You cannot book a gynaecologist in the Netherlands.
Everything runs through your huisarts, who handles contraception, cycle problems and screening directly and refers you onward only when there is a reason to.
There is no annual well-woman check here, and pregnancy is managed by a midwife rather than a doctor unless something goes wrong.
Both of those are deliberate, and both take some getting used to.
Getting Into The System
Two things have to exist before you can use any of it: a Dutch health insurance policy, which is compulsory, and a registration with a GP practice near your address.
Register with a practice when you move in, not when you need something, because good practices close their patient lists.
Most GPs consult in English.
Say when you book that you would prefer a female doctor, and the practice will accommodate it where it can.
Your GP is the first stop for contraception, painful or irregular periods, fertility questions and menopause.
A referral letter is what makes hospital gynaecology reimbursable, and you cannot go round it by paying privately.
Waiting times for a specialist run from weeks to months depending on the hospital and the urgency.
Ask the referring GP which hospital has the shortest list, because you can choose, and few people know they can.
Contraception And Screening
Contraception is prescribed by the GP and collected at a pharmacy, and repeat prescriptions usually do not need a new appointment.
The pill, hormonal and copper IUDs and the injection are all routinely available.
Contraception is reimbursed under the basic insurance up to age 21.
Over 21 you pay for it yourself unless your supplementary policy covers it, so check that before switching insurer.
Cervical screening starts at 30, not in your twenties, and runs on a five-yearly cycle by invitation from the national programme.
You can request a self-sampling kit instead of a clinic appointment, which is posted to you and returned by post.
Breast screening is by invitation from age 50, nominally every two years, and continues into your seventies.
The interval has been stretched at times because of capacity, so if an invitation is overdue, chase it rather than assuming you have been assessed as low risk.
Symptoms at any age override the schedule.
A lump, bleeding between periods or after menopause, or pain that is new is a GP appointment now, not a wait for the next invitation.
For STI testing, go to your GP or to the GGD, the municipal health service, which tests free in defined circumstances and cheaply otherwise.
Pregnancy And Birth
Your verloskundige, the midwife, is your primary caregiver from around week eight through to the birth and the weeks after it.
You choose the practice yourself - ask your GP for local names, and meet more than one, because you will see a lot of this person.
Antenatal care involves fewer scans and tests than American or British women expect.
That is a policy position rather than a shortage, and you can request more, though not everything is reimbursed.
Maternity care including the birth is covered by basic insurance, and it is covered even if the pregnancy began before you arrived.
You can give birth at home, in a birth centre or in hospital, and home birth remains genuinely common.
If complications develop the midwife transfers you to an obstetrician, which is the point at which it becomes a hospital birth regardless of the plan.
Epidurals are available around the clock in hospitals, but you have to ask for one and be in hospital to have it.
Discuss pain relief with your midwife early, because Dutch practice starts from the assumption that you will manage without.
After The Birth
Kraamzorg is the distinctive part: a maternity nurse comes to your home for up to about eight days, helping with feeding, checking you and the baby, and doing the household running.
It is covered by basic insurance apart from a small hourly personal contribution, and you book it during pregnancy rather than after.
Maternity leave is 16 weeks, at least four of them before the due date.
Partners get one week fully paid immediately, plus up to five further weeks of additional partner leave paid at 70 per cent by the UWV, claimed within the first six months.
Then comes childcare, which needs registering for well before you need it.
Where The System Falls Short
Conditions that mainly affect women - endometriosis, severe menstrual pain, pelvic floor disorders, menopausal symptoms - have been under-researched and are slow to be diagnosed here as elsewhere.
Work by TNO found that endometriosis can take up to a decade to identify.
That matters practically: if you are being told repeatedly that severe period pain is normal, ask directly for a referral and ask for the refusal in writing.
A documented request moves faster than a repeated conversation.
This is being addressed, slowly.
A national women’s health programme was launched with dedicated ZonMw research funding, and a women’s health research centre opened at Erasmus MC.
The NVOG, the Dutch obstetrics and gynaecology society, has been the loudest professional voice pushing for it.
Knowing that the gap is recognised is worth something when you are the one being told to wait.
