Postpartum

Postpartum

Maternity care 
The maternity assistant will visit you every day for the first 7 to 8 days. She does the daily medical checks of you and your baby. She provides information and advice. She helps you take care of and feed your baby. It is very important that the maternity nurse is present with you during this period. Thanks to its information and advice, this ensures a safe and successful course of your postpartum period. Birth declaration Within three working days you must declare the birth at the municipality where you gave birth. Your partner may make the declaration, but another person who was present during the delivery may also do this. What do you need? Proof of identity of the person making the declaration. Proof of identity of the mother. 

Heel prick and hearing screening 
Between days five and eight, the GGD will come to your home. They perform the hearing test and the heel prick test on your baby. The heel prick is done to detect disorders such as thyroid diseases, hormonal disorders, etc. that can be treated with medication or a special diet. Look under the leaflets for more information. 

Contraception 
You are fertile again after the birth of your child. For that reason it is important to think about what kind of birth control you would like to use. 2 weeks before you get your first menstrual period you have had an ovulation and you can become pregnant. The moment at which you are fertile again is therefore unknown. Breastfeeding can suppress ovulation, but it is not protected against a new pregnancy. We will raise this during childbirth and we will review the form that suits you best. 

If you are interested in an IUD as contraception, you have come to the right place.
An IUD is a very reliable form of contraception that can be easily combined with breastfeeding. There are two types of IUDs: the hormone-free copper IUD (T-Safe, Multi-Safe (short) and Flexi-T) and the hormone IUD (Mirena and Kyleena).

IUD without hormones
A copper IUD is hormone-free contraception. T-Safe is the most commonly used copper IUD in the Netherlands. This IUD can be used for up to 10 years and meets the highest quality standards. A copper IUD is suitable for all women who opt for reliable contraception without hormones. Immediately after placement, the IUD gradually releases a little copper. Copper paralyzes the sperm cells and prevents an egg from being fertilized. In addition, copper ensures that an egg cannot implant in the uterine wall. After installation you are protected for a pregnancy for 5 or even 10 years with T-Safe.

With a copper IUD you maintain your own menstrual cycle. In the first months after installation of a copper IUD, your period may be different than normal. Most women have little to no problems with the IUD. Others may have side effects such as heavier, longer lasting or irregular bleeding. Sometimes women also experience (severe) abdominal cramps. After a few months, your body will get used to the copper coil and the natural cycle will recover. A small number of women permanently experience slightly increased blood loss during menstruation.

The copper IUD also works as a 'morning-after IUD' when it is placed within 5 days after unsafe sex. This means that a possibly fertilized egg cannot implant in the uterine wall. A copper IUD is the most effective form of emergency contraception. Want to know more about emergency contraception? Then take a look at morning-after.nl.

There are different types of copper coils:
• T-Safe
The T-Safe has a T-shape, made of plastic and copper. According to the Dutch Association of General Practitioners, the TCu380A (T-Safe) is the most reliable copper IUD. The T-Safe copper IUD is effective for 10 years, but can also be used between two pregnancies. T-Safe is the most commonly used copper IUD in the Netherlands.
The Multi-Safe IUD has a horseshoe shape, made of plastic and copper. The Multi-Safe is suitable for women with a uterus larger than 6 cm, the Multi-Safe short for women with a smaller uterus. The Multi-Safe (short) is effective for 5 years.
The Flexi-T has a T-shape with rounded corners, made of plastic and copper. There are three choices: the Flexi-T 300 for a small uterus, the Flexi-T +380 and Flexi-T +300 for a larger uterus. The Flexi-T +380 contains more copper to increase effectiveness. The Flexi-T spirals are effective for 5 years.
 
IUD with hormones
The hormone IUD gradually releases a small amount of hormones and ensures that the mucus in the cervix becomes 'tougher', making it more difficult for sperm cells to pass through. Due to the release of the hormone levonorgestrel in the uterus, the sperm cells become less mobile; this reduces the chance of fertilization. Due to the release of the hormone and because the IUD is a 'foreign object' in the uterus, the endometrium is not or hardly built up. This prevents any fertilized egg from implanting. Finally, in some women ovulation is suppressed. If no egg is released, fertilization cannot take place.

The most common side effects with the hormone IUD are more or less blood loss during menstruation, intermediate blood loss or absence of menstruation. In addition, headaches, abdominal pain and back pain are also common, as are vaginal discharge and inflammation of the labia or vagina. Consult the package leaflet of Mirena or Kyleena for an overview of the side effects.

There are two types of hormone IUD:
• Mirena is the most commonly used hormonal IUD in the Netherlands. This hormone IUD is effective as contraception for 8 years. In addition, Mirena can also be used to treat heavy blood loss.
• Kyleena is a slightly smaller hormone IUD than Mirena. This hormone IUD also releases slightly fewer hormones. Kyleena is effective as contraception for 5 years.

Placement of an IUD
Inserting an IUD is quite quick. The cervix is made visible using a speculum (duck's bill). The midwife will then measure your uterus and the coil can be placed. Please note: before placing an IUD, it is important that there is no risk that you have an STD or could be pregnant. Therefore, it is safe in any case until installation. If you have any doubts, discuss this with us.
Tip: the placement of an IUD can be unpleasant or painful. You may take two Aleve Feminax 275 or one ibuprofen 400 mg the night before. Take the same dose again one hour before placement.

Follow-up check
After placement, we make an appointment for a follow-up check, which takes place six weeks after placement or after at least one menstrual period. During the follow-up check, we will check whether the coil is still properly in place and discuss whether you have any complaints.

Removal IUD
If you want to have your IUD removed, you can also contact us. After removing the IUD you are immediately fertile again.

Installation costs
The costs for placing an IUD are €73.35. These costs can be declared to your health insurer. The health insurer may not reimburse all costs or the amount may be (partly) deducted from the deductible. This varies per insurance and policy.
Please note: the costs of the contraceptive itself are not reimbursed by basic insurance for women aged 21 and above, unless they have additional insurance for this.

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