In 2003 research was conducted in England (n=738) to further our understanding of factors that relate to women's longer-term appraisal of their birth experience. Women's appraisals are likely to be influenced by the culture in which they give birth and the predominant norms at that time. To explore this further, the study was replicated in the Netherlands in 2004 (n=1310), where a culture of birth at home is well established. It was hypothesised that Dutch women who had an emergency caesarean birth would look back more negatively on the experience than their counterparts in England. While there was some support for this hypothesis, more women in the Netherlands were found to look back negatively than women in England irrespective of mode of birth. Binary logistic regression models were constructed for each country and common factors for a negative appraisal were: emergency caesarean and instrumental birth; feeling that the baby's life had been in danger; negative perception of the staff; and major health problems since the birth. Induction of labour and feeling that her own life had been in danger were also predictive of looking back negatively for Dutch women.