You’ve just found that out you are pregnant… Congratulations! As if being pregnant isn’t exciting enough, you are also doing it in a country in which you are not familiar with the health care system. You may feel out of your element and not sure where to turn, but you can find the most important information you need for having this baby in the Netherlands right here! If you would like more in depth information, check out this website: www.mama-su.com.
The health care system surrounding birth is most likely different here in the Netherlands than what you are used to from home. Even though your first impulse after finding out about the awesome bun in your oven may have been “I am not having my baby here!!! Get me on the first plane home!”, wherever that may me, you might find that the system here is actually quite nice once you know more about it. In the Netherlands pregnancy isn’t treated like a medical condition, but rather like a natural process. There will only be a medical intervention if a problem arises. Dutch midwives try to interfere as little as possible with pregnancy and birth. But that doesn’t mean that you won’t receive the best care possible.
- Generally, prenatal care for uncomplicated pregnancies is provided by midwives. It is recommended to register between 8 and 10 weeks of pregnancy and schedule your first appointment between 9 and 12 weeks of pregnancy. In most countries you would probably see the gynaecologist, but you can rest assured that you are in excellent hands with your Dutch midwife. They perform all the tests that gynaecologists do elsewhere and are just as knowledgeable.
You can choose between midwives located at a hospital or your local midwife clinic.
LOCAL MIDWIFE PRACTICES
All prenatal appointments with local midwife clinics take place at their local practices. You will most likely meet all of the midwives working at the clinic during your prenatal appointments, to ensure you have met the one that will be there for your birth. During labour, your midwife will check your dilation regularly but will try to intervene as little as possible. She will visit you for the postnatal appointments at home to ensure mommy and baby are doing well.
> MIDWIVES IN DELFT:
HOSPITAL MIDWIFE PRACTICE
A team of several midwives have their practice located within the walls of the hospital, but they work independently. If you give birth at a hospital with hospital midwives, they will meet you at the hospital once you are in labour. All pre- and postnatal appointments will also take place at the hospital midwife practice.
You will only be referred to a gynaecologist if there are complications during your pregnancy. You cannot go to a gynaecologist directly, you need to be referred by either your GP or a midwife. All appointments (prenatal, birth and postnatal) with gynaecologists will take place at the hospital.
Having a baby abroad brings its own unique challenges… you aren’t familiar with the local Healthcare System, the culture is different , families are far away and you might not have established a support system yet. That’s why many expats choose a doula to support them during pregnancy and birth. Studies consistently demonstrate the very significant benefits for mother, father and baby of having a doula present during labor and birth.
A doula’s presence at birth:
- – tends to result in shorter labours with fewer complications
- – reduces negative feelings about one’s childbirth experience
- – reduces the need for pitocin (a labor inducing drug), forceps or vacuum extraction and cesarean sections
- – reduces the mother’s request for pain medication and/or epidurals
- – tends to lead to increased rates of breastfeeding at 6 weeks post-partum
- – tends to lead to higher self-esteem, less anxiety and less depression at 6 weeks post-partum
Research shows that parents who receive doula support during labor and birth:
- – are more successful in adapting to new family dynamics
- – have less postpartum depression
- – feel more secure and have greater self-confidence
- – have greater success with breastfeeding
> DOULAS IN DELFT AREA
BIRTH IN HOLLAND
An excellent way to prepare for the first baby is to follow a course by Birth in Holland. They have courses, workshops and doula services in Delft, Rotterdam, The Hague and surrounding areas.
Are you less than 12 weeks pregnant? There is a simple way to help couples with fertility problems. Moeders voor Moeders is an organisation that collects urine of pregnant women, from which the hCG hormone is recovered and used by pharmaceutical companies for the manufacture of fertility medicine. If you would like to contribute, find more information at their website: https://www.moedersvoormoeders.nl/>
There are three options when it comes to giving birth in the Netherlands: You can have your little bundle of joy at Home, at a Hospital or at a Geboortehotel/Birth Clinic.
The Dutch are very big on home births, they have the highest percentage of home births in the Western World. Nearly 30% of Dutch women have their baby at home.
During a home birth there is no medical pain relief of any kind! You can look into sterile water injections as a non-medical pain relief, which can be administered by your midwife during a home birth. Find some research about it here.
It’s important to feel safe and comfortable during labor, that’s why many women prefer the comfort of their own home for this experience. If complications arise during labor or birth, your midwife will refer you to an obstetrician or pediatrician. Every hospital in the Netherlands accepts these referrals from midwives. In this case, you will either drive with your partner or in a high risk situation your midwife will call an ambulance for transport. On average this ambulance will reach the client within just ten minutes.
Your Kraamzorg nurse will arrive shortly before birth to assist the midwife during the actual birth and to help take care of the newborn when you will be busy delivering the placenta.
If you want to give birth in a hospital, you can choose to do so, but please bear in mind that your insurance may not cover the entire stay if there is no medical necessity for a hospital birth. So it’s best to check with your insurance company ahead of time.
It’s recommended to register at the hospital of your choice by five months of pregnancy. To facilitate your decision making, it’s always a good idea to visit an information event and book a tour of maternity wards of the hospitals you are considering, and they are offered regularly. Click here to see the agenda for the Reinier de Graaf hospital in Delft. The tours of the maternity ward are called ‘bevallen in Reinier’. Please always keep a backup hospital in mind, in case your first choice is full. It doesn’t happen a lot, but it’s not unheard of.
Please note that you can only receive pain relief if you give birth at a hospital! All hospitals offer epidurals and some kind of morphine-based pain relief. In the Netherlands that’s either a Remifentanil pump or a pethidine injection. BUT not all hospitals have an anesthesiologist on site 24/7, so it’s worth checking with your hospital or the hospital at which your Geboortehotel is located whether pain relief is always available or only during day time! Most hospitals don’t have a tub for a water birth, have a look when you tour the ward though. If there is no tub present, you can check with hospital staff whether you may bring a rented birth pool, as some hospitals are open to that idea. (Rent from 155 EUR. Rental period 36 – 40 weeks).
Please bear in mind that you can generally only give birth in the hospital with the hospital midwife or gynecologist. There are only few instances when you can have a hospital birth with your own midwife from your local midwife clinic.
> HOSPITAL IN DELFT
> HOSPITAL IN THE HAGUE
Geboortehotels are a compromise between a home and hospital birth. It’s a setting where women with uncomplicated pregnancies can give birth, assisted by their own midwife and a nurse provided by the birth clinic. The rooms are generally decorated nicely to create a cosy birth environment. Geboortehotels might be a nice option for women that want to give birth in a less sterile, less hospital like environment, but still want to have the peace of mind of the option of pain relief or quick medical attention if necessary. In order to help you decide, it may be best to visit an information evening and join a tour.
Please bear in mind that you cannot receive pain relief at most Geboortehotels, some offer Nitrous oxide (laughing gas) though, but that’s as much as you will get.
At a Birth Clinic you can usually feel free to walk around, shower, take a bath if one is present and try different positions – whatever feels right for you during labor. Many birth clinics are equipped with birth pools for water birth. Please bear in mind that there may only be a couple and since ‘first come first served’ also applies for women in labour, you may not get one. Most Birth Clinics have birth balls and birth stools available for you during labor. (That’s something you might want to check out when you tour the Geboortehotel, though). Your midwife will stick around with a nurse provided by the Geboortehotel who will assist her during birth. If you do decide that you want pain relief mid-labor or should there be complications, you will be transferred to the gynaecology department (usually at most a 2 minute trip within the hospital). You can stay at the Geboortehotel for several days after birth, usually up to 5. Some also have a minimum stay period.
Almost all insurance providers compensate a delivery in the Birthing Clinic as a ‘non-medical out-patient delivery’. There will be some costs that the insurance company will not reimbursed you for though, like material costs (approx. 15 EUR per day) and food costs. Moreover you will be charged for maternity care, which is equal to the Kraamzorg you would receive at home. For a 24-hour stay in the Birthing Clinic, you will be charged for 8 hours of maternity care.
> BIRTH CLINICS THE HAGUE
> BIRTH CLINICS ROTTERDAM
Congratulations! You have made it through (roughly) 40 weeks of pregnancy and have given birth to your little miracle baby! You have probably been through many ups and downs, experienced your unique birth story and had your heart stolen by your newborn gazing up into your eyes for the first time. You probably have experienced a kind of love that you never knew existed. There are some things to consider though, before you can cosy up as a family and start getting used to your new life taking care of tiny (heart stealing) human.
The Kraamzorg system is unique in the Netherlands. In the Netherlands home birth is such a big topic and extended hospital stays after birth are virtually non-existent (after a birth in the hospital/Geboortehotel women usually head home within 1 to 24 hours). In order for the new parents to not be alone with the care of their newborn, families are provided with a kraamverzorgster (home maternity nurse) to help with your babyʼs care immediately after birth.
Kraamzorg nurses support you up to 10 days after birth. Depending on your insurance coverage, they support between 3 and 8 hours every day. They give hands-on breastfeeding advice (sometimes quite literally-you have been warned!), make sure baby gets enough to eat by closely monitoring weight and diaper content and make sure a good rhythm of feeding/diaper changes/sleeping is established. They show you how to care for your baby, how to give a bath, make the bed, etc.
It’s recommended to register with a Kraamzorg as early in the pregnancy as possible! The “good” ones tend to be booked quite in advance. Please check with your insurance company, a) whether there are restrictions regarding what Kraamzorg you can register with and b) how much of the Kraamzorg will be covered. In most cases you will have to pay 4,20 EUR own contribution. You can either go with an agency like Careyn or Wereldwonder or you can find a freelance Kraamzorg for example via Kraamzorg 1 op 1, which works a bit like a dating site where you enter your preferences (for example non-smoking cat lover) and freelance Kraamzorgs that feel like they fit your demands will contact you for a non-binding meeting. All Kraamzorgs only cover certain regions, you will have to check whether they are available for your zip code. The advantage of a freelance Kraamzorg is that you will know the actual person that will be your Kraamzorg nurse. With an agency, an administrative worker will come for your intake interview, you will not meet your actual nurse in advance. If you don’t “click” with your Kraamzorg nurse though, you can always request the agency to send a new one, and that happens quite regularly.
REGISTRATION WITH THE MUNICIPALITY
You must register your newborn within three working days after birth at your local municipality. You will have to go to the Department of Civil Affairs (Burgerzaken) of your local District Council Office (Stadsdeelkantoor). Someone who was present at the birth can do the registration. There are no charges for registering the birth. If you are not married, your partner will not automatically be recognized as the father of the child. In order to be regarded as the lawful father, he must claim paternity. You can acknowledge being a child’s rightful father by having the ‘Erkenning kind voor de geboorte‘ drawn up.
When you register your baby with the municipality, your baby is automatically signed up with the GGD (Gemeentelijke Geneeskundige en Gezondheidsdienst). This institution provides care for children from birth to age 4 at the so called Consultatiebureau, which is essentially a child health clinic focussing on preventative healthcare.
You will receive a letter with a date for the first appointment, which is a home visit usually when your baby is a couple of days old. During this home visit a midwife employed by the Consultatiebureau will see how the baby is doing, how the cord is healing and whether everything is safe and sound for the baby. She will also give you an English book (Growth book) where all the appointments, the baby’s weight and length and vaccinations will be noted down for the next four years. She will also give you a date for the next appointment, a hearing test, which will take place at your local consultatiebureau. After that you will have regular appointments to check the baby’s development, growth and health, but also for immunisations. In the Netherlands vaccinations are not required for a child to be allowed into daycare or school.
This is the standard Dutch vaccination schedule:
2 months – 1st DKTP Hib *
3 months – 2nd DKTP Hib
4 months – 3rd DKTP Hib
11 months – 4th DKTP Hib
14 months – 1st BMR **
4 years – 5th DTP
9 years – 6th DTP, 2nd BMR
The credits for the wonderfully informative prenatal pages you find here – goes out to Esther. Thank you for your hard work!
Esther, the woman behind the doula practice is from Germany, and she’ living in the expat world since 2011 with her husband. When she became a mother she realized just how significant and transformative this journey is for a woman and what a profound and enduring impact it can have on her.
Her goal is to guide, support and empower new parents who may not have friends and loved ones around, through this life-changing experience. By providing emotional, physical and educational support she wants to enable an empowering and memorable birthing experience. She is a Doula (Certification with JJ Doula), and trained for Optimal Fetal Positioning Techniques – based on Spinning Babies. Esther speaks English, German and Dutch and her travel area extends to approximately 45 minutes around Rijswijk/The Hague/Delft.