Trends in the medicalisation of childbirth in Flanders and the Netherlands
Section snippets
Background
The medicalisation of childbirth has had both desirable and undesirable consequences. The development of medical procedures to respond to pathological problems that arise in pregnancy and birth has had salutary effects for sick babies and mothers: the use of these same procedures when mother and baby are healthy increases costs and creates unnecessary risks to health. In this paper we examine trends in obstetrical interventions in Flanders and the Netherlands – two regions of the world that
Methods
In order to more completely describe the varied levels of medicalisation in the Netherlands and Flanders, we use data from the national perinatal databases of the Netherlands (PRN, Perinatale Registratie Nederland) and Flanders (SPE, Studiecentrum voor Perinatale Epidemiologie). In the Netherlands the registration of data takes place in the practices of the participating midwives and general practitioners (LVR1), and obstetricians (LVR2). A form or an automated system is used for registration.
Within each country
Perinatal statistics from the Netherlands show a small but increasing trend towards more medical interventions in childbirth. Data from 2008 (PRN, 2011) show that in the past several years there has been a small but steady increase (one to two per cent yearly) in the use of epidural analgesia during labour. Other trends in the Netherlands include an increased use of inductions and augmentation in labour (28.8% in 2003 versus 35.0% in 2008), and a decreasing number of births in primary care
Discussion and conclusion
Medicalisation of the birth process is not a new phenomenon. It is something that has taken (and continues to take) place in all western countries. Until recently, however, the Netherlands was known as the country that had resisted that trend. Today, the movement toward medicalised birth – present everywhere else in the modern world – appears to be affecting the wishes and demands of Dutch women (Pavlova et al., 2009, Van der Hulst et al., 2007) and the attitudes of Dutch caregivers (e.g.
Conflict of interest
The authors declare no conflict of interest.
Acknowledgements
This research was funded by and contributes to the EU COST action ISO907: ‘Childbirth Cultures, Concerns, and Consequences’: Creating a dynamic EU framework for optimal maternity care.
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