If you come from a country where an epidural is simply part of giving birth, the Dutch approach can come as a shock. Many Dutch women give birth without medication, and maternity care is built around the idea that birth is a natural process unless there's a reason to intervene. That doesn't mean you have to do without. It means you need to know your options and ask for them clearly.
Your options for pain relief
- Epidural (ruggenprik). The most effective option, placed by an anaesthesiologist in hospital. Most hospitals aim to offer it around the clock, but in practice you may have to wait, for example at night or when the ward is busy.
- Remifentanil. A strong painkiller given through a pump that you control yourself. It works quickly, but needs close monitoring, so it's only available in hospital.
- Nitrous oxide (laughing gas). Offered by a growing number of Dutch hospitals. Ask whether yours does.
- Non-medical options. Moving around, warm water, breathing techniques, massage, a TENS device and continuous support. These work at home and in hospital, and you can use them alongside medical pain relief.
What you need to know in advance
Medical pain relief is only available in hospital. If you're giving birth at home and decide you want an epidural, you'll move to hospital and your care transfers from your midwife to the hospital team. A wish for pain relief is generally treated as a medical reason, so you don't pay the personal contribution that sometimes applies to a hospital birth.
Timing matters. An epidural takes time to arrange: getting to hospital, waiting for the anaesthesiologist, placing it. If you know you want one, say so early, to your midwife during pregnancy and again when labour starts.
Policies differ per hospital. Ask during your pregnancy: is an epidural available 24/7? Do you offer remifentanil or nitrous oxide? Can I ask for pain relief as soon as I arrive?
How to prepare
- Talk about pain relief with your midwife early in your pregnancy, not in week 39.
- Put your wishes in your birth plan, clearly and in plain words. Read more in writing a birth plan that works in a Dutch hospital.
- Make sure your partner knows what you want, so they can speak up when you can't.
- Learn a few non-medical techniques anyway. They help in the early stages and while you wait.
Where a doula helps
I help you prepare the conversation with your midwife, write your wishes down in a way the hospital team recognises, and make sure your request is heard during labour. I also support you with breathing, positions and comfort, whether you end up using medical pain relief or not. Many women find they need less than they expected when they feel safe and supported. But that's your choice, not mine.
Frequently asked questions
Can I arrange an epidural in advance?
You can't book one, but you can tell your midwife and the hospital that you want one and put it in your birth plan. That makes your wish clear from the start.
Is pain relief covered by my insurance?
Medical pain relief during labour is covered by Dutch basic health insurance. Check your policy for details such as your deductible (eigen risico).
What if my labour goes very fast?
Sometimes labour progresses so quickly that there's no time for an epidural. That's one more reason to prepare non-medical techniques as well.
Curious whether a doula would work for you? Have a look at my doula services or book a free introductory call.