The Dutch maternity care system is largely based on midwife-led care, with services available throughout pregnancy, childbirth, and postpartum. While most women in the Netherlands can access maternity care, recent reports highlight disparities, especially in disadvantaged areas where care may be less available. Efforts continue to improve accessibility for all women, including vulnerable populations.
Standard Maternity Care Model
In the Netherlands, women typically receive care from community midwives, who assist with pregnancy and childbirth. Midwives operate independently in nearly 600 practices nationwide, providing individualised care through a series of antenatal appointments, usually around 12, with increasing frequency as labour approaches. When complications arise, women are referred to hospitals for secondary care.
Since 2011, the Netherlands has implemented group-based antenatal care models, such as CenteringPregnancy, where groups of women meet regularly to share experiences and receive medical and psycho-social support. This model has become increasingly popular and is offered by about one-third of midwifery practices, improving engagement among women in both vulnerable and non-vulnerable groups.
Access in Disadvantaged Areas
Despite broad coverage, research indicates that women living in deprived neighbourhoods face barriers to accessing maternity services. These include logistical issues, lack of information, and organisational hurdles like transportation and childcare. Studies show that women in low socioeconomic settings often experience more referrals to secondary care and higher maternal healthcare costs, reflecting higher risks and needs for more intensive services.
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Regional Variations
While maternity care is available across the country, disparities exist. In urban and affluent areas, services are more readily accessible, whereas in rural or disadvantaged regions, women may encounter shortages of providers or limited facilities. Some facilities, such as birth centres, aim to offer more homely environments, but their availability and reach vary.
Challenges and Opportunities
Efforts are ongoing to scale up integrated care models and improve recruitment of women from vulnerable backgrounds. Collaboration among healthcare professionals, regional initiatives, and policies promoting inclusive practices are essential to ensuring equitable access. Training midwives and health workers to better serve women of diverse socioeconomic and cultural backgrounds is also a priority.
