A colleague sent out an email to those of us at the office who have recently had kids, asking for information and input for a friend about living in the Netherlands, especially with regard to having a baby and raising a child here. In true Krees fashion, I sent her a treatise. Then I realized that all the information (with a little opinion) might be useful to others. So here it is.
The Dutch view of pregnancy is that it's a natural part of life and
shouldn't be interfered with too much from a medical perspective. I
believe(*) that if you have a normal, healthy pregnancy, your prenatal
visits are with your local doctor / general practitioner called the
"huisarts", and not with an obstetrician or gynaecologist. I don't
happen to know how frequent the visits are or how many ultrasounds are
routinely given. (*We had complications getting pregnant, so I was able
to get a referral to the ob/gyn department of the local hospital and
have had all monthly prenatal check-ups there, including an ultrasound
at nearly every visit. Toward the end of my first pregnancy they saw me
30% of Dutch women still give birth at home with the assistance of a midwife and huisarts. This is probably more common and available in larger cities. Both of my pregnancies have been in small villages where there are not enough births to keep the huisarts very practiced with birthing. I've been required to deliver in a hospital, which is fine with me.
Maternity matters - What to expect in the Netherlands
Because of the tradition of giving birth at home with a midwife, it's also not common to use epidurals or other pain meds during labor and delivery here. Most Dutch mothers give birth without it. Even though I was in a hospital for my first delivery in 2007, I don't think I would have had the option of getting an epidural because it was the middle of the night and there may not have been an anesthesiologist available. (Personally, my preference was to give birth without meds, and fortunately I had a fairly easy delivery. But should it have been more difficult, I think I would have liked to have had the option available!)
I believe the government now requires hospitals to be able to provide pain meds to birthing mothers who want it. The article I read, however, says this is in the "guidelines" - which doesn't sound like law to me:
Epidurals now standard practice in Dutch hospitals
If you do give birth in the hospital and there are no complications, you can expect to be discharged in just a few hours. However, your health insurance covers the cost of "kraamzorg". This is post-natal care provided by a professional nurse(?) who comes to your house every day for the first week to make sure that you and the baby are both doing well, that you're able to breastfeed successfully if you so choose (the Dutch are big on breastfeeding!), and also to help with a few chores like changing the bedsheets, cleaning the bathrooms and doing laundry so that you can get some extra rest!
Kraamzorg - Postnatal Care in the Netherlands
I have a higher level of health insurance which, as Charles said, has covered almost everything, including doctor's visits, regular ultrasounds, blood tests, labor/delivery and "kraamzorg" care. The only pregnancy-related costs have been for a couple special ultrasounds to check for indications of birth defects. I imagine the basic level of health care would cover the same, but human resources should be able to tell you.
Charles mentioned the amount of maternity leave (4 weeks before your due date, 12 weeks after birth, all paid at your full rate, plus [our institute] gets money to pay for your replacement while you're on leave). I don't know if this is standard government-required leave or if it's specific to [institute]. And he was right that if you choose to breastfeed, they are obligated to provide a private place for you to pump. I think most Dutch women stop at three months when they return to work, but I was able to continue for 12 months after returning to work.
I think it's easier to find childcare where we live than in some other parts of the country. (It's WAY easier than in Germany where I understand it's nearly impossible to find daycare.) There are "kinderopvang" creches where your child goes to a nursery with lots of other children, and there are also providers (an "oppas") who take children into their homes.
The government gives you money toward childcare. In our case (my husband works full-time, I work half-time), we get something like 400+ euros/month which covers about 80% of the daycare cost. Last year the government discovered that they had REALLY underestimated the amount of money they would be paying out for this daycare subsidy. I thought we would see our reimbursement drastically cut this year, but I don't think they've cut it at all.
A short guide to childcare in Holland (Expatica)
Day-care costs through the roof (Expatica, 26 March 2008)
Cuts in child care subsidies unite opposition (Expatica, 9 September 2008)
There are also options for returning to work part-time for nearly full-pay during the first year for both mother and father.
All in all, the Netherlands is a pretty good, safe place to give birth, and it's definitely a good/supportive place to raise a child. But as Charles mentioned, society here is also really more oriented toward women working part-time rather than full-time (in my opinion). Shops and banks regularly close at 6pm or earlier, are often closed Monday mornings and at lunchtime, and are closed completely on Sundays. I don't know how a family with two full-time workers (or even single, full-time workers) do it. I guess that's why employees get so much vacation time - so we can do our banking and trips to the druggist!
More info available at:
I amsterdam - Family and Health articles
Since writing this up, there have been a couple additional news items that may be of interest:
Home births as safe as hospitals
Dutch children's wellbeing best in Europe