You just found out you are pregnant…Congratulations! It’s not like 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 if you make it through Baby Basics 101, 102 and 103 despite the fatigue you may be experiencing, you will have received all the information necessary for having this baby in the Netherlands!
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 midwifes 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.
In my work as a Doula, I have noticed that I get asked pretty much exactly the same questions by most of my expat clients. This is why I put together some information and divided it into four parts in order to make it not too confusing.
Today I will cover:
- Baby Basics in Holland 101 – Prenatal Care
- by midwives
- by hospital midwives
- by gynecologists
So here we go, let’s start with the first part of Baby Basics: 101 – what you need to know about Prenatal Care in the Netherlands
Generally, prenatal care for uncomplicated pregnancies is provided by midwives.The first decision you have to make when you find out about your pregnancy is to choose a midwife. 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 your country you would probably see the gynecologist, but you can rest assured that you are in excellent hands with your dutch midwife. They perform all the test that gynecologists do elsewhere and are just as knowledgable.
In the early stages of pregnancy, you will have monthly appointments, as the pregnancy progresses you will have more frequent check ups.
Your initial intake will take about 45 minutes, you will most likely have a brief ultrasound to estimate the due date and rule out an ectopic pregnancy. You will probably hear the babies heartbeat (the most amazing experience ever) and go through your families medical history. Your midwife will order some blood and urine tests, to check for example for STDs, Toxoplasmosis or CMV. If you have older children, it might be good to stress that you want the CMV test to be included. Some tests are not standard and only performed when there is an indication for it.
Each pregnant woman is informed about the combination test, which calculates her risk of being pregnant with a Down’s, Edward’s or Patau’s syndrome baby. It used to be that only low-risk women (e.g. younger than 36 years in their 18th week of pregnancy) had to pay for this test themselves. But as of 2015, the combination test is no longer covered by insurance. The cost is around €160,- and some insurance companies will cover this. It consists of a blood test between 9 and 13 weeks of pregnancy and an ultrasound between 11 and 14 weeks of pregnancy to measure the nuchal fold. If an increased risk of for example Trisomy 21 is discovered, you can perform a NIPT (non-invasive-prenatal-testing) test. The NIPT test is a blood test and is usually not covered by insurance companies. Should the NIPT test discover an increased risk, you most likely can be reimbursed for the cost from your insurance care provider.
At 20 weeks there will be a big anomaly ultrasound scan.
There needs to be a medical indication to have additional ultrasound scans.
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. When you go into labor you will be in phone contact with the midwife on call. Once you have regular, steady contractions, she will meet you at your home. Unless you want to have the baby at home, you will determine together when it’s good to head to the hospital or birthing clinic. Once arrived, she will check your dilation regularly but will try to intervene as little as possible with the labor (more in Baby Basics 102-Birth). She will visit you for the postnatal appointments at home to ensure mommy and baby are doing well.
- Local Midwife Clinics in The Hague
- Local midwife in Delft
- Local Midwife Clinics in Rotterdam
- Local Midwife Clinics in Leiden
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 labor. All pre- and postnatal appointments will also take place at the hospital midwife practice.
- Hospital midwives in The Hague
- Hospital midwives in Rotterdam
You will only be referred to a gynecologist if there are complications during your pregnancy.
You cannot go to a gynecologist directly, you need to be referred by either your GP or a midwife. All appointments (prenatal, birth and postnatal) with gynecologists will take place at the hospital.
I hope this overview has shed some light on the whole process of prenatal care in the Netherlands! Please feel free to contact me anytime if you have more questions. I’m happy to hear from you!
In future posts I will discuss:
- Baby Basics in Holland 102 – Birth
- at a hospital
- at a geboortehotel/birth clinic
- at home
- Baby Basics in Holland 103 – Postpartum period
- Registration with the municipality
- Baby Basics in Holland 104 – Action plan, what to do when
What has your experience regarding prenatal care been like in the Netherlands? Have you been with any of the midwives mentioned above and would like to share your thoughts? If you would like me to add midwives from your cities, please let me know.