Having A Baby In Holland
Find out what it’s like being pregnant and giving birth in the Netherlands, and the healthcare support you can expect when having a baby in Holland…
Overall standards of health in the Netherlands are very high and according to the World Health Organisation the Netherlands is one of the world’s safest places to have a baby.
PRE-NATAL CARE
Midwives in the Netherlands are trained to a very high standard and will oversee the pregnancy beginning at approximately 12 weeks and ending a few weeks after the baby is born. This is the case whether the baby is to be delivered at home or in a hospital. When a woman suspects she is pregnant, she should make an appointment with a midwife (‘verloskundige’), usually from a local practice (‘verloskundigepraktijk’) made up of several midwife practitioners.
When meeting with the midwife, the client will be asked about her own medical history and the medical background of the biological father. The mother should state whether she wants a home or hospital birth. The midwife will screen for possible complications and refer her to an obstetrician if needed.
The midwife will offer to take a PSIE blood test which is used to screen for infectious diseases (hepatitis B, syphilis, HIV), to determine the mother’s blood group (A/B/O), rhesus C/D and for various antibodies. If the results indicate a potential complication, the mother will be referred to an obstetrician for further testing or treatment.
During the initial consultation, the mother will be given an information booklet with a schedule of visits, a report on each consultation and dietary advice. The booklet also lists equipment necessary if the mother is to give birth at home, the expected delivery date and other helpful information including details of massage therapists and yoga teachers.
Visits to the midwife take place on a regular basis, starting with every four weeks and increasing to once a week as development nears full term. There are typically two ultrasounds: one between 11-14 weeks (which coincides with a blood test between 9-14 weeks) to test for Down’s syndrome and another at 20 weeks (structural ultrasound).
Throughout the pregnancy the midwife will be on the lookout for possible risks and if concerned will refer the woman to an obstetrician who will decide whether she needs to be placed under more stringent medical supervision, or if midwife’s care is sufficient.
Midwives in the Netherlands use the official list of obstetrical indications, Verloskundige Indicatie Lijst (VIL), to monitor potential diseases. The midwife reviews the patient’s personal medical history to determine if there is a predisposed risk of illness such as pre-eclampsia, in which case she will refer the patient to an obstetrician.
THE BIRTH
The Dutch medical profession strongly supports home births, natural childbirth and the use of a midwife. Anyone wishing to have pain medication, pills, epidural or a possible Caesarean section, should state this firmly at the outset and have it included, in writing, in their folder (so that the person doing the delivery knows). Pain medication is not administered as the standard in the Netherlands and most Dutch women give birth unaided by drugs.
Many low-risk women give birth at home, attended by a midwife (about 30% of all births in the Netherlands).
Giving Birth at Home
Once called, the midwife arrives to check on the mother. This is generally when the nurse/helper also arrives who, together with the midwife, attends the birth. They provide help through the labour and take care of minor medical issues; if necessary the pregnant woman is taken to hospital. The midwife and helper do not routinely care for other children in the house; this is handled by the mother’s partner or by a friend or doula. However there are no rules forbidding children from attending the birth.
Giving Birth in Hospital
A woman may choose a specific hospital in which she wants to give birth, but most elect the hospital in closest proximity to their home, or one at which their chosen midwife or gynaecologist works.
The midwife is met at the hospital; unless there appear to be complications, an obstetrician will not be present.
Women who do give birth in a hospital usually return home within 24 hours of delivery and may be free to leave from as little as an hour after the baby is born. If there are complications, an obstetrician and a paediatrician will provide assistance and pain medication or an intervention.
A woman may have her partner – or another person of choice – present during the birth.
POST-NATAL CARE
Immediately after birth, whether a child is born at home or in hospital, a post-natal in-home care service called ‘kraamzorg’ begins. This has to be booked during pregnancy as there are a number of providers and choosing one may take time. There is also an intake interview.
Kraamzorg allows that for a period of up to eight days a postnatal care nurse (‘kraamvezorgster’) comes to the home to help. The kraamverzorgster is dedicated to the new mother and baby and therefore is not required to make general household meals or undertake heavy housework. Instead, service providers will help a new mother and baby with the breastfeeding process (if relevant), show both parents how to change diapers, wash their newborn, offer advice on all aspects of newborn care if needed, distract young children if mum needs a rest, help a new father with ways to take care of his partner, his new baby and himself. He or she will also provide a gentle buffer between the new mother and visiting well-wishers.
The midwife who attended the birth (or one of her colleagues) will visit regularly to oversee the health of the mother and handle small medical procedures like removing stitches if required.
One to two weeks after the birth a district nurse from the Child Health Clinic (‘Consultatiebureau’) visits the new mother and baby at home. The nurse conducts the heal prick test, in which a spot of blood from the baby’s heel is dabbed on a card as part of a routine test for various ailments.
He or she speaks with the new parents and the kraamverzorgster to monitor care and feeding and makes an appointment for the first visit to the Well Baby Clinic. The nurse also makes sure the mother has a record book to record her baby’s development, vaccinations and medical events.
The ‘Green Book’
After birth, parents are given a document called “the green book” in which to record the growth of the child, the vaccinations received and other health information regarding the baby.
Well-baby Clinic (Consultatiebureau)
From birth until about the age of four, routine check-ups (health, vaccinations, cognitive and motor development) are carried out by the consultatiebureau. From that age onwards, routine health care is taken over by the Municipal Health Services (GGD) and motor and cognitive development by the school doctor. For any other health issues, visit the family doctor (huisart).
Vaccinations
The Vitamin K shot is not routinely offered in the Netherlands. Vitamins K and D are administered to babies by their parents in the form of oral drops, over 12 weeks and 3 years respectively. The first vaccines are given between 6 and 9 weeks and from then on the child enters the current vaccine schedule up to 12 years of age when the final HPV vaccines are administered. Vaccines are free unless a parent chooses to selectively vaccinate, in which case all vaccines must be privately purchased and administered by the family doctor. Delayed vaccination is possible but only up until the child’s second birthday. Once the first shot is administered, subsequent vaccines must be given on the normal schedule or parents forfeit the right to free vaccinations for their child.
More information about the vaccination programme for children in the Netherlands.
Medical Organisations
Pregnant women may join their local Stichting Thuiszorg or the Cross Organisation (Kruisvereniging) for pre- and post-natal services. In each community these organisations offer exercise classes, baby equipment rental, nursing help at home, special beds and lifting devices.
REGISTRATION & NATIONALITY
The birth of a baby needs to be registered within 72 hours at the local town hall (‘gemeentehuis’). This will generate a birth certificate for the child.
The passports, birth certificate and residence papers of both parents must be shown, along with the marriage/partnership certificate or official living-together contract. The mother’s name must be mentioned on the birth certificate regardless of her marital status.
The birth can be registered by the father, the mother or a third person.
International Parents
International birth certificates may not be automatically issued – request this at the Registrar’s office and provide the relevant paperwork depending on parents’ nationality. Foreign parents may apply to the Consulate of their Embassy in the Netherlands for registration of the birth with their home country. This, however, does not mean they don’t need to register with the Dutch authorities. The Dutch registration of birth must be obtained first.
Nationality of the Baby
If the mother is Dutch the baby automatically gets Dutch nationality even if the father is not. If the father alone is Dutch and the parents are not married or in a registered partnership, the baby must be ‘recognised’ (erkenning) during the pregnancy in order to qualify for Dutch nationality and to establish parenthood. Married partners or those in a registered partnership are automatically considered the parents of a child and do not need to complete the process of official recognition. A man may recognise a child who is biologically not his own up until a child is 7 years old. Assuming that the child has no legal ties to another father, they will be conferred with Dutch citizenship.
Parents who are not Dutch nationals should contact the relevant Embassy to establish the baby’s nationality.
WORK LEAVE
Maternity Leave
At least ten weeks have to be taken after the delivery, for example if the employee stopped six weeks before the birth and the birth is two weeks late, two weeks will be added to the ten remaining weeks. If the mother is ill at the end of her maternity leave she is entitled to 100 percent of daily pay. According to the Adjustment of Hours Law people in the Netherlands are entitled to work full time or part time according to their needs. Mothers who wish to spend time with their babies and children are allowed to work part-time (four hours per day) returning later to full-time employment. If a mother returning to work applies to return only part time, it is only in exceptional circumstances that an employer may refuse her request. The Netherlands has the world’s highest rate of part-time working parents.
Although maternity and paternity leave are paid to the parents by the employer, the government reimburses 100% of costs to the employer, ensuring that no added financial burden is experienced by employers.
Paternity Leave
Fathers are entitled to a paternity leave of five days which are paid in full by the employer and must be taken within four weeks of the baby’s birth. These entitlements also apply to people adopting a child and to families with more than one child. Beginning on 1st July 2020, fathers will be entitled to an additional five weeks of paternity leave at a rate of 70% of their daily wages which will be paid by the UWV. These five weeks (or less if the father chooses) must be taken within six months of the baby’s birth.
Both parents are entitled to unpaid parental leave. Unpaid leave entitlement is 26 times the normal weekly working hours (6 months of leave for a full-time employee). Many fathers in the Netherlands choose to take this leave as a single day a week, reducing working hours to a 4-day week. This day off is commonly called the Daddy Day (Papa dag).
Related information…