In principle you can carry on living your life as normal during pregnancy.
Although there are certain habits which we highly discourage, such as;
smoking, consuming alcohol, certain types of medication and the use of hard- or soft drugs.

Alcohol Consumption


Alcohol during pregnancy can be harmful to your unborn baby. From the moment of conception (or trying to conceive) including breast feeding, we warn against the consumption of alcohol. At this time it is uncertain what amount of alcohol may cause problems, although it has occurred that alcohol caused damage even in small amounts.

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Contagious Diseases


Having contracted a contagious disease can have consequences for your baby. Does anyone close to you suffer from a childhood illness, such as chickenpox, measles, the fifth disease or have you been in contact with anyone suffering from another contagious disease? In that case, contact us if you have not had these diseases before. If you have already contracted a childhood illness previously, you will have created antibodies and the disease can not harm your baby anymore.

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Cytomegalovirus (CMV)


Especially young children produce high amounts of CMV for many years through urine and saliva. As they grow older, the production and frequency will become less.

In a domestic situation with young children is it difficult to avoid contact with CMV but can be minimised through good hand hygiene, because contamination occurs mostly through mucous membranes. Advice to pregnant women:

Good hand hygiene during contact with saliva and urine from young children;
Avoid contact with saliva from young children by not sharing food, cutlery and cups.

See www.rivm.nl for more information.

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Drugs


Doctors strongly warn against the use of drugs during pregnancy. If you are a drug user, it is important you tell us.Drugs may pose a risk to your baby. The use of drugs increases the harmful effect of other stimulants such as alcohol.  In addition your baby can develop a birth defect or growth disorder and needs to go through withdrawal after the birth. It is advisable to stop the use of drugs before conceiving but otherwise as early as possible during your pregnancy. If you stop the use of drugs further along in your pregnancy, your unborn baby may suffer with withdrawal symptoms. In this case please seek advice from a professional. Soft drugs include cannabis, marijuana /weed and hash. Hard drugs include cocaine, ecstasy (XTC), heroin, magic mushrooms and smart drugs.

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Folic Acid


If you are trying to conceive, we advise to start taking folic acid. We recommend you start as soon as you stop taking your birth control, and continue up to the 10th week of pregnancy. Folic acid reduces the chances of spina bifida. A daily dose of 0.4 or 0.5 mg is sufficient. Folic acid can be purchased from your chemist or pharmacy without a prescription. You may be taking folic acid already, but if you are not and you are still very early in your pregnancy, we highly recommend you start the use of folic acid until week 10 of your pregnancy (or 10 weeks after the first day of your most recent menstruation. If you have any children in your immediate family which were born with spina bifida, you may benefit from a higher daily dose of folic acid. We recommend that you seek advice from your doctor or us before you conceive.

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Cat Litter Tray and Gardening


There exists a small microscopic creature, a parasite, which can cause the disease toxoplasmosis. Toxoplasmosis can be very harmful to your unborn child. Be careful with:

  • Faeces of (especially young) cats. Wear gloves when cleaning out the litter tray.
  • Working in the garden. Wear gloves here also.
  • A sandbox (playground). These can also be sources of toxoplasmosis.
  • Insufficiently heated meat, unwashed vegetables and fruit. Do not eat raw or rare meat (such as filet américain or roast beef). Wash uncooked vegetables and fruit thoroughly.

If you have contracted toxoplasmosis previously, you are protected against this disease. However it is difficult to determine if you are protected through means of an antibody blood test. To be safe, take plenty of precaution.

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Medication Use


Do not use any medication during your pregnancy, unless agreed with your doctor, specialist or midwife. Inform your doctor or chemist that you are pregnant. Also always tell your midwife about any medication you are using.

  • Paracetamol: of regular paracetamol (500 mg) you are allowed short term up to 8 tablets a day. Please consult with your doctor if you (plan to) use other pain medication, such as ibuprofen.
  • Sedation for a dental treatment does not cause any problems, as long as your dentist knows you are pregnant.

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Smoking


Smoking during pregnancy creates risks. Including being present in smoking environments on a regular basis has a negative effect on your pregnancy and your baby. Advice to both parents is as such: stop smoking and avoid smoky environments as much as possible.

Tobacco contains harmful substances. These substances limit the circulation of blood to the placenta, which causes your baby to receive less oxygen and will not develop as well. Babies of pregnant mothers are often born underweight and are also often born prematurely, which causes them to be vulnerable. These children will more often suffer with respiratory diseases during early stages of their life. There are also indications that cot death occurs more often when smoking happens near the baby.If you need help to quit smoking, see www.stivoro.nl

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X-Rays


Avoid having x-rays taken when you are pregnant. If possible, delay the x-ray until after your pregnancy. Should an x-ray be deemed necessary during your pregnancy, make sure that people involved are aware so that protective measures can be arranged. A MRI-scan can be carried out without harming the baby. Digital images and microwaves have not been known to cause harm.

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Harmful Substances



Avoid contact with harmful substances as much as possible during your pregnancy. Examples are turpentine containing paints, pesticides and chemicals (such as photo development solutions). There is no known harm associated with hair dyes.

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Sex Drive


Sex drive during pregnancy varies from woman to woman and pregnancy to pregnancy. Some women experience an increased sex drive and will want intercourse more often than usual while others experience the opposite.

Intercourse is not cause for a miscarriage or is able to harm the baby. Only if you are experiencing blood loss or your waters break, do we advise against intercourse.

Any issues with your sex drive you can always discuss with your midwife. This also applies to possible distressing sexual experiences from your past or if you have trouble tolerating an internal examination.

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Sports


You are fine to undertake sports such as swimming, cycling and fitness exercises right up to the end of your pregnancy.  Carry on with your activities as normal but adjust your tempo and either slow down or stop when you are experiencing problems.  In addition, make sure you drink plenty of fluids. Certain types of sports are probably not a good idea to undertake while you are pregnant.  For example sports which carry the risk of something possibly hitting your belly, such as hockey. Or sports which pose the risk of falling or physical contact. We also advise against diving sports during your pregnancy.

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Holiday and Distant Travelling


It is fine to go on holiday when you are pregnant. We do recommend choosing a destination where you have access to good medical care. If you intend to travel to a distant land, make sure you contact your doctor or the GGD for travel advice and any necessary vaccinations.  Do not travel anywhere at high altitudes. The oxygen levels are much lower there.  We advise not to spend long periods of time at altitudes higher that 2000 metres.

From a medical point of view there are no issues with travelling by air. Although airlines are often hesitant in carrying pregnant woman after 27-34 weeks or will insist on a “fit-to-fly” declaration.  Check this information with your airline.

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Vitamins


During your pregnancy and while you are breast feeding it is advisable to use 10mg of Vitamin D extra on a daily basis. That is in addition to the amount of Vitamin D that you already naturally get from your food.
If you have a healthy and varied diet, other vitamin supplements (for pregnant women) are not really necessary.

Do you still want to take extra vitamins? Please make sure that they are suitable for pregnant women, as they do not contain too much vitamin A.

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Nutrition


During your pregnancy it is important to eat fresh, healthy and varied. A ‘Food Group Chart’ may be helpful.

  • Eating for two is not necessary, but dieting during pregnancy is also unwise.  When you are pregnant and would like to fast, discuss this with your midwife. You can delay the fasting.
  • You don’t eat meat or fish? Make sure you get enough vitamin B and iron during your pregnancy. B vitamins are usually present in wholemeal products, potatoes, legumes, eggs and dairy products. Legumes and eggs are also important sources of Iron, just as meat substitutes.
  • Remember to be careful with certain foods during your pregnancy. For example, do not eat raw meat (such as filet américain, rare steak and tartar) in connection with risks of the disease toxoplasmosis. The parasite which causes the disease dies when food is heated thoroughly.
  • Wash raw vegetables and fruit well. Unwashed vegetables and fruit sometimes contain pathogens.
  • Do not eat vacuum packed (smoked) fish and raw dairy products. This is in connection with the danger of infection caused by the bacteria listeria. When a dairy product is raw, it will often say on the package, sometimes using the term ‘au lait cru’. If not, check with the shop keeper.  The listeria bacteria cannot survive heat. (Pasteurised products are safe) the bacteria also does not tolerate freezing.
  • Use vitamin A rich products moderately. Avoid eating liver; do not eat a product in which liver has been processed more than once a day. Liver contains high amounts of vitamin A. Too much vitamin A can have a harmful effect on the unborn child.
  • Make sure you work in your kitchen hygienically.


For detailed information, see www.voedingscentrum.nl.

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Work


Certain work circumstances can create risks to your pregnancy and your unborn child.  That is why various regulations are in place for pregnant women and women who have recently given birth.

  • This means that as a pregnant woman you are entitled to longer breaks and in principle do not have to work night shift or extra hours. This also applies during the first six months after you have given birth.
  • In addition you are entitled to extra time to breast feed your baby or to use a breast pump. Certain jobs may pose a problem to your health and that of your baby.  For example jobs where you are exposed to vibrations (heavy traffic and agricultural machinery), radiation from radioactive substances, chemical substances or risk of infections.
  • This also applies to heavy physical labour, such as much lifting, pulling, pushing or carrying, irregular hours (night shifts, time differences) etc.
  • Are you faced with any of these work environments? Discuss with your employer, arbodienst or company doctor. Your employer can adapt duties to suit your situation.
  • If working in a healthy and safe way is still not possible despite adaptations, then your employer must temporary place you in a more suitable job.

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Sun bed and Sauna


In principle you are fine to use either sun bed or sauna during your pregnancy.

  • Sauna: during your pregnancy you are more sensitive to heat. Therefore you must make sure you adhere to the sauna’s cooling off schedule. Listen to your body. We advise against the use of an infrared sauna.
  • Sun bed: during pregnancy UV radiation may cause brown spots (mask of pregnancy). This ‘mask’ usually disappears once the pregnancy is over.

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Pregnancy Classes


There are many classes available to help you stay healthy and fit during your pregnancy and prepare you for the birth.  In our waiting room we have information folders in which you can find details of different classes.

You can also find details on www.zwangerinutrecht.com Register for a class with plenty of notice as some fill up very quickly while others are not run very often.

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Maternity Leave


It is important that you are well rested for giving birth.  Every woman is therefore entitled to 16 weeks of maternity leave. Your maternity leave begins either 4 or 6 weeks before your due date.  Therefore the remaining leave (after the birth) is either 12 or 10 weeks. Regardless of when you give birth, your total entitlement remains 16 weeks. If you are working less hours during your pregnancy as a result of discomfort or issues or on doctor’s orders, then your leave will always begin 6 weeks before your due date.

In addition to maternity leave there are laws which grant parental leave.

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