Midwifery has changed considerably medically and socially in fifty years. The jubilating practice in Hoogeveen knows all about it. Four cigarettes a day and a glass of wine as advice to pregnant women? “It’s really unthinkable right now.”
Verloskundigenpraktijk Hoogeveen is located in the building on the Alteveerstraat where funerals were still held two years ago. Coffins and farewells have made way for birth announcements and new life.
“The circle of life ‘, typifies midwife Mirja Strijker. „A symbolic building”, adds colleague Atje Klein Langenhorst.
In the wool
The midwifery practice in Hoogeveen is one of the oldest in the country and celebrates its 50th anniversary on 17 June by pampering visitors. Including facial treatments, eyebrow styling, massages, hair creations, refreshments and fun for the children.
Since 1973, midwives have delivered nearly 24,000 babies from Hoogeveen. A small town of infants. “Every delivery is one life event ” says Ace. “An important, intense and emotional event. It is special for us to experience that moment as a professional.”
Different time
Obstetrician Ali Punt started the practice in 1973. A completely different time, without fun ultrasounds, high-quality equipment and delivery baths. Partners had no task: they were allowed to be present at the birth, but not to cut the umbilical cord, for example.
It used to be no surprise that mothers continued to smoke and drink during pregnancy. Not unlimited, but there was advice: a maximum of four cigarettes and one glass of wine per day. “Unthinkable in today’s times,” says Mirja. Atje: “Now there are special apps with nutritional advice that sometimes go too far.”
Boil urine
In the 1970s, to diagnose preeclampsia, women’s urine had to be boiled for minutes. “If it started to flake, that was evidence of too much protein in your pee.”
Former midwives still remember the foul air in which they had to work. They thought that was terrible. Today, preeclampsia is detected with a simple strip.
Midwifery used to be a solo profession. They were single and lived for their work. Ali Punt did obstetrics on her own for three years. According to Atje and Mirja, she was a pioneer in her field and one of the first to have an ultrasound machine. “On the day she had her first child, she gave birth in the morning.”
A big difference with the past is the approach to pregnancy. “At the time, people trusted their own bodies more,” says Atje. “Like: I’m pregnant and I’m just going to give birth. A miscarriage did not stop for long. Today many women find pregnancy exciting, even scary, and the pressure for a good outcome – partly due to the influence of social media – is great.”
More ultrasounds and sooner
According to Mirja, women are now more often looking for confirmation that things are going well. “So more ultrasounds and also earlier. We already do an ultrasound at seven or eight weeks. It used to be at twelve or thirteen weeks. Many pregnant women just want to know earlier, otherwise they will worry.”
Ace: “Especially millennials thinking in terms of the makeable society. Unfortunately, not every pregnancy ends well. That’s nature, which unfortunately you can’t do anything about.” About 15 to 20 percent of all diagnosed pregnancies in our country end in a miscarriage. Worldwide, this even happens 23 million times a year.
Hoogeveen has many young mothers. “The average age here is 26 years, while it is 30 years nationally,” says Atje. There are also relatively many teenage mothers. Not only in Hoogeveen, but in more Drenthe municipalities. Of every thousand girls aged 15 to 19 in our province, an average of four were mothers in 2020.
Corona peak
Hoogeveen was known for many years as a municipality in which a relatively large number of children were born. Recently, the municipality has followed the national line more, although there was a striking peak in the corona years: 10 to 15 percent more births in 2021.
Mirja: “Of course people were at home a lot. Some bought a dog, others apparently tried to avoid boredom in a different way, haha.”
Corona had consequences for the work of midwives in several ways. “A strange time,” Atje looks back. “For example, partners were not allowed to be physically present at an ultrasound, but watched via mobile phone. You also visited people less.”
Mirja: “Later we heard from many mothers that they sometimes felt quite lonely during pregnancy. Even after giving birth, when hardly any visitors were allowed or people were only allowed to look out the window.”
Less stress
Yet not everything in corona time had a negative stamp on pregnancies. There was also less crowds, less stress. Rest within families is beneficial for bonding with the child, both argue.
The jubilee practice on the Alteveerstraat has five midwives. All female. The number of midwives is extremely small. National figures show that of the roughly 4,000 female midwives, 1 percent is male. “That percentage is not increasing,” says Atje. “You also see more and more women in gynaecology.”
The practice in Hoogeveen once had a male trainee, but people had to get used to that. “He was very knowledgeable and friendly, but not all women wanted him at their bedside.” He has been working at Isala for a long time now.
Midwifery practice Hoogeveen supervises deliveries at home and in the hospitals Assen, Zwolle, Emmen and Hardenberg. In addition to planned clinical deliveries, many deliveries (44 percent in 2021) take place at home. Assen is the most popular for hospitals, because of its distance from Hoogeveen. Isala in Zwolle is in second place.
Since the hospitals in Hoogeveen and Meppel no longer have obstetrics, travel time has become a factor. The risk of a highway baby has increased, but in practice it is not too bad. This is because it is decided in good time not to leave for the hospital.
Mirja: “But now women do give birth at home because the distance to the hospital is too great. As midwives, we do everything we can to correctly estimate whether there is still time to leave for the hospital.