Expatriate women have the same dreams and hopes as women who never leave their home country. And for many that includes having children. But having children in a foreign country can add additional stress to the experience. It's not as simple as going to your family gynaecologist and saying: "I'm pregnant." The Netherlands strongly favours home births, natural childbirth (no pain relief) and the use of a midwife.

There seems to be a long history of stoic Dutch women following the orders of the medical system, not questioning if there is a better way. So how does the average expat woman cope? Fear of the unknown Many women react fearfully to the news that they were going to have their baby in The Netherlands. And many have no idea of what to expect, or they have had previous unpleasant experiences with Dutch medical care. As their pregnancies progressed, most found their fears disappeared.

In all regions of The Netherlands, midwives seemed willing to speak in both Dutch and some English, attempt to answer questions and offer support. Gill Rees and Chrissy Guido both felt their midwives became like friends. The women I spoke with found their personal requests were being considered - except for their need for pain relief. Demand what you want All the women recommend you state clearly and firmly from the beginning your desires regarding pain medication and pregnancy care - and you stick to your wishes.

Inform your medical practitioners that you are from a different country and want your own form of care, whether it be a pill, epidural or perhaps a caesarean section.

Nazeema Adams, who gave birth in The Netherlands, says: "Insist on what you want and have them write it down in your folder. While the midwives might not be there at the delivery, your folder will be."

But sometimes it doesn't work out the way you planned. Frances Jackson, whose previous child was delivered by c-section in Brazil, didn't want to repeat that experience in the Netherlands. "I was offered an epidural, but the Dutch anaesthesiologist took the hours to arrive and then just as he was about to administer the drug he was paged and left never to return".

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