Information about the Dutch system of obstetrics and your delivery
Especially for you, because you’re probably not Dutch (reading this English information), here is some information on the Dutch system of obstetrical care and on delivering your baby in the Netherlands. You’ll find information on home vs. hospital birth, pain relief and the aftercare.
In the Netherlands pregnancy and childbirth are viewed upon as normal processes
that need attendance from somebody specialised in providing the appropriate
care: de verloskundige (midwife).
Almost 50% of all pregnant women in the Netherlands receive care from a midwife.
Almost 60% of all the midwives’ deliveries are home births.
In the Netherlands you are not allowed to electively receive gynaecologist
care, you will have to have a “medische indicatie” (medical indication).
The system of obstetrical care is based on: “risicoselectie” (risk
selection): midwives for low risk pregnancies/births, gynaecologists for high-risk
pregnancies/births (in case of medium-risk there will be communication between
the two or shared care). We believe that causes the Netherlands to be in the
top 10 of countries with the lowest pregnancy related morbidity and mortality
rates.
A midwife has received a four year training to gather all the knowledge about
pregnancy and childbirth. She can tell the difference between normal and abnormal
(physiology vs. pathology) and in case of complications will refer you to the
specialist for everything that’s “abnormal” i.e. pathological
(high blood pressure, growth retardation, breech position of the baby, premature
labour etc.): the gynaecologist.
For that matter you could call the Dutch midwife: the general practitioner
for pregnancy and childbirth.
In line with this you are allowed to choose where you would like to give birth: at home or “poliklinisch” (chosen hospital delivery). In both cases we will assist your delivery. There is hardly any difference between the two: we are fully equipped to safely assist homebirths and will have the same amount of equipment both at home and in the hospital. In Amsterdam, in the uneventful case of a complication, you will not lose any more time travelling from your home to the hospital (it will take about 10 minutes) than if you are already in the hospital having a “poliklinische bevalling”. The gynaecologist will take about 10 minutes as well. We would like to emphasise that by giving you this information, we are not aiming for you to choose to have a home delivery. We do believe that by informing you on the way it works in the Netherlands, you will be able to make a more educated choice. Having a hospital or home birth is entirely up to you and we respect your choice!
In the Netherlands it is not common to receive routine pain relief (epidural, gas, pethidine). We, midwives and most gynaecologists, believe (and have scientific evidence supporting that) that if you are well prepared you will be able to endure the pain related to giving birth and are most likely to have an uncomplicated birth when there are as little interventions as possible. There are a lot of ways to make labour endurable: taking a warm bath or shower, changing your position or finding something to focus on, to take your mind of the pain. We will try to help you with that as much as we can. If you can not endure the pain, we will refer you for pain relief.
When your delivery has started (see 'delivery') and you have phoned us, one of us will visit you at home to see how you are progressing. She will examine you both externally and internally, the latter to know how far you are dilated. She will make further decisions based on the findings; leave for a while, stay and phone for assistance of a “kraamverzorgster” (specialised nurse for deliveries and aftercare) or arrange a place in a hospital for you. When you choose to deliver in the hospital you will go there with your own car or taxi. There will be a hospital nurse assisting us there. After the baby is born and everything is fine we will leave. After a homebirth the kraamverzorgster will stay to help you shower and change the bedlinnen etc. When you have delivered in the hospital you will leave about 4 hours after the birth (day and night!). In the eight days following your delivery, the kraamverzorgster will provide care for you and your baby mostly 3-5 hours a day. In addition the midwife on call will visit you at home (generally on day 2, 4 and 7). Since we combine births and aftercare in our 24 hour shifts we will not be able to tell you at what time we will be visiting you. Normally we will visit you between 9.00 and 17.00.