What is Kraamzorg?
Kraamzorg is a unique postnatal service for women in the Netherlands in the first eight to ten days (kraamperiode) after the birth of their baby. The purpose of kraamzorg is to aid the recovery of the mother and provide her with advice and assistance to care for her newborn. The goal is to get the mother swiftly back on her feet to independently care for her baby and return to daily life.
Kraamzorg is the reason why, in normal circumstances, hospital staff release mothers from their care within hours of giving birth in the Netherlands.

Kraamzorg Packages and Costs
Every pregnant woman in the Netherlands has the right to kraamzorg but the hours she is entitled to vary depending on her particular circumstances.
Kraamzorg is part of the basic health insurance package and your health insurance provider should cover the majority of the costs associated. However, a small individual contribution per hour of care is due. Depending on your health insurance policy, this amount may also be refundable.

The Landelijk Indicatieprotocol Kraamzorg (National Guidelines for Postnatal Care) categorises kraamzorg in three levels:
1.    Basic (Basispakket)
When: if there are no complications with the birth or recovery and no exceptional circumstances within the household.
What:
•    care for mother and baby,
•    regular health checks (e.g. that stitches are clean and healing, the uterus is shrinking),
•    advice and instruction (hygiene, feeding etc),
•    ensuring hygiene levels are high
•    basic household chores which directly relate to the care of mother and baby (such as cleaning of the bathroom, the nursery and the mother’s room and taking care of meals for the mother).
•    support to integrate the newborn into the family

2.    Minimum Care (Minimumzorgpakket)
When: this is the legal minimum kraamzorg that every woman is entitled to, regardless of her situation.  This leanest of levels allows for a maximum of three hours care a day spread over the first eight days after the birth, but excludes any time involved in the birth itself.
What: the focus is on care and health checks of the mother and baby, advice and instruction, observation and signalling of any problems to the midwife.

3.    Flexible Package (Kraamzorg op Maat)
When: the number of hours may be increased to take account of special circumstances up to a maximum of eighty hours, distributed over the first ten days after the birth.

Circumstances that warrant a higher level of kraamzorg include the number of children already in the family, existence of mental illness or communication barriers, an instable family situation, the birth of twins (or more) or problems with (breast)feeding.

What: in addition to the tasks included in the basic package, this package may include the care of other members of the household (e.g. other children) and additional household tasks not directly associated with the mother and newborn.

The kraamzorg company determines the level of care applicable to you through questions at an intake meeting around the six month of pregnancy. The maternity care assistant reassesses your needs at the time of the birth, and again around the third or fourth day of the kraamperiode.

Choosing a Kraamzorg Provider
It is recommended that you choose your kraamzorg within the first three or four months of your pregnancy and in some of the bigger towns even within the first eight weeks, as there are shortages in some regions.

Your midwife can usually advise on a kraamzorg provider and your health insurance company will almost certainly have preferred suppliers and contracts with selected companies. Contacting your medical insurance company for a list prior to registering with any one organisation will ensure that they will reimburse the associated costs, and approve your choice of kraamzorg. Some health insurers even take care of kraamzorg provision for you.

The Kraamzorg Experience
Speaking from personal experience, I was very wary of allowing a complete stranger into my house at a vulnerable and emotional time. So chose for just a few hours per day, instead of my maximum entitlement. In the midst of the kraamperiode I quickly realised my mistake. Her help was a blessing and I look back on the week she was a part of our household with very fond memories. When the time came to say goodbye it was an emotional, tearful farewell.
Joan, an Irish expat who has delivered two children here in Holland, found the support from the kraamzorg invaluable, particularly when she had problems with breastfeeding. Her maternity care nurse was the only help she had after the birth as her family and friends were back home.

Danijela has been through childbirth twice and also positively reflects back on the support from her maternity care assistant,
“The second time I had to breast feed I didn’t receive any help in the hospital so it didn’t work well until 5 days after birth, after lots of help from my kraamverzorgster – she was brilliant!”.

Of course, some new mothers have negative experiences with their kraamzorg, dissatisfied with the service provided. If this is the case, then contact the provider immediately to resolve the situation - after all you are paying for their services.
However, for many expats living in the Netherlands, away from their family, friends, and usual support network, kraamzorg is a welcome addition to the home during a time of adjustment and high emotions.

December 2008

Amanda van Mulligen, British born, moved to The Netherlands in 2000 and runs The Writing Well, an English language writing and translation business. She is married to a Dutchman and has one son. Amanda writes about life as an expatriate in Holland as well as travel articles. For more information visit her website at www.TheWritingWell.eu