Sunday, October 18, 2009

Positive Thoughts About the Netherlands: Home Births

To wrap up the "Positive Thoughts about the Netherlands" series, I have chosen a topic that seems to be a little controversial amongst expats (judging by the comments raised on related articles on sites such as Expatica) but one that nonetheless I see as positive: the right to choose for a home birth.

Nearly a third of women in the Netherlands give birth at home, and even more initially plan to deliver at home (up to 60% according to some studies) but end up in hospital for medical reasons. Whilst this figure is decreasing, and more women in the Netherlands are opting to give birth in hospital, the Dutch home birth rate still stands out in the world; around 2% of women in the UK have a home birth, this is even lower in the US with a home birth rate of around 0.65%.

There has been controversy around the alarming figures following the Euro Peristat data released in 2008, but a comprehensive study into the safety of home births revealed in April this year that there is no more risk with a home birth than a hospital birth, and that the home birth culture in the Netherlands is not responsible for the dismal Dutch figures. What is responsible seems to be a combination of factors, and something that needs further research.

If there are any medical indications, or risk of medical complications as the pregnancy progresses, a midwife will immediately make a hospital referral and rule out a home birth.

There are many reasons for the popularity and availability of home births amongst the Dutch. One is the emphasis here on midwives in the maternity process, who play the key role in a pregnancy and birth with no medical implications. The second reason is that the Dutch advocate natural births; using breathing techniques and relaxation methods instead of drugs. This is certainly one of the most alarming issues for expatriates giving birth in the Netherlands, but attitudes and rights to pain relief have changed in the Dutch maternity system even in the last year or so. You have the right to choose: hospital or home, natural or pain relief.

When I was pregnant in 2006, the home birth issue was one I mulled over for some time. I see-sawed between the idea of being in my own home, in a familiar environment, for the birth, and being in the safety of a hospital should something go wrong. In the end, I stuck with my initial decision to aim for a home birth and everything was ready for this scenario. However, for medical reasons I ended up having no choice but to go to the hospital for the birth of my son. The main thing at the end of the day was that he was delivered safely, but I have no doubt that the experience would have been much more pleasant had it happened at home.

However you see the maternity system in the Netherlands, the fact that there is a solid infrastructure to support home births and the choices of mothers-to-be can only be a positive thing.

If you want to read more about the Dutch maternity system here are some articles I have written on the topic:

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