Which are the options for delivering a baby in the Netherlands?
Low-risk women may choose whether to give birth at home, in a hospital or a birth centre. If you have an increased obstetrical risk, the birth will be supervised by an obstetrician.
Thuis bevallen (home birth)
If a woman chooses a home birth, her primary care verloskundige (midwife) will attend her birth, aided by a kraamverzorgster (maternity assistant). The insurance company usually provides a maternity box and the midwife will bring her own equipment, which always includes a neonatal resuscitation set and oxygen. If complications arise, the midwife will refer the patient to an obstetrician or pediatrician in a hospital. Every hospital in the Netherlands accepts these referrals from primary care midwives.
Poliklinisch or geboortecentrum bevallen (hospital or birth centre)
If you decide that you would prefer to give birth in a hospital or a birth centre (and there is no medical necessity for doing so), you will be charged an amount per day if you do not have additional insurance coverage. Some health insurance providers will cover this expense. The birth is attended by the same primary care midwife who provided care during the pregnancy. The midwife will also provide the postnatal care at home. The midwife is assisted by a (obstetric) nurse who is employed by the hospital. Both options are considered outpatient clinics, meaning the mother will usually stay less than 24 hours in the hospital or the birth centre. Please note that some health insurances covers the cost of a birth in a hospital or birth centre even if no medical reasons exist.
Ziekenhuisbevalling (hospital birth with medical necessity)
Women who have an increased obstetrical risk will have been referred to a hospital and therefore there will be no extra costs. The birth will be supervised by an obstetrician assisted by a clinical midwife, a general doctor or an obstetrician in training.
You can find more information about the different places you can give birth here.
What will happen if I choose to give birth at home?
Your verloskundige (midwife) will attend the labour and delivery. She will also help with preparations to ensure the safety and comfort of you and your child. Should any complications arise, you will be taken to hospital.
The Dutch health and safety regulations require that your bed is elevated with ‘klossen’ (which literally means ‘beer-crates’ in Dutch). This way you have a means for adjusting the height of your bed. This is also a requirement for the kraamverzorgende (maternity nurse) when she comes to your house once your child is born (usually during the first week after birth).
There are Dutch online shops that provide all the necessary equipment for a home birth, the so called ‘kraampakket’ and postnatal care. This equipment may also be useful even if you do not give birth at home. You can buy it at a drugstore or check with your insurance company if they cover or provide it for you. Alternatively, you can conduct an internet search using the terms ‘thuiszorg’ (homecare) and ‘winkels’ (shops).
Can I choose to give birth in a hospital?
If you wish to give birth in hospital, you must register with a hospital within the first five months of your pregnancy. You may choose any hospital that has a maternity facility, although most mothers-to-be elect to go to their nearest hospital, or one where their chosen midwife or gynaecologist works. The midwife first comes to your home when your labour starts. Together, you decide the best time to go to the hospital. Most hospitals organise information evenings, including a tour of the maternity unit, which may help you make a decision. Always have a second hospital in mind in case the hospital of your choice is full. Please note that unless a hospital birth is necessary for medical reasons, health insurance policies may not cover the entire costs. Therefore, you should check in advance what is covered with your health insurance provider.
Women usually return home within 24 hours of delivery and may be free to leave in as little as four hours after delivery. You will only be discharged once you feel confident and comfortable that you are ready to go home. A stay of less than 24 hours is considered outpatient clinic.
Sometimes giving birth does not go according to plan, e.g. your baby could be overdue and you have to be induced, or you might need a caesarean section. In that case, an obstetrician and a paediatrician will provide assistance. A hospital stay could vary from 24 hours to 10 days, depending on possible interventions during birth and/or necessary postnatal care.
You can contact hospitals in your area to enquire if they provide expat information evenings.
Will I be able to get pain relief?
In the Netherlands, only a third of women in labour are given pain relief and caesareans are relatively low. Traditionally, Dutch midwives and doctors preferred not to interfere with the natural process of labour and delivery, though in recent years there has been a change in this policy. For instance, in 2008 the Dutch association of anaesthesiologists agreed on the 24/7 availability of epidural pain relief for women in labour and during pregnancy, making it much easier to get an epidural.
During pregnancy, Dutch midwives provide information about medical pain relief and they provide high quality continuous support during birth. In this way they try to optimise their care and minimise the need for medical pain relief. Please note that medical pain relief cannot be administered during home births. Midwives in the Netherlands are not qualified to administer anaesthetics and are restricted to using only non-prescription drugs. Your midwife can then refer you to a hospital or birth centre, but please be aware that there is not always an anaesthetist (the person that will be able to give you the epidural) available outside normal working hours.