Dutch prenatal care

The Dutch philosophy is that childbirth is a natural, physical process, not a medical condition. Prenatal care is usually provided by a verloskundige (midwife). The role of the doctor or gynaecologist in a normal pregnancy in the Netherlands is minor, and in most cases they do not get involved at all, unless there are complications. Therefore, the first priority is to find a midwife. It is best to register with your midwife by week 8-10 or as soon as you arrive in the Netherlands.

You can talk to your huisarts (GP) – he/she will be able to point you in the right direction.

There are a few other things that you should consider:

• Make sure you know what your health insurance coverage covers for you.
• Register yourself with a kraamzorg (postnatal maternity care) agency, preferably before week 12 of your pregnancy. Your midwife can direct you to organisations that they partner with, and your health insurance provider must be contacted to ensure your chosen maternity care agency or ‘so-called’ kraamcentrum is approved by them.
• Decide where you want your baby delivered. The Dutch are big believers in home births, so make it clear if you want to give birth in a hospital. You have the flexibility of changing your mind at the last minute if you decide to go for a home birth.

Maternity care is covered by basic insurance, and pregnancy is covered even if it is a pre-existing condition.

If you have just moved to the Netherlands and have applied for health insurance, it might take some time before you are insured. In that case, it is still possible to see a midwife. You will probably have to pay for the visit. If the appointment is on or after the starting date of your insurance, the costs will be reimbursed as soon as you receive your insurance number.

In the case of a low-risk pregnancy, you will be offered two ultrasound scans: one in the first term or trimester (0-13 weeks) to determine a due date and one anomaly scan at twenty weeks. Both scans are covered by your health insurance. Some midwives perform an additional scan at 30 and/or 36 weeks, but this is not done in all cases. Usually there needs to be a medical reason to have additional ultrasound scans. The scans are sometimes made by the midwife herself in her own practice; otherwise, you will be referred to a primary care ultrasound centre.

As a pregnant woman living in the Netherlands, you have the option of having your child tested before birth. In this way, you can opt for tests that screen for Down’s, Edwards’ and Patau’s syndromes. It is worth noting that not all pregnant women opt for screening tests, but all will be offered them.

1. If you decide to have your child tested for Down’s, Edwards’ and Patau’s syndromes, you can choose to have:

• A combined test: a blood test between the ninth and fourteenth week and an ultrasound scan between the 11th and 14th weeks of pregnancy.

or

• The NIPT (non-invasive prenatal testing): a blood test that can be performed in the eleventh week of pregnancy or later.

2. Parents who are expecting a child can have their unborn baby tested for spina bifida or other genetic disorders. The ultrasound is performed between the 18th and 22nd weeks of pregnancy.

Prenatal courses are organised to educate expectant women and their partners in the preparation for labour, offering you tools to manage your labour pain, optimal positions for birth, tips for recovery after birth and how to be a new mother. They usually last between four to eight weeks and are often followed by a postnatal session. It is recommended to register by week 16, as the classes can often fill up quickly.

A prenatal course provides the opportunity to meet other expectant mothers or couples, but the class you choose and how helpful it is once labour starts may depend on your knowledge of the language (courses will be available mainly in Dutch but also in English). Therefore, it is important to choose a prenatal course carefully.

In larger Dutch cities, you can find prenatal courses offered especially for internationals. ACCESS offers childbirth preparation courses in various cities. These courses are tailored specifically to the international community and are conducted in English. The courses provide an informative practical insight into pregnancy, childbirth, postpartum and breastfeeding and explain how the Dutch healthcare system works. The courses also have the added advantage that you are able to meet other international couples.