Controversy over Home Birth Brews in the Netherlands

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... a debate is “raging” in the Netherlands, the country which has always had the highest rate of home birth in Europe, about where women should give birth: home or hospital? There has been a dramatic decline in home births in the past two years ... from 34 to 24%. Media reports have raised questions about the safety of home births. Some experts say these are merely scare stories and that a ban on home birth would have no impact on the the number of infant mortality at birth.

“Dutch women grow up thinking home birth is good for you, and that it’s part of mother nature. But I didn’t consider it at all. I think it’s too risky. If something is wrong, it’s better to be in hospital,” said a recently new Dutch mother. The Dutch government is worried by the fact that the rate of death among newborn babies is higher than in the Netherlands than other European countries.

The health minister said recently that obstetric care needed to improve, and there was sometimes “insufficient communication” between professionals. Some doctors say women are choosing hospital birth because they want a full range of pain relief and quicker deliveries.

Last year in the Netherlands, there were around 1,700 stillbirths and deaths among newborn babies. Everyone agrees that figure is too high, and that Dutch midwives and doctors should work more closely together. But are home births being unfairly blamed?

Some believe that home births are safe and even if totally abolished, wouldn’t make a small dent in the mortality statistics. “It’s very short-sighted. I think it would be really sad if choice disappears – and there’s a real risk of this happening in the Netherlands.”

Homebirth isn't to blame as the death rates are high in hospitals too. I would suggest the cause of the high death rates are either a) non-adherence to the standard of care offered in other developed countries (eg intermittent auscultation in labour; a routine morphology ultrasound in pregnancy etc) or b) the heavy reliance on risk management approaches to maternity care when it is well known that risk is a poor predictor of outcome. Perhaps a more balanced approach would be care delivered by midwives and obstetricians with the offering of an appropriate standard of care, and homebirth to continue as an option for women and families. Homebirth has been shown to be safe in the Netherlands' own research which showed that homebirth is no less safe than hospital birth for low risk women who are attended by a midwife. This research supports research from Canada and the US.

Melissa Maimann, Essential Birth Consulting 0400 418 448