Dutch pregnant women wish to have midwife-led care in their vicinity


A recent study conducted by TNS NIPO (Dutch survey agency) has shown that Dutch women wish to have midwife-led care in their vicinity, and choice on where to give birth. Over 90% of pregnant women and those who have given birth are very positive about the Dutch midwifery care. However, the continuous support during labour can be improved. The survey commissioned by The Royal Dutch Organisation of Midwives (KNOV) was conducted in December 2013, and involved 341 pregnant and nursing women. The main objective of the survey was to assess the quality of midwifery care and areas of improvement. Findings are outlined below:

Women are positive about midwifery-led care
In 79% of the cases, midwives are the main caregivers during pregnancy. During birth, these are mainly the women’s chosen midwives or hospital midwives, together accounting for 68%. Knowledge, commitment, and availability - these are the most important factors that women are looking for in a midwife. These factors have remained unchanged during the past years. 94% of pregnant women and nursing women are very positive about midwives: they inform, provide support and continuous care close to home, and are the first point of contact being medically knowledgeable and accessible. In most cases (80%), both the women who have recently given birth and pregnant women, state that the midwife respects their choice on where to give birth, if that is medically reasonable.

Continuous support during labour
In 54% of cases, the midwife is continuously present during childbirth. An area of improvement for midwives would be working in cooperation with maternity nurses. Previous research conducted by the Cochrane Collaboration, suggested that continuous support has many benefits, among the following: greater satisfaction of the woman in labour, which lasts shorter on average, less use of analgesics.

Calling on the midwife if possible, on the gynaecologist – when necessary
Women have full confidence in midwives. Over 80% of the women believe that the midwife is knowledgeable enough to refer to the gynaecologist when necessary. There is no preference to be cared for by the gynaecologist if there is no medical reason for it. Midwifery care prevents unnecessary medicalization, interventions, and healthcare costs. 7 out of 10 women who have gynaecologists as care providers said that they wish to be put in contact with a midwife. This research showed that it is unclear how the cooperation between the midwife and the gynaecologist/general practitioner progresses. This is an area of improvement and should be integrated into birth care.

The online survey was conducted among 170 pregnant women (from 10 weeks) and 171 women who have given birth over the last 6 months. This is a representative sample of the population. Full survey results (in Dutch) can be found here.