Midwife care and home birth in the Netherlands, explained for expats

Updated October 13, 2026 · sources checked October 13, 2026

In short

In the Netherlands, a healthy pregnancy is looked after by a community midwife (verloskundige), whom you contact yourself; the first visit is usually between weeks 7 and 10. The midwife refers you to a gynaecologist if there is a medical reason. You can give birth at home, in a birth centre or in hospital; a home birth is fully covered by basic insurance.

Why a midwife and not an obstetrician

If you come from a country where every pregnancy is followed by an obstetrician, the Dutch model can feel unsettling at first. It is built on a clear division of roles.

Primary care (eerste lijn): the community midwife. For a healthy pregnancy and birth, care is usually given by a verloskundige, a midwife who works independently in the community, often in a group practice. Zorginstituut Nederland notes that a GP or gynaecologist can also provide this care, and that few GPs still do.
Secondary care (tweede lijn): the hospital team. When there is a medical reason, the midwife refers you to a gynaecologist. In hospital, care is often given by clinical midwives and doctors training as gynaecologists, under the gynaecologist's final responsibility.

KNOV, the Royal Dutch Organisation of Midwives, explains on its English page that women refer themselves to a midwife, and that community midwives provide care in outpatient centres, birth centres, hospitals or at home, transferring to obstetrician-led care when necessary. Midwifery training in the Netherlands is a 4-year direct-entry bachelor's degree.

Is it normal?

Being in midwife care does not mean you are on your own. It means nothing currently calls for a specialist. The midwife's job includes assessing risk at every visit and referring you as soon as something needs a doctor.

Your first appointment

Contact a midwife practice near your home as soon as your test is positive. Zorginstituut Nederland says the first appointment is usually between the seventh and tenth week.

According to Zorginstituut Nederland, your midwife:

checks your health and your baby's growth throughout the pregnancy;
assesses your risks and refers you to a gynaecologist, GP or paediatrician if needed;
explains prenatal screening, its aims and your options;
helps you with practical matters: registering with a kraamzorg agency, writing a birth plan, pain relief and the places where you can give birth;
provides care during and after the birth.

The midwife can also refer you to other professionals, for example if you have debts or psychological problems.

Bring your questions on paper: it helps when you are tired or nervous, and when the conversation is not in your first language.

Which hospital do you work with, and where is it?
What is your emergency number, day and night?
Do you offer appointments in English?
When do I register for kraamzorg?
What happens if I want an epidural?
Which scans and tests are offered, and when?

Scans and tests, and who pays

Test	When	For whom	Paid by, per Zorginstituut Nederland
Dating scan (termijnecho)	Between 10 and 14 weeks	All pregnant women	Basic package
Counselling about screening	At or after the first visit	All pregnant women	Population screening programme
Blood test (infections, blood group, antibodies)	Early pregnancy	All pregnant women, voluntary	Free, per RIVM
NIPT	From week 10	With a medical indication	Basic package
NIPT	From week 10	Without a medical indication	Population screening programme (free, per RIVM)
13-week scan	Around week 13	All pregnant women, voluntary	Subsidy scheme
20-week scan	Around week 20	All pregnant women, voluntary	Subsidy scheme
Extra scans, CVS, amniocentesis, advanced ultrasound	As needed	With a medical indication	Basic package
Keepsake or gender scan (pretecho)	Any time	By choice	Not reimbursed

The RIVM screening site explains that your midwife first asks whether you want information about the NIPT and the 13- and 20-week scans. You can say you prefer not to know, or have an in-depth counselling conversation and then decide. If your blood group is Rhesus D-negative or Rhesus c-negative, you are offered an extra blood test at 27 weeks.

When you go to a gynaecologist

Zorginstituut Nederland gives examples of referral to the gynaecologist:

high blood pressure;
complications in a previous pregnancy or birth;
an anomaly in the unborn baby;
a baby growing differently than expected.

The referral can be for the whole pregnancy or part of it. If the medical reason disappears, you go back to your midwife. For the birth, your midwife or GP can refer you to hospital if a gynaecologist needs to supervise the birth because of increased risk, if you need pain relief such as an epidural (ruggenprik), or to prevent you or your baby from running more risk. A birth with a medical indication has no own contribution.

Home, birth centre or hospital

If your pregnancy is healthy and no extra risk is expected at the birth, you give birth in primary care and choose the place.

	Home	Birth centre (geboortecentrum)	Polyclinic hospital birth
Who is there	Your midwife and a kraamverzorgende	Your midwife and a kraamverzorgende	Your midwife and a kraamverzorgende, in a hospital delivery room
Pain relief	No medicines; warm shower, birth pool (to rent), positions, massage, TENS	Some offer nitrous oxide; no other medical pain relief	Transfer to the hospital team for an epidural
Going home	You are home	Usually 2 to 4 hours after the birth	Usually 2 to 4 hours after the birth
Cost	Fully covered by basic insurance, outside the deductible	Own contribution, like a polyclinic birth	Own contribution without a medical indication

Source: De Verloskundige (KNOV) and Zorginstituut Nederland.

What a polyclinic birth costs, as of October 2026

Zorginstituut Nederland lists, for a hospital or birth centre birth without a medical indication:

an own contribution of €22.50 for the mother and €22.50 per baby per day (so €45 a day for one baby);
the insurer reimburses at most €161.50 for the mother and €161.50 for the baby, €323 for one baby; with the own contribution deducted, the insurer pays €278;
if the hospital or birth centre charges more than €278, you pay the difference.

The own contribution disappears if a medical indication arises during the birth, and also if you use nitrous oxide (lachgas) as pain relief during a polyclinic birth.

Is home birth safe?

The midwives' association states that for a healthy woman with a pregnancy that went well, a home birth is as safe as a polyclinic or birth centre birth, with fewer medical interventions. If an intervention becomes necessary, you go to hospital with your midwife: this happens in about half of home births, usually without urgency; in about 3 in 100 women it is urgent and you go by ambulance.

Dutch research supports this for low-risk women in a system where home birth is well integrated:

A nationwide cohort of 743,070 low-risk women in midwife-led care found no increased risk of adverse perinatal outcomes for planned home births (de Jonge et al., BJOG 2015, PMID 25204886). The authors note their results may only apply where home births are well integrated into maternity care.
A national study of 146,752 low-risk women found that planned home birth was not associated with a higher rate of severe maternal morbidity; among women who had given birth before, rates of severe morbidity and postpartum haemorrhage were lower with planned home birth (de Jonge et al., BMJ 2013, PMID 23766482).

Your midwife can help you weigh the options for your own situation.

Preparing your home before 37 weeks

Even for a hospital birth, the care continues at home. The midwives' association lists: a maternity pack (kraampakket), bed raisers, two hot water bottles, a digital thermometer, clean towels, two buckets and bin bags, running water on the same floor, a bag ready in case of transfer, and baby supplies. Our hospital bag checklist helps with the bag.

When to call your midwife

The Dutch midwives' association gives these rules:

Waters breaking before 37 weeks: call straight away, even in the middle of the night.
Green or brown fluid, or a bad smell: call straight away.
Waters breaking from 37 weeks, clear fluid, no contractions: usually you can wait for labour to start; if contractions do not come, call during the day. Follow any calling agreement your midwife has made with you, for example if the baby's head is not yet engaged.
Your baby suddenly moves much less than usual: call your midwife.

For the partner

Save the midwife's number and the kraamzorg number in your phone now, and learn the route to the hospital the midwife works with. At a home birth, your job includes the practical side: bed raisers, towels, the maternity pack, and opening the door to the kraamverzorgende.

Questions parents ask

Do I need a referral to see a midwife in the Netherlands?

No. KNOV explains that women refer themselves to a midwife. Zorginstituut Nederland says the first appointment is usually between the seventh and tenth week of pregnancy.

When will I see a gynaecologist in the Netherlands?

When there is a medical reason, for example high blood pressure, complications in a previous pregnancy or birth, an anomaly in the baby or unexpected growth. Your midwife refers you; when the reason is gone, you go back to the midwife.

Can I have an epidural in the Netherlands?

Yes, in hospital. Zorginstituut Nederland lists needing pain relief such as an epidural among the reasons a midwife refers you to hospital, and a birth with a medical indication has no own contribution. There is no medical pain relief at home.

Is home birth safe in the Netherlands?

For healthy women with a healthy pregnancy, the Dutch midwives' association states that home birth is as safe as a birth centre or polyclinic birth. Large Dutch cohort studies found no higher risk of adverse perinatal outcomes for planned home births among low-risk women.

Sources

Zorginstituut Nederland — Verloskundige zorg (Zvw) checked October 13, 2026
KNOV — Dutch midwifery (English) checked October 13, 2026
De Verloskundige (KNOV) — Thuis bevallen, in het ziekenhuis of in een geboortecentrum? checked October 13, 2026
De Verloskundige (KNOV) — Spontaan gebroken vliezen checked October 13, 2026
De Verloskundige (KNOV) — Bewegingen van je baby in je buik checked October 13, 2026
Pre- and neonatal screenings (RIVM) — The NIPT and the 13-week and 20-week scans checked October 13, 2026
Pre- and neonatal screenings (RIVM) — Blood test during pregnancy checked October 13, 2026
de Jonge A et al. Perinatal mortality and morbidity up to 28 days after birth among 743 070 low-risk planned home and hospital births. BJOG 2015 (PMID 25204886) checked October 13, 2026
de Jonge A et al. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands. BMJ 2013 (PMID 23766482) checked October 13, 2026
Government.nl — Emergency number 112 checked October 13, 2026

Mamavela explains; it does not replace your midwife, doctor or pediatrician, who know your situation. If something worries you, call them. In an emergency, call 911 (US), 999 (UK) or 112.