and family  

PREGNANCY - NUTRITIONAL RECOMMENDATIONS
Certain bacteria and parasites in food can be extra dangerous during the pregnancy.
To avoid ingestion of and contamination by harmful bacteria and parasites:

• Do not consume raw meat, make sure the meat is well cooked
  Examples of raw meat products are roast-beef, ‘filet Americain’, salami, chorizo, tartar and carpaccio
• Wash fresh fruits and vegetables thoroughly before consption
• Prevent contact between raw food and prepared meals
• Do not consume cheese that contains raw milk
• Do not consume pre-packed smoked fish

The following list gives an overview of these and other risk factors in the pregnancy, with an explanation:

PRENATAL CHECK-UPS
During your pregnancy you will have regular check-ups at the practice. The frequency of the check-ups will increase during the pregnancy, in the last stage of the pregnancy they will take place every week.
The first check-up will take about half an hour and the following check-ups about 15 minutes.
When you think you will need more time, please let us know up front.
It could be that you feel there’s too much time between the check-ups and you’d like to come by more often. This is always possible!
Whether you’d like to come more often, you’d like an extra visit to listen to your baby’s heartbeat, or you would like to come for an additional visit to talk about a specific subject like breastfeeding or pain during the labour, it’s all possible.

During the prenatal visits the midwife will always:

• check your blood pressure
• check your weight
• check the growth and position of your baby and your baby’s heartbeat
• answer your questions

Also certain important subjects will be discussed with you, such as:

• maternity care, pregnancy courses, daycare
• the location of labour
• breastfeeding
• the heel prick
• childbirth
• pain during labour

The following tests will take place during your pregnancy:

• an ultrasound scan before the 12th week of gestation to determine your exact due date
• a routine ultrasound scan between the 18th and 20th week of gestation (optional)
• thorough blood tests
• if necessary, a urine test

We also offer extra information and visitations beside the regular check-ups about:

• breastfeeding
• pain during labour
• childbirth in our practice (a special presentation once every 3 months, which takes place at the practice in the evening)

Helpful websites you can consult:

• www.knov.nl
  (i.e. the Royal Dutch Organization of  Midwives)
• www.zwangerwijzer.nl
  (a preconception indicator that can help you prepare for your pregnancy)
• www.erfocentrum.nl/english.php
  (the Dutch national genetic resource and information center)
• www.rivm.nl/en/
  (the national Dutch institute for public health and the environment, contains information about the heel prick and infectious diseases)
• www.stivoro.nl
  www.rookvrijzwanger.nl
  (websites that provide information about smoking cigarettes and offer support to quit smoking)
• www.voedingscentrum.nl/nl/voedingscentrum/english.aspx
  (the Dutch nutrition center)
• http://english.szw.nl/
  (Dutch ministry of social affairs and employment)
• www.fnvbondgenoten.nl/fnvbondgenoten/english/
  (the largest Dutch trade Union)
• www.llli.org/resources.html
  www.borstvoedingnatuurlijk.nl
  www.borstvoeding.nl
  (websites that provide information about breastfeeding)

BREASTFEEDING
Breastfeeding benefits both mother and child. There are many health and practical benefits of breastfeeding.
Breast milk is always available, it has the right composition and temperature and it’s hygienic and cheap. 98% of women are physically capable to breastfeed.
In the Netherlands 80% of women choose to breastfeed after birth.
To breastfeed successfully it is important to have a certain amount of basic knowledge, as well as good support and faith into the process.
During the first week after birth the maternity nurse and midwife will help and support you where needed and provide specific information.
If you already have a lot of questions during the pregnancy or if you want to talk about previous experience with breastfeeding, discuss this during your check-up. We can make an extra appointment to discuss your questions and wishes before birth.
On our website and in this brochure there are websites mentioned that you can consult for more information about breastfeeding. You can read more about starting the breastfeeding process and what you can expect.

SAFE NIGHTS FOR THE BABY

• Place your baby to sleep on its back, it’s the safest position, with your baby’s face  free of cover.
• Do not use a duvet, or a blanket in a duvet cover for the first two years, this is too warm for your baby. Your baby can also wriggle under the covers, which might cause suffocation. Use a blanket and sheet instead.
• Don’t dress your baby too warm. Your baby is warm enough when the feet feel warm. The room should be between 16 degrees and 18 degrees Celsius.
• Put your baby to sleep in a crib or baby bed. This is the safest place to sleep. Never let your baby sleep in your bed when you have been drinking alcohol, taking medication or drugs, or when you are extremely tired or stressed.
• Keep your baby away from cigarette smoke, not only at home but also in other surroundings, such as in your car. The risk of cot death is significantly higher when people smoke in the house. With 1-9 cigarettes a day the risk is twice as high as for non-smokers, and with 10 or more cigarettes a day the risk is three times as high!
  Air the room your baby is sleeping in regularly.
• Make sure your baby is in a safe environment; never put a baby bed or crib near wires or curtain cords.
• Make sure you have a safe bed. Use a crib or baby bed with ventilating sides, the distance between the bars should be between 4.5 and 6.5 cm. Choose a firm and fitting mattress. Soft or blocking bedding like head protectors, sheepskins, pillows, plastic mattress protectors or waterbeds can obstruct your baby’s breathing.
• Don’t restrain your baby, it can wriggle into a dangerous position.
• Do not use medication that has a sleep inducing effect, unless the doctor prescribes it.
• Try to disturb the rest and regular routine of your baby as little as possible. Do not expose your baby to unnecessary fatigue; this disrupts the baby’s sleep/wake rhythm.
• Breastfeed your baby. There are strong indications that breastfeeding reduces the risk of cot death, which is also the case for using a baby pacifier
• Whilst comforting and playing with your baby, it’s important to move your baby around calmly and gently.

BIRTH
When the pregnancy is healthy and uneventful, the choice where to give birth is up to you. You can give birth at home or in the hospital.
A hospital birth actually is a relocated home delivery: we will accompany your labour in the hospital (you ‘rent’ a delivery room).
For hospital births we collaborate with the Bronovo hospital (The Hague) or the Lange Land Hospital (Zoetermeer).
Depending on your insurance company, you might have to pay an additional fee in case of a hospital birth without a medical reason.
Several studies have shown that a home birth is as safe as a hospital birth when having your first child. After the first birth, a home birth is even safer. What is important is that you choose the place where you can feel safe.
When you’re not sure about the location of anticipated birth, remember:
- all births start at home
- in case you choose to give birth in the hospital, you will go to the hospital when you are about halfway through your cervical dilation. Then you will have a good picture of whether the childbirth is going as you had expected, whether you can handle it and whether you feel at ease at home.
You can also decide at that point where you want to childbirth. In that case, please prepare yourself for a home birth when it comes to necessities for the birth, so we will have everything we need.

From 37 weeks on your childbirth is allowed start. In case any birthing activities start before 37 weeks (your water breaks or the contractions start): contact us immediately!
When you are approximately 37 weeks pregnant, we will discuss with you when you need to call us when the birthing activities start. It is advisable that your partner is present during this consult.
Normally you should call us when:

• you have 15 painful contractions in one hour that last at least one minute each
• your water breaks during the day
• your water breaks during the night and the amniotic fluid is green or brown, or you are not sure about the color of the fluid
• You have blood loss (more than at the  beginning normal menstrual bleeding)

The instructions can vary per person and they are discussed individually with each client.
The midwife on call can be reached on the mobile phone: 06-43029073.
If your call is not answered straight away, try calling again after a few minutes (it’s possible that we’re doing another birth, or your call couldn’t be answered for some other reason). If you can’t get through again, call 06-65130715, choose option 2, dial your phone number and finish with #. We will call you back as soon as possible.
Do not call us with a private phone number, because we will not be able to call you back!
Again we want to inform you about the possibility of visiting the additional pain consult. In case you want more information about pain during the birth (for example: why is pain part of a labour, will I be able to handle the pain, what are the possibilities for pain-medication at home and in the hospital, how can the midwife serve me, then you can make an appointment for this extra consult.
We also recommend writing a birth plan. On our website you can find more information on this subject.

NECESSITIES FOR THE BIRTH
Home birth

• Big sterile gauzes (size 10 x 10) (10-15 pieces)
• Small sterile gauzes (1 pack)
• Umbilical cord clamp
• Cellulose birthing mattresses (10-15 pieces)
• Alcohol 70%
• Unicura soap and towel
• Two buckets with grey bin bags
• Fabric diapers (‘hydrofiele luiers’)
• Wecesin powder from the brand Weleda (available at the pharmacist)
• Baby clothes and at least two baby hats
• Two hot water bottles

For a home birth it is important that:

• The room where you give birth is on the ground or first floor
• There is running water on the floor of the labour
• There is  bright, moveable lighting available
• The bed is raised on blocks
• Maternity care is arranged

For a hospital birth you need:

• Cellulose birthing mattresses (5 pieces)
• Small sterile gauzesp (1 pack)
• Unicura soap and towel
• Alcohol 70%
• Umbilical cord clamp
• Wecesin powder from the brand Weleda (available at the pharmacist)

For a hospital delivery it is important that

• There is transport to hospital
• The bed is raised on blocks
• Maternity care is arranged

Advice!    
Keep the necessities for the labour together in a box, regardless of where
you wish to deliver. Keep this box under your bed.
Advice!    
If you wish to give birth at home, keep the other necessities with the same box
(buckets, bin bags, fabric diapers, two baby hats, two hot water bottles).
This way we will have everything we need close at hand.


THE MATERNITY PERIOD
The first week after the childbirth is called the maternity period.
Important in this period is that you get the opportunity to recover from giving birth, enjoy your baby, get to know your baby and learn the skills to take care of your baby. The person to help you with this is maternity nurse; she can teach you everything involved in taking care of the baby, she will inform you on minor problems and their solutions, and should you have requested beforehand, she will also do (part of) your housekeeping.
In the first week after the childbirth we will visit you at your house about every other day.
We check the medical part of the maternity period; we keep an eye on your recovery and we check your baby. We also perform the heel prick when your baby is between three and seven days old.
When you have questions or problems or things you need to discuss with us you can always call us. It is better to call us than your general practitioner or the maternity centre. We have all the background information on your childbirth and are responsible for your childbed.
If you would like to have a final check-up at six weeks after the birth, you can call the practice to make an appointment.
You can pick up your pregnancy chart and childbirth record at the practice during consultation hours from our assistant.

IMPORTANT TELEPHONE NUMBERS AND WEBSITES

Other English links:
www.wiegedood.nl/safe-sleeping#safesleeping

www.rivm.nl/hielprik/Images/091506%20Hielprikfolder%20ENG%20def_tcm94-35067.pdf

www.bigregister.nl/en/

OTHER SERVICES BY SIFRA
Besides providing care during your pregnancy, birth and maternity period, we also offer the following additional services at our practice:

• Preconception consults
• Care in case of a miscarriage
• A free pregnancy test

On our website you can find up-to-date information and news from the practice. For example you can find advice on:

• Writing a birth plan
• Lower back and pelvic pain
• Constipation
• Nausea

COMPLAINTS PROCEDURE
If you are dissatisfied about our midwifery care or treatment it is important that you first mention it to us. By talking to each other we hope to resolve the problem.
In case you are not able to speak to us in person about your dissatisfaction, you can find support at ‘Zorgbelang’ (www.zorgbelang-nederland.nl, phone number: 0900-2347070, € 0,10 per minute). They can give you advice and inform you about your rights. They can also help you with approaching us directly in case you find this difficult, or with writing a letter about your complaint.
Off course we hope these measures are not necessary. But it’s possible that we are not able to solve the problem together, in that case we can ask a mediator for help if you would like. This is a trained and impartial person that can help us find a solution. The goal of the mediator is to rebuild the trust between us.
In case these measures are not possible or do not solve the problem, there is the possibility to file a complaint to the KNOV Complain Committee (www.knov.nl). This complaint committee will judge on the validity of your complaint. Based on their findings, the board can make a recommendation to us to improve the quality of our care.
For more information about the Complaint Committee and their procedures, you can consult the KNOV website or you can contact the KNOV Complaint Committee (Postbus 2001 3500 GA Utrecht, phone number 073-369 18 90)