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Table 1 Characteristics of included birth locations as presumed birth centres

From: Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study

Topic

Content

Characteristics

Included birth locations n = 46 (%)a

Philosophy

Commitment to physiological birth and facilities that contribute to the fulfilment of that philosophy

Facilities for discomfort and pain management which are allowed to be used in primary care (bath, shower, massage, nitrous oxide and/or TENS)

46 (100)

Facilities to encourage spontaneous pushing in non-supine positions (birth chair, birthing ball)

42 (91)

Assistance for community midwife during labour and birth by a maternity care assistant

42 (93)

Providing one-to-one support

23 (51)

Environment

Homelike

Alterable lighting / homelike atmosphere

46 (100)

No ‘medical’ equipment in sight

26 (57)

Responsibility for care

Community midwife

A Dutch community midwife is an independent medical professional who has full responsibility for providing care for healthy low risk women during pregnancy, childbirth and postpartum. The midwife conducts antenatal assessments, supports women giving birth at a place of their choice (at home, in a birth centre or in a hospital), and provides post-natal care up to six weeks postpartum. If medical assistance is required, the midwife will refer the women to a secondary caregiver (obstetrician or paediatrician). Community midwives in the Netherlands have a greater degree of autonomy in relation to the other medical professions than do midwives in most countries, but only as far as the low-risk population is concerned.

46 (100)

Population

Low risk women

Low risk women are women with a singleton pregnancy of a child in cephalic presentation who start labour spontaneously between 37 and 42 weeks and who do not have any medical or obstetric risk factors that are an indication for secondary care, such as formulated in the so-called List of Obstetric Indications [12]. They can choose where they would like to give birth (at home, in a hospital or in a birth centre).

46 (100)

Medium risk women

Medium risk women are low risk women with a “medium risk” indication. Due to a specific reason they are advised to give birth in hospital but still under community midwife led care. The official medium risk indications according to the so-called List of Obstetric Indications are postpartum haemorrhage or retained placenta after a previous birth.

23 (50)

Management

Midwifery managed

In the organizational structure it is formally established that an independent community midwife is leading in care content and organization.

23 (50)

Obstetric managed

In the organizational structure the obstetrician is leading in care content and organization.

23 (50)

Physical transfer in case of referral

Always needed

By wheelchair, bed, car or ambulance

10 (22)

Always with exceptions

By wheelchair or bed but for some urgent reasons an exception is made and the secondary caregiver (obstetrician or paediatrician) will enter the room

13 (28)

Not needed

The obstetrician enters the room

23 (50)

Location in relation to obstetric unit

Freestanding

Separate from the obstetric unit, in a different building than the hospital with an obstetric unit

3 (7)

Alongside

Separate from the obstetric unit but in a hospital with an obstetric unit

17 (37)

On-site

On the same ward as the obstetric unit

26 (57)

  1. a due to one missing value some percentages are calculated based on available data