In many parts of the world, childbirth is increasingly associated with medical intervention, pain relief and carefully managed hospital deliveries. Discussions surrounding labour often focus on how to minimise pain, with epidurals becoming a routine part of the birthing experience for millions of women.
Yet in the Netherlands, a strikingly different approach continues to shape maternity care. For many Dutch women, labour pain is not necessarily viewed as something to fear or eliminate. Instead, it is often understood as a natural part of childbirth—and, for some, a powerful symbol of personal strength, bodily autonomy and empowerment.
According to research published on ScienceDirect in the journal Midwifery, Dutch women frequently associate childbirth pain with achievement, capability and confidence in their body's ability to give birth naturally. The findings help explain why epidural use has historically remained far lower in the Netherlands than in many other Western countries.
The ethnographic study, conducted by researchers Katie Logsdon and Carolyn Smith-Morris, explored how women in the Netherlands perceive labour pain and how those perceptions influence decisions about pain medication during childbirth.
Why Dutch Childbirth Culture Stands Apart
One of the most striking findings from the research is the significant difference between Dutch attitudes towards labour and those found in more medicalised healthcare systems.
At the time of the study, only around 22 per cent of women in the Netherlands used an epidural during childbirth, compared with approximately 61 per cent of women in the United States.
Researchers suggest that the difference cannot be explained solely by healthcare access. Instead, cultural beliefs surrounding childbirth play a major role in shaping expectations long before labour begins.
For many Dutch women, childbirth is viewed primarily as a physiological process rather than a medical event requiring intervention. As a result, labour pain is often framed as an expected part of the journey rather than a problem that must be solved.
The study found that participants commonly defined a 'natural birth' as one involving minimal technological intervention and little or no pain medication unless medically necessary.
Labour Pain Becomes a Source of Empowerment
Perhaps the most compelling finding was the way many women linked labour pain with personal empowerment. Rather than describing contractions solely as suffering, participants often viewed pain as evidence that their bodies were functioning as intended. The experience became closely connected to ideas of resilience, capability and self-belief.
Researchers identified autonomy as one of the study's central themes. Many women described childbirth as something they wanted to accomplish independently, viewing the decision to avoid an epidural as an expression of personal control over the birthing process.
The findings suggest that for some Dutch mothers, successfully navigating labour without pain medication can create a strong sense of achievement and confidence.
Instead of focusing exclusively on pain relief, many women developed strategies to work through labour naturally. These included movement, breathing techniques, water therapy, massage and continuous support from midwives and birth partners. The study found that these approaches often helped women view labour as an active process rather than a medical procedure happening to them.
The Powerful Influence of Dutch Midwives
The Netherlands has long been recognised internationally for its midwife-led maternity care system, which differs significantly from approaches used in many other developed nations.
Women with low-risk pregnancies are generally supported by midwives throughout pregnancy, labour and delivery. Obstetric specialists typically become involved only when complications arise or additional medical care is required.
Researchers argue that this structure plays an important role in shaping perceptions of childbirth from the earliest stages of pregnancy.
Rather than preparing women to expect intervention, midwives often reinforce the belief that childbirth is a normal physiological process that most healthy women are capable of navigating.
The study suggests that this consistent messaging helps create confidence around natural birth and contributes to positive perceptions of labour pain.
Home Births and Low-intervention Care
The Dutch maternity system has also gained international attention for its historically high rate of home births. Although home birth rates have declined over recent decades, they remain considerably more common in the Netherlands than in many Western countries.
For generations, Dutch women have grown up surrounded by stories of births taking place at home or in low-intervention environments, helping to normalise childbirth outside highly medicalised settings.
Researchers suggest these cultural narratives influence expectations about pain, intervention and what constitutes a successful birth experience. Many women enter pregnancy already familiar with examples of natural childbirth among relatives, friends and members of their community.
Family and Friends Reinforce Positive Attitudes
The study found that professional guidance is only one part of the equation. Social networks also play a significant role in shaping attitudes towards labour pain and childbirth choices. Participants frequently described receiving encouragement from friends, sisters, mothers and other women who had experienced natural births themselves.
These conversations often reinforced the idea that labour pain is manageable and meaningful rather than something inherently frightening. Researchers concluded that support from family and community networks helps sustain cultural beliefs surrounding natural childbirth across generations.
In many cases, women reported hearing positive birth stories that emphasised capability, confidence and personal achievement rather than fear.
A Growing Debate Around Childbirth Choices
While the study highlights positive attitudes towards labour pain, researchers acknowledge that childbirth experiences vary widely and that medical interventions remain essential in many situations.
The findings are not presented as an argument against epidurals or pain relief. Instead, they offer insight into why some women choose not to use them and how cultural beliefs influence those decisions.
The research also arrives amid ongoing discussions about rising intervention rates and changing maternity care practices in the Netherlands. Although epidural use has gradually increased over time, the study suggests that deeply rooted cultural values surrounding natural childbirth continue to influence many women's choices.
Rethinking the Meaning of Labour Pain
For many women around the world, labour pain is something to be feared, managed or avoided whenever possible.
Yet the Dutch experience offers a different perspective.
According to the research, many mothers in the Netherlands do not see labour pain solely as suffering. Instead, they view it as part of a transformative process that reflects strength, autonomy and trust in the body's natural capabilities.
As global conversations around women's health, birth experiences and maternal choice continue to evolve, the Dutch approach highlights how culture can profoundly shape perceptions of pain — and how, for some women, the experience of childbirth itself becomes a powerful expression of empowerment.
