Dutch obstetric system

The Dutch obstetric system is known for its physiological approach and autonomous midwives. The system of primary and secondary care is unique compared to many surrounding countries. There, midwives often work in a hierarchical relationship with gynaecologists and paediatricians associated with a hospital.

Primary care

This care is accessible care close to home. A client or patient can contact the primary care providers themselves, without a referral. This applies, for example, to the general practitioner ( family doctor), the dentist and the midwife. They act as gatekeepers to secondary care: the specialist care in hospital of, for example, a gynecologist and pediatrician.

The primary care of a midwife

We accompany pregnant women as long as the pregnancy is physiological. We have our own practice. If it turns out that a pregnancy or birth is not proceeding normally, we will make an assessment of the nature and severity of the complications. During this risk selection, the midwife determines whether specialist care is needed and then refers the care to the gynecologist, the secondary care.

Vision on pregnancy and birth

In the Netherlands, pregnancy and birth are seen as normal processes that can be supervised in primary care by midwives. There is an active collaboration between gynecologists and obstetricians, so that specialist care can be provided in the hospital in the event of complications.

Advantages of the Dutch system

The Dutch system has a number of advantages:

• If there are no risks, women can choose where they want to give birth: at home or in the hospital (outpatient)
• Pregnancy and childbirth are approached as much as possible as normal events
• In the case of a medical indication, pregnant women have the choice to be accompanied by a clinical midwife
• Secondary care is only used on medical grounds, this prevents unnecessary medical interventions.