Get access


Denmark, Sweden, and the Netherlands


  • Susan McKay RN, PhD

    Corresponding authorSearch for more papers by this author
    • Susan McKay, RN, PhD, is Professor of Nursing at the University of Wyoming School of Nursing, Laramie, Wyoming. She was affiliated with the World Health Organization European Headquarters, Office of Maternal Child Health, Copenhagen, Denmark, from March to July 1991.

2 Susan McKay, RN, PhD, University of Wyoming, School of Nursing, PO Box 3065, Laramie, WY 82071.


The organization of maternity services in Denmark, Sweden, and the Netherlands was studied under the sponsorship of the World Health Organization European Headquarters Office of Maternal and Child Health. Midwifery care is highly respected and is a central feature of obstetric care in each of these countries. In Denmark and Sweden, almost all births are in the hospital, and autonomous midwives are employed by national health services. About three-quarters of Dutch midwives are in independent practice, and 34% of Dutch women give birth at home. In each country midwives provide “the first line” of care for normal pregnant women and are viewed as essential to the excellent perinatal outcomes these three countries enjoy.