If you want a baby or are already pregnant, this guide explains antenatal care, childbirth, aftercare and parental leave in the Netherlands.
Are you thinking about getting pregnant or are you already expecting? The Dutch healthcare system is one of the best in Europe and is one of the safest places to give birth, despite a more unusual prenatal and childbirth system compared to other European countries. New mothers feel safe with this high level of postnatal care, which can even include personal help at home covered by Dutch health insurance.
Pregnancy and childbirth in the Netherlands
Hospitals remain the most popular place to have a baby in the Netherlands, although one in eight babies is born at home. This is one of the highest rates of home births of any highly developed country.
The Dutch see childbirth as a natural process and not as a medical condition. Consequently, pregnant women interact most with midwives and, given the nature of the healthcare system, may see different midwives in a clinic during pregnancy, unless they book specifically with a particular professional. Parents receive a maximum of 10 days' care from a maternity nurse (kraamverzogster) after the birth. The nurse is available to offer advice, support and assistance with everyday chores.
Accessing maternity services in the Netherlands
As in most other countries in the developed world, the first step when you suspect you are pregnant is to make an appointment with your doctor, who will confirm your pregnancy and perform a blood test before referring you to a midwife (obstetric practice). From here on, the midwife generally provides you with antenatal care. If you suffer complications, the midwife will refer you to a general practitioner or gynaecologist.
You are free to choose your midwife, so it's a good idea to talk to friends or colleagues for recommendations, especially if you want to find a midwife with a good knowledge of English. However, Dutch citizens generally have an excellent knowledge of English.
You can also consult the Royal Netherlands Organisation of Midwives (KNOV - Koninklijke Nederlandse Organisatie van Verloskundigen), where you can search for midwives in your area. Similarly, you can ask for local midwives from your GP during your initial examination.
Royal Dutch Organisation of Midwives www.knov.nl
Insurance for maternity costs in the Netherlands
Public health insurance in the Netherlands covers most maternity costs as well as abortions. For those not covered by the state health insurance system, there are many private health insurances to choose from. Most, however, choose private insurance because, although more expensive, it offers more coverage and more treatment options. Large, expat-friendly international health insurers offering maternity cover in the Netherlands include:
- Allianz Care
- Cigna Global
Everyone is free to choose their health insurer according to their family's needs. However, you may find it useful to have a list of some health insurance companies that also offer information in English:
Pregnancy test in the Netherlands
If your period is late and you think you might be pregnant, you can buy a urine test at the supermarket, pharmacy or drugstore. The tests cost between €5 and €15 and different brands are available.
If you have a negative test but think you might be pregnant, repeat the test a week after your period is late or talk to your GP about a confirmatory blood test.
Antenatal care in the Netherlands
The first appointment with the midwife usually takes place at three months of pregnancy. The appointment consists of an initial screening to identify possible complications. At this time, the midwife asks you whether you prefer a home birth or a hospital birth. Be sure to check with your insurance provider before selecting the home birth option; it may involve an additional cost.
The midwife will also provide you with a schedule for upcoming appointments, as well as information booklets outlining dietary tips, expected due date and other relevant information.
Meetings with your midwife take place at regular intervals throughout your pregnancy. They start every four weeks and progress to two weeks as you get closer to your due date. You also receive a booklet outlining the pregnancy process. The booklet is particularly useful for those who opt for home births, as it contains information that is of great help to the midwife assigned to attend the birth.
Scans, tests and checks
Prenatal testing and genetic screening are not routine in the Netherlands. However, if a woman is over 36, has previously had a child with a birth defect or there is a history of such defects in her family, she will certainly be screened for chromosomal defects. Usually the midwife will advise you on the best course of action. You can also consult a gynaecologist if necessary; make sure you get a referral from your GP if you want your insurer to cover the consultation.
At your first visit, the midwife will give you an optional blood test to determine your blood type, whether your blood contains antibodies to foreign blood groups and whether you have been exposed to syphilis, hepatitis B or HIV. The midwife will offer you treatment depending on the results.
In low-risk pregnancies, the midwife performs two scans. The first is in the first trimester to establish the date of birth. The second scan is for abnormalities at about 20 weeks. The midwife often does these in her own practice, but you may be referred to a specialist centre. Additional scans require a medical reason.
Prenatal screening tests for genetic conditions and abnormalities will be done to determine if there are possible Down, Edward or Patau syndromes through a blood sample between nine and 13 weeks and an ultrasound between 11 and 14 weeks. If your baby is likely to be born with Down syndrome, you will be offered a NIPT test. Basic insurance does not generally cover these tests. More information is available in a brochure from the Ministry of Public Health.
Antenatal courses
With home births so popular in the Netherlands, it makes sense that there is a wide range of antenatal courses available. Yoga is popular, but you can find hypnotherapy, acupuncture and classes for both partners in English, Dutch and other languages.
Some courses to consider:
- Samen Bevallen (couples courses in English and Dutch, nationwide)
- Amsterdam Mamas (list of options, Amsterdam)
- Birthlight Yoga (Utrecht)
- Access NL (courses for expat mothers, The Hague)
- Bump and Beyond (Amstelveen)
- Birth class Irma (Eindhoven)
- Truss Gale-Swinkels (midwife, Haarlem)
- Verloskundigen Praktijk (list of courses in Utrecht)
- Willeke Klerks (doula and birth trauma coach, Haarlem)
Abortion in the Netherlands
Abortion is legal on request up to 21 weeks after conception and for medical reasons up to 24 weeks. Women can go to specialist clinics, but a family doctor can make a referral to a clinic or at a hospital performing the operation. Patients seeking an abortion may have to answer some routine questions, such as why they want the operation, and will be informed of all their options and risks. There is a mandatory five-day waiting period, so there is plenty of time to think about the decision.
Abortions in the Netherlands are free for residents. Licensed hospitals and specialist clinics perform the procedures, while health insurers cover the costs. Fiom, the national specialists in unwanted pregnancies and biological offspring, has information in Dutch about abortion and other options such as adoption and fostering.
More information can be found at www.fiom.nl
Childbirth in the Netherlands: hospitals, home births or birth homes
If you plan to give birth in the Netherlands at a hospital, you should go to the one closest to your home. Your midwife will meet you at the hospital maternity ward on the day of the birth.
It is important to note that midwives in the Netherlands prefer birth to be as natural as possible; therefore, the use of pain-relieving drugs during childbirth is quite rare. However, if you insist on accessing medication, then you should discuss it with the hospital before the birth and ask for it again on admission. Don't hesitate to ask if an anaesthetist is available in the event of an after-hours birth.
A few hours after the birth, if the birth went normally, the new mother and the newborn baby go home. Any complications before, during or after birth will usually be seen by an obstetrician or paediatrician.
Following the birth, parents receive a childcare book (Het Groeiboek) in which they keep a record of vaccinations and other important medical details about the child.
Birth outside the hospital
For home births, the midwife will come after you have been informed and will help you through the process. A nurse will also be present to ensure the delivery goes as smoothly as possible. Keep in mind, however, that pain relief is not an option during home births.
Women who choose a home birth receive a Kraampakket, a maternity kit, from their insurer. In addition, the midwife will bring her own specialised equipment.
In some areas, there are also special birth hotels (kraamzorghotel) with a family environment, while allowing the partner to stay overnight. You must register your intention to use a kraamzorghotel up to two months before the birth date. You can visit Kraamzorg Rotterdam for an example of a maternity hotel.
Although childbirth and antenatal care are part of your basic health insurance package, it may be worth purchasing additional private insurance to protect you from the costs of any medical complications that may follow, such as the need to go by ambulance.
All newborns in the Netherlands receive vitamin K after birth. In addition, newborns receive vaccinations within eight days, with regular vaccinations scheduled until the age of nine. Newborns can receive vaccinations against infectious diseases such as hepatitis B, measles, polio and tetanus. More information is available from the National Institute of Public Health and the Environment. Your child's health is then monitored by GGD GHOR Nederland, which provides community health services.
More information can be found at: www.kraamzorgrotterdam.nl
Postnatal care in the Netherlands
One of the unique features of childbirth in the Netherlands is every woman's right to a maternity nurse (Kraamzorg); compulsory basic insurance packages cover the cost of this. The service will see a healthcare professional who will visit you at home every day during the week following the birth, with their services covered by your health insurance. In some cases, however, it may not be fully covered, so it is important to clarify this beforehand.
As well as offering advice and answering any questions you may have, Kraamzorg can help you with everything from general housework to buying groceries. Depending on your needs, the maternity nurse will be available to help you full time or just for a few hours each day.
If you wish to take advantage of this service, you must register before the 12th week of pregnancy to ensure that you are allocated a nurse in time for your birth.
Parents receive a book documenting their child's growth and general health information. In the early years, your child will receive regular check-ups to monitor their health.
Day nurseries and childcare
Other postnatal services are available from various church and community groups, offering everything from exercise classes to additional home care assistance.
It is never too early to register your child for nursery, such as when you are pregnant, given the limited places.
Vaccinations for children
The Dutch believe that every child should be given the best possible start in life. As a result, the country's National Immunisation Programme vaccinates children living in the Netherlands free of charge against almost a dozen different diseases. Vaccination is not compulsory, but more than 95% of the country's parents have their children vaccinated. The first round of vaccinations is before the age of four. By the age of nine, two vaccines are repeated: DTP (diphtheria, tetanus and polio) and MMR (measles, mumps and rubella; BMR in Dutch). Girls are also offered a vaccine to protect them against cervical cancer the year they turn 13. Vaccinations for schoolchildren are provided either by municipal health services or at a youth and family centre (CJG).
Doctors generally discuss vaccinations one month to six weeks before each round.
More information can be found at: www.ggdghor.nl and www.rivm.nl
Breastfeeding in the Netherlands
Breastfeeding is an accepted part of everyday life for millions of women around the world, and the practice is strongly supported by health bodies such as the World Health Organisation (WHO). However, public attitudes towards the practice differ. In 2015, women in the Netherlands reported being insulted by staff in cafes and shops, but attitudes have since relaxed considerably.
Many companies and public institutions now encourage women to breastfeed in public by displaying a logo at the entrance. Several municipalities are openly breastfeeding-friendly; you can find out more about them at Voedingscentrum.nl (in Dutch). There are no laws against breastfeeding in public.
For women returning to work, Dutch law requires employees to provide adequate space for them to breastfeed their babies for the first nine months, and 25% of working time to be used for feeding or pumping. After that, conditions for breastfeeding still have to be met, such as breastfeeding rooms and timely breaks, but time spent breastfeeding is no longer paid.
Non-residents, visitors and tourists giving birth in the Netherlands
Tourists in the Netherlands must have health insurance or pay their own health costs. EU citizens are covered by the European Health Insurance Card. Non-residents and tourists applying for a Schengen visa must take out a travel insurance policy with up to EUR 30,000 of cover.
Some travel insurance policies cover pregnant women in their first trimester. However, cover rarely extends beyond this period unless you add an additional component. Policies often do not cover miscarriages either. Check with your insurer when planning your trip.
In an emergency or life-threatening situation, you can call the free emergency number 112. The call centre will send you the help you need: ambulance, police or fire brigade.
Will my child get Dutch citizenship?
European countries do not offer citizenship by birthright, but a child with a Dutch mother becomes a Dutch citizen by law. And in the case of a child with a Dutch father, the child's parents must either be married on the day of the child's birth or the Dutch father must recognise the child before the child's seventh birthday. After this date, he must provide proof of DNA.
Dutch maternity and paternity leave
New mothers receive 16 weeks paid maternity leave. In general, leave starts anywhere between four and six weeks before the date of birth. Leave taken during pregnancy is known as zvangerschapsverlof. Ten weeks of leave must be taken after the birth (bevallingsverlof). If the child is one week late, then this time is added to the leave entitlement.
As a new mother, you are entitled to 100% of your income during your leave, which is calculated by dividing your social security income (SV-loon) over the last 12 months by the average of 261 working days in a year. There is a maximum amount of EUR 203.85 per day.
Employees must notify their employer at least two to three weeks before the start of their maternity leave. Claim maternity pay at least two weeks before the start of your leave. Claims can be made either through your employer or through the UVW (Employee Insurance Agency).
Dutch labour law limits fully paid partner/paternity leave to one week. Partners can take this leave at any time during the first four weeks after the birth. From 1 July 2020, partners can also take up to five weeks of additional unpaid leave. They will have to take this leave within six months of the birth. These weeks must be whole weeks, although they can be non-consecutive if agreed with the employer.
Self-employed workers can also receive the same maternity benefits as employees if they claim self-employed maternity benefits with UWV - www.uwv.nl
Birth registration
The local town hall (gemeentehuis) requires all newborns to be fully registered within 72 hours of birth. Registration takes place in the municipality of birth; this is important to remember if the birth takes place in another municipality. Both parents must present their passports, birth certificates and residence papers at the time of registration. If applicable, marriage certificates must also be included. The town hall issues the child's birth certificate on completion of registration. In addition, the authorities provide a kinderbijslag form, which allows parents to claim child benefit.
Expats who wish to register their birth in their home country can do so via their embassy in the Netherlands. However, this can only be done after a Dutch birth certificate has been obtained.
Expats living in the Netherlands will have to apply for a residence permit for their child. The IND website has a comprehensive page on the subject: www.ind.nl
Child benefit in the Netherlands
The Dutch government realises how hard it is to raise children and helps with a little extra. Parents living or working in the Netherlands with children under the age of 18 are eligible for child benefit. The Sociale Verzekeringsbank (social insurance bank; SVB for short) pays these benefits.
New parents are usually contacted within two to four weeks of registering their child's birth, at which point they can log on to the SVB website and fill out an online form. You will need to call the SVB if they have not contacted you within four weeks of registering the birth.
The allowance, called kinderbijslag, depends on the age of the child. From January 2019, the benefit is EUR 219.97 per child per quarter for children up to the age of six. It rises to EUR 314.24 between the ages of 12 and 17.
More information can be found at: www.svb.nl
Author: Loredana Tripp
2 Comments
Didi
Very complete and well written article. The only thing I might add is the moas training which takes 4 or 5 years at the college level. Midwives take specialized courses throughout their work. They work together with hospitals in the surrounding area. They may also attend births in hospital or not depending on the form of birth. If the labour was traumatic or there is pre- or partum depression then the midwife or GP will recommend a specialist (psychotherapist or psychiatrist).
Dana Marin
Thank you!