PRIMARY CARE OBSTETRICS AND PERINATAL HEALTH IN THE NETHERLANDS

Authors

  • Lammert Hingstman PhD

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    • Lammert Hingstman is currently a Senior Research Fellow at the Netherlands Institute of Primary Health Care, Utrechi, The Netherlands.


2Lammert Hingstman, PhD, Netherlands Institute of Primary Health Care (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands.

ABSTRACT

The Netherlands is the only industrialized country in which a large percentage of obstetric care takes place at home. Almost 31% of all deliveries are home confinements under supervision of a midwife or a general practitioner, and 84% of all postnatal care is given at home by maternity care assistants. To gain a better understanding of this unique situation, the structure of Dutch obstetric care is examined with special attention to the four pillars on which the system rests: the special protected position of the midwife, a generally accepted screening system for high-risk pregnancies, a well-organized maternity home care system, and the sociocultural environment in The Netherlands in which pregnancy and childbirth are considered normal physiological processes. Description of the obstetric system shows a degree of competition between the obstetricians, midwives, and general practitioners, in which the general practitioner has lost a considerable part of the “obstetric market.”

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