Off to a Good Start – giving birth in the Netherlands is an oral history journey through the Dutch birth landscape. Via in-depth interviews, we get to know six healthcare professionals as they share their personal views on birth and relate their hands-on experiences, and we learn that the Netherlands is a unique place to have a baby. It’s the only country in the world in which giving birth at home is still common, as part of an obstetric care system that makes this a safe choice. Pregnant women can choose between giving birth at home, in a birth centre, or in hospital… and wherever the baby is born, mother and newborn are entitled to ten days of at-home support from a maternity carer. No other country has this sort of structural postnatal care in place.

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The midwives, maternity carers and obstetrician featured in the film paint an image of a powerful – but also fragile – birthing culture, one that’s under great pressure in these times of increasing medicalisation, market forces in health care, and the present-day need for control and the idea of safety. The number of hospital births is increasing rapidly as a result, while the number of home births is decreasing: from 32% of births in 2000 down to around 15% today.

 

This change means that pregnant women's freedom of choice hangs in the balance. Is the current Dutch obstetric care system able to weather these cultural changes? And where will they lead us? Will today’s teenagers be able to choose to give birth at home in the future? Or will the Netherlands fall in line with the rest of the world, with medicalised and induced hospital births becoming the norm?

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The stories told by these professionals lay bare the extraordinary nature of each and every birth. They emphasise how valuable and exceptional Dutch obstetric care is, even while most Dutch people simply take it for granted. They also make clear the importance of a familiar face while giving birth (whether at home or in hospital), the function of pain, and the consequences of trauma, poverty and racism. The documentary also serves as a reflection on Dutch society and on universal values such as trust (both in ourselves and in others), autonomy, and freedom of choice.

 

With their stories illustrated with documentary photography of births, aerial footage of the Netherlands, and a voiceover by an American sociologist sharing his observations on Dutch childbirth culture, the film’s editing creates a dialogue amongst these health care professionals as they share their takes on a system that is unique in the world.