title: The choice of obstetric care by low-risk pregnant women in the Netherlands: implications for policy and management.
abstract: In the Netherlands, pregnant women at low risk of complications during pregnancy, have the opportunity to choose freely between giving birth at home or in a hospital maternity unit. This study analyses how various attributes of obstetric care, socio-economic characteristics and attitudes influence the decisions that these women make with regard to obstetric care. The method of discrete-choice experiment was applied in the process of data collection and analysis. The data were collected among low-risk nulliparous pregnant women. The analysis suggests that there are strong preferences among some Dutch women for a home birth. Nevertheless, the absence of a medical pain-relief treatment during home birth, might provide incentives for some women to opt for a birth in a hospital, especially at the end of their pregnancy. If the attractiveness of home birth should be preserved in the Netherlands, specific attention should be paid on the approach to pain during a home birth. Efforts could also be made in offering a domestic atmosphere during hospital births to improve hospital-based obstetric care in view of women's preferences.
authors.affiliation: Department of Health Organisation, Policy and Economics, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands. M.Pavlova@BEOZ.unimaas.nl
authors.forename: Milena
authors.initials: M
authors.lastname: Pavlova
authors.forename: Marijke
authors.initials: M
authors.lastname: Hendrix
authors.forename: Elvira
authors.initials: E
authors.lastname: Nouwens
authors.forename: Jan
authors.initials: J
authors.lastname: Nijhuis
authors.forename: Godefridus
authors.initials: G
authors.lastname: van Merode
mesh_terms: D000328:Adult; D002755:Choice Behavior; D005260:Female; D006291:Health Policy; D006801:Humans; D008880:Midwifery; D009426:Netherlands; D009774:Obstetrics / Q000379:methods*; D011247:Pregnancy; D018570:Risk Assessment; D011795:Surveys and Questionnaires