Information on the Dutch midwifery system
With this letter we would like to inform you on the Dutch midwifery system, as it might be a little different than midwifery care in other countries around the world!
Pregnancy care at a midwifery practice
In the Netherlands, all healthy, low risk pregnant women who do not experience any complications during the pregnancy receive midwifery care at a midwifery practice. A midwifery practice is a bit similar to the general practitioner, the huisarts, in that it is usually situated quite close to your house. In a midwifery practice a number of midwifes work together providing all of the midwifery care, so both prenatal, natal and postnatal care. During the pregnancy you will come for check-ups a number of times. In the beginning there is 4-5 weeks between check-ups. In the second half of the pregnancy you come every 3 or 2 weeks for a check-up. During these check-ups we discuss certain things you need to think about or arrange, we ask you how you are doing and check the blood pressure. We also check how the baby is doing by a physical examination of your belly to feel if the baby is growing well and we listen to the heartbeat of the baby. Ultrasounds such as the first ultrasound in the beginning of the pregnancy and the 20-week ultrasound are also done at the midwifery practice.
The birth
Women who are healthy and have a low-risk pregnancy have the option in the Netherlands to choose where they want to deliver. You can choose to deliver at home or deliver in the hospital. Either way, as long as there are no complications, your own midwife will guide and take care of you during the birth. When you give birth at home the midwife and the kraamzorg (see postpartum care for explanation) will attend the birth. The costs for this care is fully covered by the health insurance. When you decide to give birth at the hospital your own midwife and the kraamzorg will accompany you to the hospital. The costs for the midwifery care are covered by the insurance. However, because you ‘rent’ a room in the hospital you will need to pay a personal contribution for this. It depends on what type of insurance you have how much this own contribution is. Usually this contribution is a few hundred euros, ask your insurance for the exact amount.
In case a complication or risk arises during the birth this could mean that you are referred to the hospital and are going to give birth with the care of the medical staff (midwife and nurse from the hospital under supervision of the gynaecologist)
Pregnancy care at the hospital
Sometimes women can have a high risk for complications during the pregnancy because of their own health or because of complications that are common in the family. Also during the pregnancy complications or a high risk for complications can arise. All high-risk pregnant ladies who experience a complicated pregnancy receive midwifery care in the hospital. This means that the prenatal check-ups are done in the hospital, either by a midwife who works in the hospital or a gynaecologist. Women with a high-risk pregnancy also give birth in the hospital under the care of the midwife from the hospital under supervision of the gynaecologist.
Postpartum care
Postpartum care in the Netherlands is quite different from most countries. In a lot of countries you will need to stay in the hospital for a few days after the birth. In the Netherlands however, if everything went well and the baby is doing good you are allowed to go home quite soon after the birth. At home you are going to receive care from the kraamzorg. The kraamverzorgster is a special obstetric nurse who will come to your house for the first 8 days after the birth. The kraamverzorgster will teach you everything about taking care of a baby and does check-ups to see how you and the baby are doing. She will check for example both your temperatures, see if your bloodloss after the birth is normal, check if possible stiches heal well and she will check the weight of the baby. Furthermore the kraamzorg guides you during breastfeeding. To receive kraamzorg you will need to register for this at a kraamzorg organisation, preferably register before you have reached week 16 of your pregnancy. We will help you remind to arrange this!
Your own midwife from the midwifery practice in your neighbourhood will come and visits you at home 2-3 times during the first week after the birth to discuss how you are doing, how the transition to being parents is going and to keep an eye on all the checks that are done by the kraamzorg
