When it comes to being pregnant and birthing your baby in Belgium it is important to fully understand the options available so you can make the best choices for you and your baby. Your first choice:
WHO CARES FOR YOU?
In Belgium, you can select your caregivers freely! As long as they are registered with the ‘National Institute for Health and Disability’ (INAMI/RIZIV), you can still get subsidised care. You can choose a doctor in your area, at a hospital, in private practice, or anywhere in Belgium.
Your choice of caregiver could be one or more of the following:
For information on WHERE you can birth your baby
Gynaecologist Led Care
In Belgium, most women are cared for by a gynaecologist throughout their pregnancy journey, even in cases considered low-risk. One of the advantages is that you have the freedom to choose any gynaecologist that suits your needs, without the requirement of obtaining a referral from a family doctor. Although you may want to ask your family doctor for recommendations. Some family doctors provide shared care with hospitals and gynaecologists.
It’s important to be aware that gynaecologists typically have partnerships with specific hospitals, meaning they are licensed to deliver babies solely at those designated locations. This presents you with a couple of options:
you can either begin by finding a gynaecologist — perhaps based on personal recommendations or convenient location—and then select the hospital where they practice
you may choose to select a hospital first — again based on recommendations or proximity—and then seek out a gynaecologist who is authorized to deliver babies there
If you have specific medical needs related to a pre-existing condition or your unborn baby is found to have a problem that may dictate who cares for you and your place of birth. Belgium has excellent medical services and you can seek out the hospital/gynaecologist with the expertise to provide the care you need.
What does your gynaecologist do, and when?
During pregnancy
Your gynaecologist typically sees you once a month for the first 28 weeks, every two weeks until 36 weeks, and then weekly until birth. They can perform or arrange all tests and checks. If they have the right equipment and training, your gynecologist may do all your ultrasounds; otherwise, they will give you the paperwork to have the three official ultrasounds done by a sonographer.
Labour and birth
Hospital midwives will care for you during labour. If they think you need any procedures, like breaking your waters or speeding up labour, they will talk to you first, then consult your gynaecologist for approval. They will also coordinate with your gynaecologist to ensure they arrive in time for the birth. Sometimes, the gynaecologist may only be there briefly before your baby is born. After the birth, your gynaecologist will make sure the placenta is delivered and manage any blood loss. If needed, they will stitch any tears. After this, the hospital midwives will continue caring for you.
Postnatal period
Your gynaecologist will see you before you leave the hospital to check your recovery and will sign your discharge papers. Your next visit is usually six weeks after birth for a check-up.
How much does a visit to my gynaecologist cost?
Most gynaecologist are not ‘conventionnées’ / ‘geconventioneerd’ and so are free to fix their fees. A typical consultation may cost around €50. Irrespective of the kind of insurance you have, you will probably have to pay this amount in full at the time of the consultation. If you are registered with a ‘mutuelle’ / ‘ziekenfonds’, around 75% of this is reimbursed.
Remember that some ‘top-up’ hospitalisation insurance providers reimburse ALL supplements for birth-related expenses that you incur in the month before, and the three months after the birth. Ask your insurer about this.
Midwife-led care
Midwife-led care is available in Belgium during your pregnancy, labour and birth and after your baby is born.
When it comes to birthing your baby with a midwife you can choose to give birth either:
at home
in hospital under the care of your independent midwife - your midwife would be affiliated to a particular hospital(s) and that would be the hospital you would attend. You will need to check with your independent midwife which hospital she is affiliated to. From September 2024 all hospitals in Brussels that have a maternity ward should have a midwife led unit or birth centre - an internal hospital unit where fit healthy women with a healthy baby can be cared for exclusively by midwives. An example being Le Cocon birth centre in Anderlecht. Outside of Brussels it depends on the hospital and arrangements with local independent midwives
in a ‘birth house’ - there are not many birth houses in Belgium but if you have an Independent Midwife they will know the availability in their area. More information on birth centres
What can an Independent Midwife offer you?
During pregnancy
Your midwife typically meets with you once a month for the first 28 weeks, then every two weeks until 36 weeks, and every week until you give birth. She can perform most tests and check-ups, but you may still need to see a gynaecologist at times. Your midwife will give you the paperwork for the three official ultrasounds to be done by a sonographer.
Labour and birth
Your independent midwife can provide various services based on her practice:
If she supports homebirths, she will help during the birth at home and deliver your baby there, with a second midwife as backup
If she supports hospital births, she will assist during labour both at home and in the hospital, where she will deliver your baby
If she works with a birth center, she will provide care at home and at the birth center, supporting you to birth your baby there
If you labour at home and go to the hospital, she will support you until hospital midwives take over, and a doctor will deliver your baby
Not all midwives can attend births in every hospital due to individual agreements.
Postnatal period
You can see an independent midwife after giving birth, no matter where you delivered or if you saw a midwife during pregnancy. If you want to leave the hospital sooner than the usual 2-3 days, you can arrange for an independent midwife to provide care at home. Even if you stay the full time, you can still consult an independent midwife for help with questions or issues, such as breastfeeding, family planning, postnatal checks, and baby care. Some also offer postnatal exercise classes and pelvic floor training.
How much does a visit to my midwife cost?
Many midwives are 'conventionnées' and charge a standard fee, usually between €35 and €60, depending on the day. You may pay this amount upfront, or the midwife might bill your health insurance directly if you're registered.
For 'conventionnées' midwives, your insurance covers 100% of consultation costs. But, this does not apply to special birth preparation sessions, which are only partly covered.
If the midwife is not 'conventionnée', your insurance typically reimburses around 75% of the fee. Additionally, some supplemental health insurance plans cover all additional birth-related costs incurred one month before and three months after the birth, so ask your insurer for details.
For home birth there will be two midwives present at your birth, for each midwife a waiting fee of €250 plus mileage will be charged to you. You may be reimbursed some of this total amount by your hospitalisation insurance. Ask them yourself whether and how much they will reimburse you.
Physiotherapist
What does my physiotherapist do, and when?
In Belgium, physiotherapists have a key role during pregnancy, childbirth, and recovery. You can choose any perinatal physiotherapist, but to get partial reimbursement from your health insurance for prenatal and postnatal therapy, you need a prescription from a gynaecologist, which is usually given to you around the middle of your pregnancy.
During pregnancy
Many women join weekly exercise classes with a physiotherapist around the 6th month of pregnancy. These classes focus on gentle exercises, birth preparation (breathing techniques and positions), and tips for common pregnancy issues such as back pain and sciatica. Women typically attend alone, but some sessions include partners to learn massage and comfort techniques for labour. While individual sessions are available, group classes offer a chance to connect with other expectant mums.
Labour and birth
Your physiotherapist may offer labour support, which is especially useful if you hope to give birth without an epidural – though a physiotherapist can still offer support and advice on positions etc if you have an epidural. You usually contact your physiotherapist yourself when you decide to go the hospital, and agree how soon he/she will come to support you.
Some hospitals do not allow external physiotherapists and instead have an internal team who offer labour support.
Postnatal period
A hospital physiotherapist often visits the day after the birth to perform some basic checks (notably on how your uterus is returning to its pre-pregnancy size and position) and to explain some basic exercises to strengthen the pelvic floor muscles. If your own physiotherapist has the necessary agreements with your hospital, he/she may also be able to visit you in hospital as of the second day.
Between 4 to 6 weeks after the birth, many women start postnatal physiotherapy sessions, whether individually or in a group. The aim of these sessions is to work on strengthening the pelvic floor and abdominal muscles, and gently get you back into shape.
If you continue to have issues caused by a weak pelvic floor (e.g. leaking urine when you sneeze, laugh etc), it is also possible to have internal pelvic floor therapy, where a small probe is used to help work the muscles.
How often can I see my physiotherapist?
In theory, you are entitled to nine sessions of perinatal physiotherapy per pregnancy. In addition to this, each calendar year it is possible to have a total of 18 sessions for a specific reason (i.e. two additional prescriptions of nine sessions each) and so, any extra sessions you need can be taken under the umbrella of ‘pelvic floor re-education’.
Physiotherapist support during labour
Some independent physiotherapists also offer labour support, and will be affiliated with certain hospitals. Ask your physiotherapist about this.
Not all hospitals accept ‘external’ physiotherapists, and instead have an internal team who offer labour support. Ask about this when you visit hospitals.
How much do physiotherapy sessions and labour support cost?
Some physiotherapists are ‘conventionnées’ / ‘geconventioneerd’ and so apply the same ‘conventioned’ tariff, while the others are free to fix their own tariffs.
Individual pre-/post-natal physiotheraphy sessions may cost in the region of €30 (conventionnées), €60-70 (non-conventionnée) and if you are registered with a ‘mutuelle’ / ‘ziekenfonds’, around 60% of this will be reimbursed. Group classes may be cheaper, but are not reimbursed by the mutuelle.
Labour support may cost around €250 and is not typically covered by the mutuelle, though some mutuelles offer extra reimbursements for physiotheraphy, over and above the usual cover. Labour support may be fully covered if you have ‘top-up’ hospitalisation insurance that reimburses ALL supplements for birth-related expenses that you incur in the month before, and the three months after the birth. Ask your insurer about this.
Doula
‘woman who provides emotional and physical support to a mother before, during and just after birth’
A doula's aim is to make the woman and their partner feel safe, empowered, informed, respected, and heard during pregnancy, labour, and delivery, whether in a hospital or at home. Although it's not common in Belgium to have a doula at birth, you can find trained and experienced English-speaking doulas who will support you and respect your choices.
What can a doula offer you?
Having a doula by your side can bring a great deal of comfort and reassurance, whatever stage you are at in your journey. Depending on their training they can support you during:
pregnancy, including birth preparation
labour and birth
postpartum period or
support you through the whole of your pregnancy journey
The amount of support a doula can provide depends on their field of expertise, your needs and the agreement you have with them.
Doula Support for Labour and Birth Provides:
Emotional Support
A continuous presence by staying with you throughout labour and offering consistent reassurance
Encouragement - by boosting your confidence and provide motivation during difficult moments
Create a calm, supportive environment which helps reduce any anxiety and stress
Informational Support
Education: Doulas explain medical procedures, options, and interventions to help the birthing person make informed decisions
Advocacy: They help communicate the birthing person’s wishes to medical staff, ensuring their birth plan is respected when possible
Guidance for Partners: Doulas also support the birthing partner by suggesting ways they can help and stay involved
Pain Management Techniques
Doulas use non-medical methods such as massage, breathing techniques, and relaxation to help manage pain
Positioning Suggestions: They assist in positioning the birthing person to promote comfort and progress in labor (e.g., upright positions, movement)
Hands-on Comfort Measures: Techniques like applying counterpressure, using heat or cold, and providing comfort tools like birth balls or water therapy
Post-Birth Support
Initial Bonding: They can assist with early skin-to-skin contact and breastfeeding initiation.
Emotional Processing: After birth, doulas can help the birthing person reflect on the experience, offering emotional support if needed.
Doulas work collaboratively with medical staff and are not responsible for medical decisions, but they play a crucial role in enhancing the overall birth experience.
Doulas - their cost
Doula fees in Belgium can vary but are usually in the region of €50 - €60 per hour with a fixed fee for their support in labour and birth.
In Belgium, doulas registered with the Association Francophone de Doulas de Belgique (the French speaking doula association) must respect the AFDB fee schedule.
Doula support is not usually reimbursed by the mutuelle/ziekenfonds.
Why not read our blog: A Doula?: 6 Good Reasons Why
To read more about your choices for support in labour and birth click here: