16–24 weeks
During this period, your baby grows from the size of an avocado to that of a small melon. The second trimester of your pregnancy has begun, and these weeks are usually more energetic and enjoyable than the first trimester. Around twenty weeks, your blood pressure is at its lowest point during pregnancy; some women may feel dizzy as a result. The best thing about these weeks is that you’ll start to feel the baby move. For some, this happens sooner than for others, but by 24 weeks, every pregnant woman will have felt a little kick.
Twenty-week scan
The 20-week scan is also known as a ‘structural ultrasound scan’ (SEO). This scan is primarily intended to check during pregnancy whether your baby has spina bifida or anencephaly. In addition, other physical abnormalities may also be detected during the 20-week scan.
As this is a highly specialised scan, we have it carried out by our experienced sonographers at Focus Midwifery Centre. You can book an appointment for this online yourself.
During the 20-week scan, your baby is examined from head to toe to detect any congenital abnormalities. Unfortunately, if no abnormalities are found, this does not guarantee a healthy baby, as not all abnormalities can be detected. The aim is to offer a treatment plan or options for action in good time should an abnormality be detected. This is because the results of the SEO scan may have significant implications for your pregnancy, and you may be faced with the choice of terminating the pregnancy or preparing for a baby who may die. It may also be the case that your baby has a mild abnormality, but that it is safer for the birth to take place in hospital so that the paediatrician can provide your baby with the best possible care straight away.
The scan is carried out between 18 and 21 weeks, and preferably between weeks 19 and 20. If any abnormalities are detected, further investigations will be offered. These consist of a detailed scan in a hospital. Sometimes you will also be given the option of having an amniocentesis or a blood test to gain more clarity about the abnormality. With an amniocentesis, there is a small risk of miscarriage (risk of 2 in 1,000). For every test, you decide for yourself whether you want to have it and what you will do with the results. This choice is yours. The 20-week ultrasound scan is included in the basic healthcare package and is covered by your insurer.
Breastfeeding or bottle-feeding
Various studies show that breastfeeding is the best start for your child: breast milk contains exactly the right amount of nutrients your baby needs and protects your child against infections, amongst other things, because it contains antibodies. Children who are breastfed also tend to suffer less from allergies and generally have a stronger immune system.
Breastfeeding also has benefits for mothers: you’ll return to your pre-pregnancy weight more quickly, and the risk of breast cancer is demonstrably lower if you breastfeed for longer.
If you’re planning to breastfeed, it’s a good idea to start learning about breastfeeding whilst you’re still pregnant. By attending a breastfeeding information evening or reading books and websites, you’ll be fully prepared when the time comes.
Breastfeeding is a completely natural process, but it doesn’t always come naturally to every mother from the start. Of course, we and your maternity nurse can support you through this. It can also be helpful to consult a lactation consultant during the postnatal period; they specialise in breastfeeding and everything else that goes with it. A consultation with a lactation consultant is usually covered by your health insurer if you have supplementary cover. Breastfeeding sometimes requires an investment. Getting extra help and advice helps ensure a good start to breastfeeding.
You may also choose to use formula from the start, or find that you need bottles during the postnatal period – either to supplement breastfeeding or to replace a breastfeeding session. If you feed your baby formula, the brand doesn’t matter. The composition is regulated by law to ensure your baby receives all the necessary nutrients. For babies aged 0 to 6 months, this is called ‘infant formula’, and from 6 months onwards, ‘follow-on formula’. Bottles come in various shapes and with different venting systems, but ultimately it’s about what your baby finds comfortable. Try out which bottle works best. In the first few months, a small bottle will suffice; make sure the measurement markings are clearly visible. The teat is more important than the bottle itself. Babies have their own preferences: round or flat, a small or large hole. A voracious feeder benefits from a small hole, whilst a gentle feeder benefits from a larger hole or multiple holes. You can read more about formula feeding here. Or take a look at the Nutrition Centre.
We have all sorts of breastfeeding products available for you at the practice. These include herbs to stimulate milk production, nipple care products and good-quality bottles in case your baby isn’t yet ready to breastfeed. Ask the practice assistant about them.
Courses
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Many expectant parents choose to attend a antenatal course to complement their basic care. There’s a huge range on offer, from courses focused on relaxation and exercise to informative ones. See what suits you best. Are you looking for a course designed by your own midwife, based on experience and science? Then sign up for the Westerkade online antenatal course. It contains all the necessary information, including in-depth background details, and is packed with practical tips and exercises.
For an overview of other courses in Utrecht, visit www.zwangerinutrecht.com. You might also consider an information evening on breastfeeding, or how about a first-aid course for babies? Use the code WKV10 to get a discount on your registration.
There are also great courses for fathers: ‘Getting Ready for New Dads’, the ‘Fatherhood’ platform and the online antenatal course ‘Mankind’.
Arranging parental leave
It’s a good idea to think about your maternity leave during these weeks and to discuss this with your employer. You can choose when to start your leave, between 34 and 36 weeks of pregnancy. Our advice, especially if your job involves physical exertion and/or travelling, is to take leave at 34 weeks. For full information on leave, visit the government website. Are you self-employed? There are also arrangements in place to ensure you have adequate maternity leave.
Whooping cough vaccination
You can choose to have a whooping cough vaccination at around 22 weeks of pregnancy. This vaccination is intended to protect your baby against whooping cough during the first few weeks after birth. If you decide to have the whooping cough vaccination, you can book an appointment with the JGZ.
Between 15 October and 1 March, if you are pregnant (from 22 weeks onwards), you can also get vaccinated against influenza (the flu jab). This also requires an appointment with the JGZ. You can find more information in a video and on a page with frequently asked questions.
RS virus vaccination
The RSV vaccination for babies protects them against serious illness caused by the RSV virus. The RSV virus (
) is most common in autumn and winter and causes a respiratory tract infection. It can make babies very ill. The younger the baby, the greater the risk of serious illness. From autumn 2025, babies will be offered the RSV vaccine. This vaccine is for babies born on or after 1 April 2025. The vaccine is safe and effective and provides protection for around 6 months. Therefore, the season in which your baby is born determines when they will be offered the vaccine. You can read more here.
