Home or Home-like Hospital Birth
Home or Home-like Hospital Birth
In the Netherlands, which has about 200.000 births per year, maternity care is provided by
 midwives or general practitioners unless medical reasons necessitate specialist obstetric
 care. Women with low risk pregnancies are free to decide where to give birth, attended by
 their midwife or general practitioner, at home or in the hospital, from which they are then
 discharged within 24 hours. In the Netherlands these hospital births are referred to as
 "poliklinische bevallingen" (i.e. outpatient deliveries) to indicate that they do not involve
 formal hospitalisation, or as "verplaatste thuisbevalling" (i.e. relocated home births) to
 indicate that they are supervised by the same caregivers as the home births without
 involvement of specialist obstetricians.

 In the last two decades a marked increase in the referral rate to obstetricians during
 childbirth has occurred, especially for nulliparae, both in planned home births and planned
 hospital births (outpatient deliveries). 90% from all primigravidae will start their
 pregnancy under care of the primary caregiver (midwife of general practitioner). During the
 pregnancy 30% will be referred to the secondary caregiver (obstetrician specialist). The
 other 60% will start labor guided by the primary caregiver. More than 50% of these women will
 be referred to the obstetrician during labor.

 Despite this unique situation of the Dutch maternity care, the differences between home and
 hospital birth (outpatient deliveries) with regard to effectivity and efficiency have never
 been investigated. It is also unclear if pregnant women are informed about a 50% risk of
 being transported to the secondary caregiver/ hospital during labor at home. Neither do we
 know what their experiences are.

 This study aims to investigate the differences between home and hospital deliveries under
 care of the primary caregiver with regard to effectivity (costs) and efficiency (patient
 satisfaction) of care.
Inclusion Criteria:

 -  Primiparae

 -  No medical indication for specialistic care

 -  The pregnant woman will be able to give birth at home or at a hospital

 -  The woman and her partner will be fluent in the Dutch language