Home birth in Holland

AIMS Journal, 2008, Vol 20 No 3

Dutch ENCA member Thea van Tuyl dispels some of the myths about why Holland has such a high home birth rate

During our ENCA (European Nations Childbirth Association) meeting in May 2008 we heard again the same stories as we have heard before about Dutch home birth. These stories are complete nonsense. They are spread around in several European countries to convince women that home birth is something special, that it only can exist in Holland because of the perfect Dutch pelvis of Dutch women and our ambulance service.

If doctors say that Dutch women have a perfect pelvis for giving birth at home without complications, they lie. The pelvis of Dutch women is no different from all other women in European countries. The reason why our pelvis would be so great for giving birth, they say, is because we bike a lot. But that is not true either. Of course many Dutch women do ride bicycles, but that does not change their pelvises.

Another story is about our ambulance service. When a woman gives birth at home, they say that there is an ambulance waiting in front of her door. So, if there is a problem they can act immediately. We heard the story of doctors who come in and spray around so the house will be sterile and so they can do a caesarean section at home. Of course this is a fairy tale! If a woman gives birth at home there is NO ambulance! Her midwife visits her frequently to check the progress of the birth process. If needed the midwife stays with her and a home nurse comes to assist her. They both attend a home birth.

When there is a problem during labour the midwife will advise the couple to go to the hospital and accompany them to hand over the woman to the gynaecologist’s care. When a problem arises during second stage the midwife will take the woman to the hospital in her own car and the partner follows in his. However, if it is better that she is transported in an ambulance, the midwife will call and ask the ambulance to come. In the third stage women will mostly be transported by ambulance.

The transport to the hospital is something you take into consideration. You never know how the birth process develops and you might end up in hospital. Every woman who gives birth at home knows that and she trusts the midwife who will anticipate any problems and handle them correctly.

The reason why doctors and the press tell these stories is because they fear home birth and they want women to believe that this fear is right. In a home birth there will be little intervention. The only intervention a midwife can do is an episiotomy. There is quietness and peace in a woman’s own bedroom or bathroom. It is totally safe because there are none of the strange and hostile microorganisms present in hospital.

The perinatal death rate in home birth is very, very low. Babies die in hospital and only sometimes during a home birth. So all this fear is so unnecessary.

But, don’t forget that women who are allowed to give birth at home are only healthy pregnant women. If there is any problem during pregnancy a woman will be sent to the hospital to give birth there.

In Holland we have home bir th because of:

• the selection of healthy pregnant women
• the distance to the hospitals is not far because our country is small
• an ambulance can reach every emergency within 15 minutes
• the midwife who attends a home birth will always be accompanied by a home nurse (kraamverzorgster)
• it all started from a tradition so most women are convinced it is normal to give birth at home, because it is not an illness but a natural event.

We hope that many women, doctors, nurses, midwives etc. will read this explanation, so they change their minds about home birth.

Thea van Tuyl
ENCA Nederland

To read more about the system of birth in the Netherlands, along with reports and maternity statistics from other ENCA member countries please see AIMS Journal Vol 20 No 2 2008.