Now comes the tricky bit. The most important decision to make is whether you want a home or hospital birth. Your midwife will ask you this at the first visit, and it will determine which midwives you are allocated, since some do homebirths and some hospital births. Approximately 50% of people here choose to have a homebirth, 50% hospital (some for medical reasons of course have to). In the event, only about 30% of people actually have a homebirth, as there are later reasons for going to hospital. Everyone has their own feelings about these things, and of course you should do what feels right for you. Your midwife will ask you at your first visit which you want. Having had two home births myself, I think they are great, but you will not be turned away if it's not your thing! You will also need to have a 'kraampakket' at home and will still need to raise up your bed. I must also add that I have two friends who have fully intended to have their (second) baby in hospital, but never made it that far and ended up having a surprise homebirth! And very proud of themselves they were too. So especially with a second or consequent baby, it's as well to be prepared.
Being in hospital does not mean that you will be offered pain relief, as it's not offered as standard here. If you are certain you want an epidural, it's best to say so straight away. As in all health care here, they are fairly non-interventional. If you want something, therefore, you need to ask for it. Do your research, get informed, and ask for what you want and you will usually get it. Don't listen to people who love to moan about the system: it is what you make it. Most couples know what happens in their country amd have problems adjusting to a system that is a little different. If you don't mind going to The Hague, Bronovo hospital gives two hour information evenings every month explaining the health care and the childbirth system. Late last year there was a directive sent out that all hospitals must offer 24 hour epidural / pain relief. The Bronovo hospital in Den Haag is now known as the Expat hospital. See their website www.bronovo.nl for more information.
Be aware that since you will probably remain at home for most of the labour, so you should read the section on preparing for a homebirth too. After the birth if everything is normal, you will be discharged a few hours after the birth depending on the time of day
If you choose for a homebirth, all your appointments will be in the midwife's practice. They start off at once a month, up to once a week (towards the end of the pregnancy). It is important that you choose a Kraamzorg (maternity care) company at around 12 weeks, because they soon become fully booked and then register with them (see Kraamzorg section below). They will come to your house before the birth to see that everything is ready, will be present at the birth and will come in to help you every day for the week after the birth.
Personally, I would warmly recommend having an additional birth partner for a home birth. I had a close female friend with me as well as my husband for both my homebirths, and it was absolutely fantastic. There is a lot to do, and the midwife is not there for most of the labour. Having two people means that one of them can go to the loo/ring the midwife/eat/make a snack/have a break while the other stays with you. It enables them to consult with each other, and to take shifts if necessary. Ideally, this person should also speak some Dutch, so that you don't have to translate, but most of the heathcare professionals I have come across speak at least some English or French and so it is not imperative. You can also hire a doula: a professional who will support you personally and individually through the pregnancy and during the birth. There is an English-speaking doula in Leiden, a lovely woman called Sarah Reakes.
Contact Sarah on firstname.lastname@example.org for more information or go to www.doula.nl and click on 'doula vinden'.
There is also a new doula practice opening up in Noordwijk. Birte Dettmann-Wohlers has recently begun to take on clients.
www.doulapraktijknoordwijk.nl or www.expat-doula.nl
Phone: 06 39 50 50 89
Having a baby in a foreign culture, far away from family and support network is a tremendous challenge in itself. This can give extra stress and an uncomfortable feeling to you and your partner. Speaking from my own experience, this lack of personal support network from family and friends is the biggest reason why a Doula could be meaningful to you. A Doula will be able to provide her clients with continuous emotional and practical support, lots of knowledge and information about what to expect during labour and delivery. I offer continuous support during the whole delivery and can help to protect you from miscommunications due to language barriers and cultural differences, as I do speak the Dutch, English(and German)language fluently and am aware of the Dutch culture due to my own expatriate stay. When a woman feels safe, and trusts that she and her baby are in good hands during pregnancy and childbirth, she is more likely to relax, which can be crucial for an uncomplicated delivery. I hope to be able to help you create a memorable experience giving birth to your child in the Netherlands!
If you have a medical condition that might cause problems, a previous caesarean, complications, or are in any way considered 'high risk', you will need to have a hospital birth. You can also choose to have a hospital birth (if it is by choice the cost to your insurance is higher). Be aware that unless there are complications you will still only have midwife care, although if you are adamant that you want a gynaecologist it may be possible for you to push for one. They will not admit a 'straightforward' labouring mother into hospital until your contractions are less than 3 minutes apart for a first baby, so much of your labour will still be done at home under the intermittent care of your midwife. You will be sent home if you go into hospital before she deems it necessary to do so!
Do also be aware that you may be sent home as soon as a few hours after the birth, so don't count on a long period of cosseting in hospital! Of course if you have had a caesarean or complications, a longer stay may be involved: this will reduce the hours of kraamzorg care to which you are entitled, although you may be able to buy some hours back on request.
You have a choice of hospitals: