Patterns in primary midwife-led care in the Netherlands : trends and variation in intrapartum referrals
doctoral thesis
The number of obstetric interventions during normal term labour is increasing in the Netherlands, for instance for augmentation of labour and epidurals. Offerhaus also observed that the number of unplanned caesarean sections increased for healthy women who were pregnant and gave birth for the first time. These changes were not accompanied by better perinatal outcomes. For women, the availability of pharmacological pain relief improved. At the same time, there was more fragmentation of care during labour. This rise in caesarean sections among healthy women deserves as much attention in the Netherlands as reduction of perinatal mortality. Midwives need to reflect critically on their referral behaviour. Furthermore, unplanned caesarean sections among healthy women can be audited in a multidisciplinary way, just like term perinatal mortality. Critical reflection can help to keep the caesarean section rate low. Fragmentation of care may be reduced by extending the current tasks of midwives. The author analysed almost 800,000 cases of healthy women giving birth in primary midwife-led care in the years 2000-2008.
TNO Identifier
529024
ISBN
978-90-824061-0-8
Publisher
Radboud Universiteit
Collation
160 p.
Place of publication
Nijmegen