Pregnancy and birth in the Netherlands: the verloskundige, what insurance covers, and what you pay yourself

A healthy pregnancy in the Netherlands is led by a verloskundige (midwife), not by a hospital doctor. She is an independent medical professional with her own practice in your neighbourhood. In the Netherlands you do not need a referral. You contact a midwife practice yourself. You only see a gynaecologist if there is a medical reason. This guide covers what to arrange in which week, what the basic health insurance pays, and the amounts you pay yourself in 2026. It also covers the paperwork around the birth: recognising the child, the surname choice, the 3-day birth registration, the baby's insurance, and parental leave.

An eerstelijns (first-line) verloskundige works in a practice in your area and looks after healthy pregnancies. She checks your blood pressure, follows the growth of the baby, explains the prenatal screening, guides the birth and visits you afterward. A tweedelijns (second-line) verloskundige works in a hospital alongside a gynaecoloog (obstetrician). This is called a klinisch verloskundige. She has extra training for pregnancies with a higher chance of problems. Examples are diabetes, high blood pressure, or a baby that is not growing as expected.

You move from the first line to the second line through a referral (verwijzing) from your own midwife. Zorginstituut Nederland lists the usual reasons: high blood pressure, complications in an earlier pregnancy or birth, a finding in the unborn child, or growth that differs from what is expected. The referral can cover the whole pregnancy or only part of it. When the medical reason ends, you go back to your own midwife. Both routes are paid from the basic package.

Most midwives work in a group practice. They take turns between consulting hours and on-call shifts, so you meet several midwives during your pregnancy, and the one on duty attends your birth. Some practices work one to one, which is called caseload verloskunde. Practices usually cover a postcode area, so that they can reach you quickly in an emergency. When you compare practices, ask how many midwives work there, how many births they attend per month, and which postcodes they serve.

You register as soon as you have a positive pregnancy test. The first appointment is usually around week 8. You have at least thirteen appointments across a pregnancy. The rhythm is one appointment in the first trimester, then every 4 to 6 weeks from week 12. From week 24 it is every 3 weeks, from week 32 every 2 weeks, and weekly from week 37. Six weeks after the birth you come back once for a final check (nacontrole). You find practices by searching for "verloskundigenpraktijk" plus your postcode or town. Your huisarts (GP) can also name the practices that cover your address.

Before any screening you have a longer conversation with your midwife, called counselling. She explains what each test looks for and what a result would mean. You decide afterward which tests you want. No test is compulsory. The counselling conversation is free.

The NIPT costs you nothing. The government pays for it for every pregnant person under care in the Netherlands, whatever your age. When there is a medical indication, the insurer pays instead, and it still does not touch your eigen risico. Follow-up tests after an abnormal result are different. The vlokkentest and the vruchtwaterpunctie come from the basic package and can count toward your eigen risico. Ask your insurer how much of it you have left for the year.

The 20-week scan looks for physical conditions such as spina bifida, heart defects and kidney problems. It takes about 30 minutes and the sonographer tells you the result straight away. In about 5 of every 100 pregnancies the sonographer sees something that may be a condition, and you can then choose follow-up examination. The 13-week scan is similar but earlier and less detailed. In the Netherlands you can only have it as part of the IMITAS scientific study, which is looking at the advantages and disadvantages of scanning this early. Your midwife will explain the study before you choose.

The pregnancy blood test is offered at your first appointment, usually around week 12. It tests for hepatitis B, HIV and syphilis, and it determines your blood group and whether you carry antibodies against blood groups. All three infections can be treated during pregnancy to protect the baby, which is why the test is offered early. It is voluntary and free. Four weeks after the blood is taken, the results also appear in MijnRIVM.

If your pregnancy is healthy and no extra risks are expected, you give birth in the first line and you choose the place yourself. Your own midwife attends in all three cases, supported by a kraamverzorgende (maternity care assistant).

• At home (thuisbevalling). Your own midwife and a kraamverzorgende come to you. The basic insurance covers it in full and it does not touch your eigen risico. About half of home births move to hospital during labour, usually without urgency. In 3 of every 100 the transfer is by ambulance. At home you can use a warm shower, a birth pool you rent yourself, position changes, massage or a TENS device, but no pain medicines.
• In a birth centre (geboortecentrum). A room with a home-like feel and the equipment of a delivery room, often inside or next to a hospital. Your own midwife attends. Some centres offer lachgas (nitrous oxide) as pain relief. No other medical pain relief is available there. You usually go home 2 to 4 hours after the birth. You pay an eigen bijdrage.
• In hospital without a medical reason (poliklinische bevalling). Your own midwife attends in a hospital delivery room. You drive there yourself when labour starts. You usually go home 2 to 4 hours after the birth. You pay an eigen bijdrage.
• In hospital with a medical reason (medische or klinische bevalling). A clinical midwife or gynaecologist takes over. Reasons include twins, a birth after an earlier caesarean, an induction, or a health problem in you or the baby. There is no eigen bijdrage.

Pain relief changes the category. Lachgas can be given by your own midwife if she is trained for it, and it does not end a poliklinische birth. For an epidural (ruggenprik) your midwife hands you over to the hospital team. From that moment your birth is a medical birth, not a poliklinische one. That is why an epidural cannot be planned into a home birth.

Maternity care does not count toward the eigen risico (the €385 deductible). That includes midwife care, the birth and kraamzorg. It also includes the prenatal screening tests and costs directly connected to the pregnancy or birth, such as treatment within 6 weeks after the birth for a condition caused by the birth. Our eigen risico guide explains how the deductible works for everything else.

You still pay three kinds of cost. First, the eigen bijdrage on kraamzorg and on a birth without a medical reason. Second, costs during the pregnancy that are not directly maternity care: your medicines, transport to hospital or home, and blood tests. Those do come out of your eigen risico. Third, anything the basic package does not cover at all, such as a pretecho or most pregnancy courses. The coverage gaps guide lists the rest.

The eigen bijdrage amounts are set by the government and are the same at every insurer. They change on 1 January. For a birth without a medical indication, the hospital or birth centre sets its own price on top of the €45. Your insurer reimburses at most €278 per day after the eigen bijdrage, and you pay anything above that. Ask the hospital what it charges before you choose a poliklinische birth. Two things cancel the eigen bijdrage: getting a medical indication during the birth, and using lachgas as pain relief. Many aanvullende verzekeringen (supplementary policies) reimburse part or all of these contributions, so check your policy while you are still pregnant.

Kraamzorg is maternity care at your home in the days after the birth. A kraamverzorgende comes to you every day and:

• checks your recovery and the baby's weight, temperature and feeding
• helps with breastfeeding
• teaches you how to care for a newborn
• keeps the bedroom and bathroom hygienic
• looks after your other children

It is not household help. Cleaning the living room or washing the windows is not part of it. The same person also supports the midwife during the birth itself, which is called partusassistentie.

You have a right to a minimum of 24 hours and a maximum of 80 hours. The standard indication is 49 hours, spread over the first 8 days after the birth. In some cases the care runs to day 10, and the law allows kraamzorg up to 6 weeks after the birth in specific situations. Straight after the birth the kraamverzorgende and the midwife decide together how many hours you get. Complications, an admission to hospital for you or the baby, and breastfeeding all change the number.

You arrange it yourself. Many organisations accept registrations from the twelfth week of pregnancy. Register that early, because some providers are full well before the due date. You choose the organisation, but check first whether your insurer has a contract with it, since that changes what you get reimbursed. Around week 30 you have an intake conversation, in which the organisation estimates your hours. If a shortage of staff means you are offered fewer hours than agreed, say so to the organisation and to your midwife.

If you are married or in a registered partnership, the partner is automatically the second legal parent and nothing extra is needed. If you are not, the partner has no legal relationship with the child until he or she recognises it. That act is called erkenning. It is free.

You can do it during the pregnancy, at any gemeente in the Netherlands. This is called erkenning van de ongeboren vrucht. You can also do it at the birth registration, but then only at the gemeente where the child was born. Both parents normally go together. If the mother cannot come, she must give written consent. Doing it during the pregnancy is the safer choice. It removes the time pressure in the first days after the birth, and it settles the legal position if the birth goes differently than expected.

Recognition has real consequences. You become the legal parent. Since 1 January 2023, a recognition also gives you joint parental authority (gezamenlijk gezag) with the mother automatically. You need that authority to register the child at school, apply for a passport, travel abroad with the child, or see its medical file. You owe maintenance until the child is 21, and you and the child become each other's legal heirs. If you hold Dutch nationality, the child you recognise gets it automatically, provided you recognise the child before it turns 7.

The surname choice is made at the same moment. Since 1 January 2024 a first child born on or after that date can carry the surnames of both parents. Whatever you choose for your first child also applies to every later child, so this is a one-time decision for the family. You must record it before the birth or at the birth registration, and both parents must appear at the burgerlijke stand (civil registry) together. One parent alone cannot do it, and it cannot be done in writing. If you record nothing, the law decides: a child of unmarried parents gets the mother's surname, and a child of a married man and woman gets the father's.

You must register the birth (aangifte van geboorte) within 3 days, at the gemeente where the child was born. That may not be where you live. The day of birth itself does not count. If the deadline falls on a Saturday, Sunday or official holiday, you get one extra working day, and you always have at least 2 working days in total. A child born on Monday must be registered by Thursday. A child born on Friday must be registered by Tuesday.

The father or duomoeder (the mother's female partner who is the legal second parent) must do it. The mother who gave birth may, but does not have to. If none of them can, the law names who registers instead:

• someone who was present at the birth
• the owner of the house where the child was born
• a member of staff of the institution where it was born, such as the hospital

You do not bring the baby. Bring valid ID. Bring the deed as well if you arranged erkenning or the surname choice before the birth, because its details go into the birth certificate. The hospital or midwife usually gives you a statement of birth (verklaring van de geboorte). It is useful to have but not required.

Registration is free. A copy of the birth certificate (afschrift van de geboorteakte) costs money, and you will need one for some later applications. Some municipalities let you register online, and only the father or the mother can do that. Check your gemeente's website, because it differs per municipality. If you register late, the registrar reports it to the Openbaar Ministerie (Public Prosecution Service) and you can be fined. The registration gives your child a burgerservicenummer (BSN), which everything else depends on. The BSN and gemeente registration guide explains what that number is used for.

A newborn is not insured automatically. You must register the baby with a health insurer within 4 months of the birth. Do it as soon as you have done the birth registration, because you need the child's BSN. If you register inside the 4 months, the basic insurance starts retroactively from the date of birth, so care given in the first days is covered. If you register later, cover starts on the day you register, and you pay any care costs from before that date yourself. For a baby who needed an incubator, that difference runs into thousands of euros.

You may register the baby with your own insurer, with the other parent's insurer, or with a new one. Children under 18 pay no premium and have no eigen risico. If the parents are with different insurers, register the child with the one whose supplementary cover is broader, because the child then benefits from it. If you are not yet insured in the Netherlands yourself, sort that out first. The health insurance guide covers the deadline and the zorgtoeslag that can pay part of the premium.

You have a right to 6 weeks of zwangerschapsverlof (pregnancy leave) and at least 10 weeks of bevallingsverlof (maternity leave), so at least 16 weeks in total. Pregnancy leave must start at the latest 4 weeks before the day after your due date. Maternity leave starts the day after the birth. If the baby comes late, the maternity leave is not shortened and your total leave becomes longer than 16 weeks. If the baby comes early, the days you lost from the pregnancy leave are added to the maternity leave, so you always get 16 weeks.

You request the leave from your employer at least 3 weeks before it starts, which means at least 7 weeks before your due date. Ask your midwife or huisarts for a zwangerschapsverklaring and keep it in your own records. Your employer may not refuse the leave. Your employer then applies to UWV for the benefit and normally keeps paying your salary as usual.

The partner gets one week of geboorteverlof at full pay from the employer, to be taken within 4 weeks of the birth. On top of that come up to 5 weeks of aanvullend geboorteverlof, paid by UWV at up to 70% of the dagloon. The employer applies to UWV and pays the partner. The additional weeks must be taken within 6 months of the birth, and only after the first week has been used. UWV pays a partner who has recognised the child, is married to the mother, is her registered partner, or lives with her and shares the housing and household costs. After that, each parent can take 9 paid weeks of ouderschapsverlof at 70% in the child's first year.

Two situations work differently. If you receive a WW, Ziektewet or wage-related WGA benefit, you apply to UWV yourself, at least 8 weeks before your due date. If you are self-employed, you may qualify for the ZEZ benefit (Zelfstandige en Zwanger, the maternity benefit for self-employed women), which lasts at least 16 weeks. The ZZP guide covers the wider position of freelancers. If your baby stays in hospital longer than a week, you can apply to your employer for extra maternity leave under the couveuseregeling (the incubator rule). That is up to 10 extra weeks, with the first week not counted.

The birth registration comes first. Everything else follows from it. In the first week a screener from the youth health service visits your home for the hielprik (heel prick) and the hearing test. From about one month the consultatiebureau (child health clinic) invites you for free child checkups and the vaccinations of the national programme. The GGD and consultatiebureau guide explains that schedule. The SVB starts kinderbijslag (child benefit) for a child born here. The kinderbijslag guide gives the 2026 amounts and the payment dates. Depending on your income you may also get kindgebonden budget (an extra income-based allowance for parents) on top, which is covered in the toeslagen overview. If you plan to go back to work, apply for a childcare place early and check kinderopvangtoeslag (the childcare allowance) in the childcare guide.

In many countries a positive test means booking an obstetrician, and the huisarts arranges every referral. In the Netherlands you contact a verloskundige practice yourself, and there is no waiting for a referral. If you wait, you miss the first appointment around week 8. The blood test and the NIPT are then also late. Call a practice the week your test is positive. If the practice that covers your postcode cannot take you, ask them which nearby practices still have space. They know their neighbouring practices. Practices also run kinderwensspreekuren (consultations for people planning a pregnancy) before you are pregnant, so you can meet one in advance.

Kraamzorg is often arranged too late. Providers accept registrations from week 12 and some are full months before the due date. Registering costs nothing and commits you to nothing. If every provider in your area is full, ask your midwife which organisations she works with, and ask your insurer for the list it has contracts with. A late registration can leave you with fewer hours than the standard 49, at exactly the point when the help matters most.

Choosing a hospital birth for comfort rather than for a medical reason is a poliklinische bevalling. You pay at least €45 per day, plus whatever the hospital charges above the reimbursement limit. An epidural is different: it means your midwife hands you over to the hospital, which makes the birth a medical one, and the eigen bijdrage falls away. But a hospital birth is never free of every cost. Medicines, transport and blood tests still come out of your €385 eigen risico. Ask the hospital and your insurer for the amounts before you decide, and check whether your supplementary policy reimburses the eigen bijdrage.

The screening blood test for hepatitis B, HIV, syphilis, blood group and antibodies is paid by the government. Laboratories often draw extra blood in the same appointment for tests the government does not pay, such as glucose or iron levels. Those come from the basic package and count toward your eigen risico, so a bill can follow months later. Ask at the blood draw which tests are being done and which are outside the screening programme.

If you leave the recognition until after the birth, both parents must visit the burgerlijke stand together in the first days. Those are the same days as the 3-day registration deadline and a newborn at home. Until the recognition, the partner is not a legal parent, has no parental authority, and cannot claim aanvullend geboorteverlof from UWV. The surname choice is made at the same appointment. Arrange the erkenning and the name choice during the pregnancy, at any gemeente. It costs nothing and takes one appointment.

The leave is a legal right and the employer cannot refuse it. But the request has a deadline: at least 3 weeks before the leave starts, so at least 7 weeks before your due date. The employer needs that time to apply to UWV, otherwise your payment can be delayed. Ask your midwife for the zwangerschapsverklaring at an appointment well before week 30, and put the request to your employer in writing so the date is recorded. Your employment contract guide covers what else changes when you go on leave.

Nothing reminds you. The insurer does not add the baby to your policy by itself, and the gemeente does not do it for you. After 4 months, cover starts only from the day you register, and every bill from before that day stays with you. Register the baby in the same week as the birth registration, keep the confirmation, and check your policy overview a month later to make sure the child is actually on it.

Two other guides cover what comes next. The GGD and consultatiebureau guide covers the checkups and vaccinations from birth to age 4. The eigen risico guide explains the deductible that starts applying again to everything outside maternity care.