This blog was written by Jim
Henderson, Ph.D., Jan’s husband, HUG Your Baby’s Vice-President, and developer
of The HUG for Dads.
lets us appreciate how cultures have developed in different ways to meet shared
human needs. During the HUG Your Baby International Teaching Tour, Jan and I
have enjoyed sampling each country’s amazing variety of food, music and visual
art. We’ve also been fascinated to learn about the different customs cultures
have evolved for welcoming babies to the world and for preparing moms and dads
and I generally try to avoid judging or ranking cultural practices, when it
comes to the various national systems of health care we have encountered it is
hard NOT to compare them to what America offers. By most measures (using both
international standards and our own impressions), America comes off pretty
poorly in comparison to the systems of health care that most other developed
countries have evolved—especially with regard to care provided for babies and
Jan and Elly
Netherlands we were particularly impressed by how the Dutch health care system has
evolved to offer excellent maternal-child care. We learned a great deal from
chatting with our host in Holland, Elly Krijnen, a nurse, IBCLC, educator, mother
of three, former owner of a maternity center in Amsterdam, and currently
co-owner of “Baby & Borst” in Almere.
centuries, midwives (vroedvrouwen, or
“wise women”) have been at the center of Dutch health care. During the last
century, as medical science advanced, Dutch midwives held their ground as a
distinct, and powerful, group of practitioners. To this day midwifery is the
standard of care in Holland (as it is in many European countries, as well as in
Australia and New Zealand). Dutch women who do not have medical complications
give birth in the hands of midwives.
At a home birth in Holland
generation ago the majority of Dutch women gave birth at home. Today about one-third
of babies are born at home in Holland. Women can choose either a home or a
hospital birth. In either case, midwives do the delivery, unless there is an
emergency, a medical complication, or some other special indication. But
excellent midwifery care is just the beginning of the benefits that are
guaranteed to Dutch citizens through the basic health insurance premiums of
$140/month that everyone is required to pay.
8 days of care, 3-8 hours per day.
in the 1950s the specialized profession of “Maternity Nurses” (kraamverzorgenden) evolved. To this day,
new Dutch mothers receive, according to their needs, either three, five or
eight hours per day of “maternity nurse” care during the first eight days after
their baby is born.
not only participate in labor and delivery. They educate their clients,
one-to-one, about baby care—and also will cook, clean up, provide care for
other children, or do whatever the family needs during their daily home visits.
In a Dutch Consultation Bureau
mothers receive sixteen weeks’ paid maternity leave, time that typically begins
four or six weeks before delivery. Beyond this, parents may elect to take
another six months of non-paid “family leave,” during which time their jobs are
guaranteed. Dads get just two days of “paternity leave,” but they may also exercise
their option to a portion of the family’s total leave time.
Holland have the right to breastfeed at work. Either a work place must provide
an approved lactation room, or the employed woman may take off up to 25% of her
work time (paid, for nine months) to accommodate breastfeeding. Holland has
done the research and concluded that the benefits to both society and business
justify this arrangement. Furthermore, lactation consultations are paid for by most
insurance companies in Holland.
with the third week of life, Dutch families receive well child care, and parenting
guidance, from the Consultation Bureau, where they see a nurse and then a
doctor (on alternating visits) once a month during the first year of life.
America, at last, begins to move toward justice in public health, American citizens,
insurance companies, and policy makers are wise to embrace or adapt policies
and practices that have proven effective in other countries. Wouldn’t the USA be
a better, healthier country if it treated its mothers and babies as they are treated in
Holland? Jan and I—and HUG Your Baby—think so!