The Netherlands is the odd one out when it comes to childbirth. It's the only Western country where more than 30 percent of births take place at home. A system of highly trained, independent midwives and maternity aid nurses makes it all possible. But some people wonder whether home birth will survive.
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"Six years ago I thought that home birth in the Netherlands was about to disappear. At that time we had 30 percent home deliveries at about 200,000 deliveries in the Netherlands. But six years later we still have 30 percent."
Jan Nijhuis, Professor of Obstetrics at the Maastricht University Hospital, generously admits he made a wrong prediction. He thought home births would go out of fashion and that modern prospective mothers would increasingly opt for hospital deliveries.
"We obviously have a strong lobby to have home deliveries going on. I'm sort of proud that we have this high number of home births and I think it leads to fewer interventions."
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Beatrijs Smulders
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In the Netherlands, midwives and gynaecologists strongly feel that if a pregnancy develops well and without complications, home birth is a good thing. Highly trained, independent midwives, assisted by maternity aid nurses make it all possible.
Natural not medical
"There's this strongly ingrained belief that pregnancy and birth are really normal things in a woman's life," explains Beatrijs Smulders, an independent midwife in Amsterdam and director of the International Birth Centre. "Women in the Netherlands still have a very strong belief in the power of their bodies."
In addition, in this small, densely populated country, a hospital is always virtually around the corner. So medical assistance is close by in case a birth at home runs into difficulties and that's by no means an exception, as Professor Nijhuis points out:
"If you try to have your first baby at home and you get into labour at home, you still have a 50 percent chance of being transported to the hospital because of a complication. When you have your second or third baby it's about 20 percent."
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Tessa pregnant with Olle
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However, this doesn't stop many expectant mothers from trying to have their babies at home. Tessa Hobbs, for instance, is really looking forward to the event:
"I hope I can have the baby at home because it feels more natural and I think I will be more relaxed myself at home. It will be good for the baby, too, but if I have to go to the hospital, it won't be a problem either. Whatever happens happens."
Steep decline
Nonetheless, since the 1970s home birth figures in the Netherlands have seen a steep decline, from 70 percent then to 30 percent now.
The huge advance in check-ups for unborn babies is part of the reason. Potential problems are spotted at an earlier stage and so more women end up having their babies in hospital.
In addition, there's the increased request for pain relief during labour. This can only be administered in a hospital setting because the unborn baby's heart rate needs to be monitored. But in contrast with neighbouring countries it's still very difficult to get an epidural or other forms of pain relief during labour, says Jan Nijhuis.
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| Professor Jan Nijhuis |
"It's still the case that in at least one third of the hospitals in the Netherlands you can't have an epidural outside 'office hours'. As gynaecologists we think that is not a good thing and the discussion about that has sort of exploded. I think it's the social pressure and the pressure of the women themselves who come up with the questions and who say, we need epidural analgesia. We see more midwives who send in women for pain relief."
Even though expectant mother Tessa Hobbs had hoped for a natural birth at home, events took quite a different turn. The birth of her son Olle was a very heavy one, with lots of medical intervention and pain relief but in the end both mother and son are fine and Tessa is grateful for the expert help she got in the hospital.
"I feel quite naïve but then, how was I to know? I now know that hospitals are very important and that they do a wonderful job, but that doesn't mean that I no longer value the Dutch system of home births. If I ever get another child, I will certainly try again to give birth at home."
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Tessa with Olle and husband JR
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Other threats
So if it's up to Tessa and many other Dutch women, the tradition of home births will go strong for the years to come. However, gynaecologist Jan Nijhuis warns there may be other factors that could negatively influence the number of home births.
"If insurance companies are going to close down a lot of smaller hospitals, it may well become too dangerous for women in certain regions of the Netherlands to give birth at home. The distances then become too big and the time to go to the hospital in case of an emergency too long. And, if the number of midwives decreases, you'll have a problem as well. Or if insurance companies further reduce refunding the costs involved with maternity aid nurses, then that will certainly weaken the system as well."
For the moment though, the profession of midwifery is as popular as ever and insurance companies are not making a move yet to budget on the home birth system. So the immediate future for home births still looks rosy.
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Tags:
baby,
childbirth,
delivery,
family,
gynacology,
gynaecologists,
home birth,
midwives,
motherhood,
The Netherlands
Refugio Rochin,
fugeeo@gmail.com,
12-09-2006
- BVI
Seeing several sides of the issue, I feel Netherlands is blessed. It has technology, and it has internal trust. There is something about technology, when one sees media, that eventually gives people a heightened fear state. Media is generally downsided and negative, not generally positive. Media as well as technology tends to take people away from their sense of selves. In fact, in alpha states that sensual media can create, the mind absorbs even sensual information. So media interferes with our own senses and eventually leads people away from internal trust. As humans, we are here on earth to discover our personal trust, and to return to a true state. The farther one goes down the road to losing personal trust, the farther one goes away from true state. People experience pain in many ways. Birth experience is only one type of pain. Perhaps men do not live as long as women, because women take on such a birth pain. In effect, I am saying, that pain is healthy, and can lead to greater life understanding. Each individual is different. Hurrah for those who seek to know more about their true spirits. Hurrah for the Netherlands and their exemplary system.
Yawei Chen,
01-09-2006
- The Netherlands
I have myself experienced a nightmare of the Dutch midwife system. I can understand why a lot of women chose home birth. Partly it is because there are overwhelming brainwash of "public media education" how wonderful home birth is, partly I think it is because even I chose to give birth in a policlinic (you are not allowed to go to hospital unless your birth risk the life of yours or your child), I was not allowed to use any equipment that a clinic possess except the one that test the baby'ss heart beat. The system ensures those who chose not to have home birth must have exactly the same treatment you gat as if you give birth at home. I had thirty hours struggle of contraction and in the first twenty-six hours I hardly get any help from the midwife, simply because she is busy with another lady who give birth at home and without her approval, the clinic and the adjacent hospital are not allowed to interfere at all!!!.
Even I was told the baby was very big ever since I know I was pregnant, there was no precautions. The midwife simply said every baby fit the birth channel of the mother. What is the result? After my baby's head was out, her shoulder was too wide to come out. After all tools have been used, five or six professions in the operational room pressed on me and some even sit on me to try to get the baby out. In the end, they have to break her key bone to get her out. She was without breathe when she was out. It took them half hours to get my baby alive again! Suppose this was happening at home, what result will be?! I even heard one of my Dutch neighbour had the similar problem and had to call the emergency to come and pick them to hospital. I really suspect how healthy the system here in Holland as it claimed. Yes, it has less artificial interference, since the people here think women should suffer just because they want to have children. Of course it will be better within the natural way. But what is the point of having doctor, midwife and the whole technology innovation if babies died or become handicapped just because the birth "should" be natural? In many ways, I think the way how they arrange the system for birth and the way how they think about women's birth is still in the middle age. It is simply a taboo for so many years here to be even discussed whether a women can get pain relief to reduce suffer until a few months ago!
Muthusivakumaran,
muthusivakumarvpm@yahoo.co.in,
31-08-2006
- India
Surely, home birth is sweet news. See, if the child gets birth in the hospital, maybe it has many advantages, it has some disadvantages like infection, not a homely treatment etc. But home birth has also some disadvantages, like if the house is situated in a remote area and in case of emergency need, no hospital is nearby then the situation worsens. In total, I welcome home birth. Thanks for allowing me to make this comments.
jasmin,
31-08-2006
- India
Great that the Dutch women still prefer home delivery if the pregnancy is uneventful and also that medical aid reaches them fast if needed. Here in India, home delivery isn't in fashion and is for the lower socio-economic group. Moreover, the conditions at home aren't aseptic and sometimes ill-trained midwives worsen the matters so state health dept is promoting hospital delivery. As far as labour pains are concerned , women won't need epidural pain relief if they take a deep breath when the labour pain starts. It will lessen the pain and only few last essential labour pains will produce the sweet fruit of labour. My first hand experience...
