LESS IS MORE

Dutch midwifery views childbirth as a normal physiological life event and aims to achieve a non- interventionist birth. The Dutch midwife works independently at primary care level and cares for low-risk women only. Referral to an obstetrician occurs when complications arise. Despite the physiological view the intervention rate in the Netherlands has increased since the 1990s. Simultaneously midwifery practices increasingly organised themselves in large-sized group practices. This raises the questions whether there is a relationship between interventions and practice size. The study in this book relates experiences and birth outcomes of low-risk women in the Netherlands and compares differences between small midwifery practices (1-2 midwives), medium-sized practices (3- 4 midwives) and large practices(5 or more midwives). A sample of Dutch low-risk women answered a questionnaire and after the data were analysed results were in favour of women in practices with a maximum of two midwives. Discussion of the findings may contribute to the re-organisation of midwifery care in order to safeguard the well being of Dutch low-risk childbearing women.