Primary care obstetrics and perinatal health in The Netherlands.
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."
Hingstman
L
L
Netherlands Institute of Primary Health Care, (NIVEL), Utrecht.
D005194:Family Practice; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D009426:Netherlands; D009721:Nurse Midwives; D009774:Obstetrics / Q000458:organization & administration*; D010500:Perinatology / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*