During my first pregnancy, when I said that I wanted to give birth at home so many people shared their worries and tried to change my mind so that I would have my baby at the hospital instead. With how things worked out with my first delivery, I was expecting that this time around people would be a little more chilled about my decision, but no, it did not change one bit.

It didn't take long for me to realize that most of these worries were coming from a place of fear and being so used to only knowing one way of doing things. Whilst most women who aren't moms yet told me that I am brave for choosing to give birth at home, other women who gave birth at the hospital, over thirty years ago, persist on trying to change my mind and criticize my decision.
I come from Portugal, a country where as far as I know, you'll have no other option other than to deliver your baby at a birthing center or hospital, so I can understand that having a baby at home can be quite of a weird concept. After all, we're talking about two countries with huge cultural differences.

With that in mind, I thought that perhaps it would be nice to share a little bit more about how things work around here when it comes to delivering a baby. Hopefully, it will bring some clarity on the subject of having babies at home and give you more insight on how things can be done differently, as well as to help any of you who, like me, moved countries and are building a family in the Netherlands. This is, of course, all based on my personal experiences, so if you have any new insights on this topic, I would love to read it in the comments!

A brief insight of the birth system in the Netherlands

There are mainly two ways of doing things here in the Netherlands when it comes to giving birth.

A) You decide to have a baby at home.
B) You decide to have a baby at the hospital/birthing center.

This decision is taken solely by you as a mom and no one will push you in one direction or the other unless, of course, you suffer from complications or health issues and need medical assistance. But we'll get to that in a bit.

In the Netherlands it is imperative to have a health insurance. There are many you can choose from depending on your needs and these have consequently different price ranges, being the most basic insurance around one hundred euros per month.

Even though this type of insurance is more than enough for someone who doesn't have any specific health issues, it does not cover the expenses of you deliberately having a baby at the hospital. Meaning that, in case your health provider doesn't see the need for you to deliver a baby at the hospital but you alone wish to do it, you'll be responsible to cover for all the expenses at the hospital.

So, in case you're planning to have a baby in a near future and would like to do it at the hospital without medical indication, you may want to upgrade your insurance beforehand, since some do actually fully refund all of the expenses related to hospital births.

If you decide to deliver at home, then the basic insurance will cover all costs. The same goes in case you have to be transferred to a hospital during labor due to complications or need of medical assistance.

Birth at the hospital

Differently to many other countries in the world, in the Netherlands unless you suffer from severe complications or need further medical assistance after birth chances are you're out of the hospital within just a few hours after the delivery, and I mean three to four hours in case of a normal delivery.

So the process works more or less the same as everywhere else with the exception that you don't have an extended stay at the hospital. You get admitted when you're in labor, you deliver the baby, take a shower and as soon as the doctors/nurses make sure you and the baby are doing good you're dispatched home. This is all in case of a normal vaginal delivery, I'm not sure how long you have to stay in case of a c-section or other complications, I guess it depends on each case.

Birth at home

In order to have a delivery at home, there are a few things you'll need to have prepared in advance, such as having your bed raised in case it is too low (you can rent some bed lifters for free), having a garbage bin in the room and a maternity package. The maternity package provides things such as cotton buds, alcohol, mattress protector, compresses, sanitary towels, etc., that will be used by the midwife during the delivery and assist you after the birth as well. You can either buy the maternity package yourself or your insurance will send you one a few months prior to the due date.

Once you're in labor a midwife comes to your place to check how progressed you are and see if there's anything you still need to arrange for the delivery. In case you allow it, the midwife may also be accompanied by a student midwife who will, under supervision, check up on you as well. Depending on your progression, the midwife may stay for the delivery or go away and come back later. 

This is also the time where you'll need to contact the kraamzorg (maternity care), who will provide assistance to you and the midwife during and after the delivery, but I'll get to that in a bit.

In case everything goes well with your delivery - awesome! Your baby and yourself will be checked and once the midwife is sure that everything is stable and both you and the baby are doing well, she will leave your home and the maternity nurse will then stay providing you assistance for a little longer if you'd like. However, if during or after the delivery there's a faint worry or need for medical assistance, you'll be immediately transferred to a hospital. In this case the maternity nurse will no longer be present, but the midwife should stay with you in order to exchange information with the doctors and, if needed, provide you support during the delivery.

So simply put, you're not delivering a baby alone or unassisted. You're actually in the hands of experienced and well equipped midwifes who have accompanied your journey from the beginning and who will put your and the baby's health above all and whenever in doubt will prefer to transfer you to the hospital, even if just for precociousness like it happened during my first birth - you can check the full story here, in case you're interested.

Assistance after birth

The Netherlands also provides a service called kraamzorg (maternity care) which consists of having a maternity nurse coming to your house everyday during the first seven to ten days after the delivery, in order to check on the mom and baby's health and assist with any worries that the new parents may have as well as to help out with cleaning, taking care of the baby while you shower, etc..

This is a paid service that you can hire at a minimum of 24 and a maximum of 40 hours independently of having a baby at the hospital or at home. These hours will be equally divided throughout the eight days after the delivery. So say, for example, that you have a contract of 24 hours, you'll then have the visit of the maternity nurse for three hours each day. Depending on your insurance and the kraamzorg company you hire, you may be requested to give a personal contribution which is usually around 4 euros per hour, or you'll be refunded for these expenses.

I find this to be a great support system, especially for first time parents, since the maternity nurse will ensure that the mother is healing well and that the baby is growing healthy at all times. She will keep track of yours and your baby's progress, which will later on be shared with your midwife, who will visit you a few days after the delivery to make sure you're doing good. In case of any extra help, assistance or doubts you can speak to either of them who will best advise you depending on your concerns. There's also support groups available to anyone such as for breastfeeding and even for just socializing with other moms and babies, which is great.

A few weeks after the delivery, you'll also receive a visit from a nurse who will run a few tests on your baby, such as the heel prick and a hearing test. I find this to be super convenient because this way you don't need to go through the struggle of leaving your home with a newborn for something that takes a maximum of 20 minutes to complete.

After this, at around four weeks, you'll start attending regular appointments at the consultation office to check on your baby's development and general health, as well as you can just come in on specific days with no appointment, just to check on the baby's weight and clarify any doubts you may have personally with the nurse. These appointments last until the child is four years old.

My personal view

Giving birth to me is one of the most natural and primal things in life. As someone who has always been healthy and confident in the process of giving birth, I wanted to keep things as natural and drug free as possible.

I've decided to give birth at home both times so far for no particular reason other than I knew I would feel more comfortable and relaxed doing so. My home is my nest, if you will. Here, I know all of my surroundings, I feel secure, I can move around freely and do everything at my own pace. All of these are major contributors for me to feel relaxed and enjoy the process as much as possible, which I find it to be so important when delivering a baby.

Having that said, births never go the way you plan and because of that I entered this journey with a complete open mind. I knew from the beginning that ending up at the hospital was a possibility and I was completely fine with that too. If I'd changed my mind or was in need of medical assistance, it would take be a maximum of ten minutes to reach the nearest hospital. But given the option to choose, I knew I would personally feel much less anxious if I could at least start the delivery process in the comfort of my own home.
You see, I don't have anything against hospitals, drugs or doctors, but the same way I'll only use these resources when in actual need, the same goes when it comes to giving birth.

I don't think I'm braver than anyone else for choosing to have a baby at home or an un-medicated birth. Delivering a baby at home is not for everyone as chocolate is not everyone's cup of tea, and that is totally fine! We are all different, we have different ways of functioning, different ways to deal with pain and emotions. The most important thing is that we feel completely comfortable and confident in our own decision and no one should ever interfere in that or try to make us feel scared of the natural process that is delivering a baby.

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