Are you pregnant? The American Woman's Club of Amsterdam (AWCA) recently compiled an informative brochure containing an extensive list of resources for pregnant mamas-to-be in the Netherlands. We are pleased to feature a selection from their "Having a Baby in Holland" resource guide. To download the complete version of the guide, please click here.
Pregnancy and childbirth are a time of excitement no matter where you are living. In Amsterdam, most of us are further away from friends and family than we would like to be. The goal of this resource guide is to provide expectant moms with a network of support here in Amsterdam, so they will have the friends and resources they need during this important journey.
Maternity Care in Holland
Holland is internationally recognized as one of the leading countries for maternity care. The Dutch maternity care model is based upon the principal that a womanʼs body is perfectly designed to give birth safely. The Dutch trust a womanʼs ability to birth her baby and do not treat birth as a medical event.
In Holland, midwives attend normal low risk births. The midwives approach birth as a healthy process best accomplished free from drugs and other medical interventions. The Dutch maternity care model does not approach pregnancy as an illness. Obstetricians are only called upon to attend women during their pregnancy or labor when it becomes medically necessary.
It is always important to be informed and take responsibility for your own healthcare. There are many wonderful books cited at the end of this brochure that will help you better understand the Dutch approach to pregnancy and birth. Information is empowering.
Conception & Fertility
If youʼre just beginning to try to conceive, try to be patient. Medical evidence suggests that stress can reduce the chances of conception, so relax and enjoy the process for a year or so. If you still haven’t had any luck, research your options and discuss them with your family doctor (huisarts.) There are a whole host of medical tools available to resolve reproductive issues. These treatments are usually administered in hospitals in the Netherlands.
It is also wise to consider your overall health, life-style and diet. Amsterdam has a wonderful network of alternative health care practitioners that regularly support women during their reproductive years. Acupuncture for infertility is probably the most popular and commonly recognized alternative treatment for those trying to get pregnant.
Once you discover youʼre pregnant, begin by scheduling an appointment with the midwife (verloskundige) of your choice, or by visiting your family doctor (huisarts) if you prefer. He or she can then refer you to either a midwife or an obstetrician/gynecologist (gynaecoloog), a specialist in problem pregnancies, depending on your situation. The huisarts does not generally test to see if you are pregnant (the assumption is that your home test was accurate enough). Typically your first appointment with the midwife or obstetrician is scheduled around 9 to 12 weeks of pregnancy. If you have specific concerns before your first scheduled appointment, be sure to call your midwife or gynecologist. For example, you may want to discuss whether you need prenatal vitamins or may be having a miscarriage.
The only way to be cared for by an obstetrician/gynecologist is by referral from the family doctor or midwife. Your doctor or midwife can assign you to a specific doctor, or to the outpatient clinic of the hospital of your choice.
The Dutch typically take a very “hands-off” approach towards the delivery process, which is regarded as a very natural occurrence in the Netherlands. Many couples opt to deliver their children at home with the help of a midwife, who will make recommendations for transfer to the hospital if indicated or preferred. As an expectant mother, you will need to do your research and decide where you will feel most comfortable planning to deliver your child.
One important factor to consider when making this decision is insurance coverage. Some Dutch insurance companies will not cover a hospital birth unless there is a medical indication to send you to the hospital. Another item to consider is pain medication, which is more readily available in a hospital setting. Whatever your choice for delivery, be sure to make it very clear to your verloskundige or gynaecoloog. The sooner you discuss your wishes, the easier it will be to make the necessary arrangements.
Approximately 28 percent of births take place at home in Holland. Homebirth is a safe and viable choice for women. The maternity care system in the Netherlands is set up to support homebirths. Obstetricians and hospitals accept laboring mothers working with midwives when homebirth transfers are medically necessary or wanted.
The World Health Organization (WHO) supports homebirth for low risk women. According to the WHO “It has never been scientifically proven that the hospital is a safer place than home for a woman who has had an uncomplicated pregnancy to have her baby.”
A homebirth study from the British Journal of Medicine found that among 5,000 low risk pregnancies, babies were delivered just as safely at home with a midwife as in a hospital.
The cesarean rate in the Netherlands is 14 percent, the lowest among industrialized nations. The WHO states that no region in the world is justified in having a cesarean rate greater than 10 to 15 percent. Comparatively, the CDC National Center for Health Statistics reports the U.S. cesarean rate is currently 33 percent.
The U.S. spends twice as much or more per capita on health care than any other industrialized nation, yet 28 other countries have lower maternity mortality rates; 41 have lower infant-mortality rates. (CDC) The Netherlands boasts one of the worldʼs lowest infant and maternity-mortality rates. American women preparing to give birth in the Netherlands are fortunate that they are in such competent hands. Healthy births result in healthy babies! 2010
Statistics from WHO:
|Infant Mortality||5 per 1,000||7 per 1,000|
|Maternal Mortality||7 per 100,000||16 per 100,000|
Vaginal Birth After Cesarean (VBAC)
A vaginal birth after a cesarean is the standard of care in the Netherlands. In fact, VBACs are so common here that the Dutch medical community does not have a special word or acronym to describe the practice.
The Dutch healthcare system provides you with a kraamverzorgster, or home maternity nurse, to help you out with your care and your babyʼs care immediately after delivery. According to mothers in the AWCA, this exceptional service is one of the best aspects of having children in the Netherlands. Dutch insurance covers a home care nurse for 3 to 8 hours per day for 8 days after the birth of a child. These nurses help care for both baby and mother, and can be relied on for light cleaning and even a few trips to the Albert Heijn! You will need to reserve a kraamverzorgster early in your pregnancy, as they get booked up quickly.
Also beginning in the first few days of life, the Dutch GGD (Gemeentelijke Geneeskundige en Gezondheidsdienst) provides well-baby care for children birth to age 4 through their well-baby clinics (consultatiebureaus). A nurse usually comes to your home for your first appointment; then from about three weeks of age, you bring the baby to your local consultatiebureau. The doctors and nurses at these offices provide immunizations and hearing tests, as well as charting your childʼs growth, development and general health, free of charge. Though the immunizations provided are roughly equivalent to those given in the States, some differences may be noted.
Registering Your Child
Dutch Government (Gemeente): You will need to register the birth of your child within 3 workdays at your local Staadsdeel office; the midwife or hospital will give you the papers and information necessary to do this. In addition, women who are not married to their Dutch partners need to make sure that their partner claims paternity prior to delivery to ensure that the child gets a Dutch passport and citizenship.
If both parents are non-Dutch, you will have to return to the Gemeente after obtaining your childʼs passport to change its Nationality Status with the Dutch authorities from “Unknown” to “American.”
American Consulate: If you have a child while in the Netherlands, you need to file for a Consular Report of Birth Abroad (CRBA). This is how your child receives U.S. citizenship and is the first step to getting a U.S. passport. Because of the time involved, donʼt wait to submit your CRBA application. It can take up to three weeks for the CRBA and passport to be ready. To apply for the CRBA you will need:
- Current passports of mother, and spouse or partner if applicable
- The CRBA application forms (DS-2029)
- Your childʼs original Dutch birth certificate
- Originals of your current marriage certificate, previous divorce certificates, and death certificates of previous spouses (if appropriate)
- Original documents showing your presence in the United States
- Be sure to get the “international version” which includes the English translation
- If you are married and only one parent is American, provide original documentation of five years of presence in the United States.
- If both parents are American, you need to only show residency in the United States for any point in time. (school transcripts, W-2 Forms, etc)
- If you are an unmarried American mother, you must show you were in the United States for one full year at any point before your child was born. (school transcripts, W-2 Forms, etc.)
- Unmarried American fathers must document five years of presence in the United States as well as fill out form DS-5507, which is a pledge to support the child until they are 18 years old.
Complete details and instructions for making an appointment at the U.S. Consulate to apply for the CRBA and passport can be found on the Consulate website.
Vaccination is not required for children to attend school or day care in the Netherlands.
This brochure is a reflection of the personal experiences of the writers and the many AWCA members who contributed recommendations, but is not intended to be comprehensive. For more information about pregnancy, childbirth and raising children in the Netherlands please refer to Babies and Toddlers: The ACCESS Guide to Having Children in the Netherlands, as well as the other resources listed in this guide.