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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Preferences for birth center care in the Netherlands: an exploration of ethnic differences

Authors: Dominique Lescure, Sanneke Schepman, Ronald Batenburg, Therese A. Wiegers, Ellen Verbakel

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

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Abstract

Background

To examine the preferences for comprehensive services and facilities in a new proposed birth center which will be established in a large Dutch city, specifically among pregnant women from different ethnic backgrounds.

Methods

The analyses of this study were based on a survey among 200 pregnant women living in The Hague, the Netherlands in 2011. Multiple linear regression was applied to analyze if preferences differ by ethnic background, controlling for various other predictors.

Results

Pregnant women had relatively strong preferences for comprehensive services and facilities to be offered by the new proposed birth center compared to both other dimensions of birth center care: extensive practical information and comfortable accommodation. With regard to ethnic differences, non-Dutch women had higher preferences for comprehensive care compared to Dutch women. This difference between Dutch and non-Dutch women increased with their level of education.

Conclusions

Especially for non-Dutch women, birth centers that are able to provide comprehensive services and facilities can potentially be a good setting in which to give birth compared to hospitals or at home. In particular, higher educated non-Dutch women had a preference for the personalized care that could be offered by this new birth center.
Appendix
Available only for authorised users
Footnotes
1
The percentage of home births in the Netherlands is decreasing. A possible cause for this trend is a slowly increasing number of medium risk situations due to an increase in local protocols for risk perceptions. Women with a medium risk indication can no longer choose where they want to give birth. As a consequence, there is an increase of births in obstetric hospital units.
 
2
The Steering Committee on Pregnancy and Childbirth was established as an answer to the results of the first European Perinatal Health Report (2008) [27], in which the relatively high perinatal mortality rates of the Netherlands were shown. Its aim was to increase the quality of the maternity care together with various other implemented policy measures.
 
3
In the Netherlands, almost all women who give birth, whether at home or in hospital, receive care from a maternity care assistant (MCA) at home, between 3 and 8 h a day, up to eight consecutive days following the birth. When women give birth at home, the MCA is also expected to be present at the time of birth, to give assistance to the midwife or GP and to take care of the mother and her child for at least 2 h after the placenta has been born. When women give birth in a hospital, the MCA is present when mother and newborn return home from the hospital. The care that is provided by maternity care assistants is part of the standard insurance package [28].
 
4
In the Netherlands, maternity care is organized in three levels; primary, secondary and tertiary care. The level of care is organized according to the presence or absence of risk factors in medical and/or obstetrical history. The primary care is formed by midwives and GPs (with a focus on low-risk women); the secondary care is formed by obstetricians and specialized ‘clinical’ midwives in general hospitals (for women with an a priori high risk profile); and the tertiary care consists of obstetricians in academic hospitals. In this article we focus on the collaboration between primary and secondary birth care.
 
5
From autumn 2009 until April 2014, the Dutch Ministry of Health, Welfare and Sports commissioned the ‘Primary focus’ program, which was organized by the Dutch Organization for Health Research and Development. The program was aimed at improving integrated care and enhancing our knowledge of collaboration efforts in primary health care [29]. As part of the program, projects concerning birth care in Dutch birth centers were monitored with an emphasis on interprofessional collaboration. In the survey used for this paper, questions on preferences in child birth care were added.
 
6
The current policies refer to the national policy of the Netherlands that is focused on customized care.
 
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Metadata
Title
Preferences for birth center care in the Netherlands: an exploration of ethnic differences
Authors
Dominique Lescure
Sanneke Schepman
Ronald Batenburg
Therese A. Wiegers
Ellen Verbakel
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1254-3

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