From: Regional variations in childbirth interventions in the Netherlands: a nationwide explorative study
Nulliparous women, total and by care setting at the onset of labour (abbreviated as ‘midwife’ or ‘obstetrician’) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 | Total | GR | FR | DR | OV | FL | GD | UT | NH | ZH | ZL | NB | LB |
Total n | |||||||||||||
 All women | 276,701 | 8901 | 9564 | 6785 | 18,051 | 7233 | 30,961 | 23,662 | 49,582 | 63,785 | 4853 | 38,544 | 14,780 |
 Midwife | 153,091 | 4827 | 5701 | 3550 | 10,292 | 3979 | 18,559 | 14,293 | 29,280 | 32,817 | 2695 | 20,2019 | 6879 |
 Obstetrician | 121,612 | 4045 | 3831 | 3217 | 7648 | 3230 | 12,247 | 9266 | 19,663 | 30,283 | 2140 | 18,198 | 7844 |
Induction of labour, % | |||||||||||||
 All women | 21.2 | 24.8 | 20.7 | 26.2 | 23.3 | 20.8 | 18.6 | 18.0 | 19.1 | 23.0 | 22.4 | 21.4 | 24.4 |
 Obstetrician | 48.2 | 54.6 | 52.2 | 55.1 | 54.3 | 46.9 | 47.0 | 46.1 | 47.6 | 48.0 | 51.2 | 45.5 | 46.3 |
Augmentation after spontaneous onset of labour, % | |||||||||||||
 All women | 42.9 | 40.7 | 38.0 | 41.5 | 36.2 | 48.4 | 44.3 | 45.9 | 43.7 | 42.1 | 33.5 | 45.6 | 42.2 |
 Midwife | 39.1 | 37.9 | 34.8 | 37.5 | 32.7 | 43.3 | 41.2 | 43.4 | 40.3 | 37.1 | 29.5 | 41.8 | 37.6 |
 Obstetrician | 54.5 | 49.9 | 51.5 | 53.9 | 48.9 | 62.6 | 55.1 | 54.7 | 55.6 | 54.9 | 47.1 | 56.0 | 52.0 |
Intrapartum oxytocin use, % | |||||||||||||
 All women | 62.2 | 62.4 | 61.7 | 63.3 | 59.0 | 66.5 | 64.3 | 65.6 | 63.4 | 62.4 | 55.1 | 59.9 | 58.0 |
 Obstetrician | 61.6 | 64.6 | 64.4 | 67.5 | 60.9 | 69.5 | 63.2 | 63.7 | 62.1 | 60.9 | 56.5 | 58.7 | 58.4 |
Epidural, % | |||||||||||||
 All women without prelabour CS | 27.4 | 25.4 | 20.1 | 12.3 | 27.7 | 13.7 | 27.6 | 31.0 | 22.3 | 27.3 | 19.1 | 37.5 | 36.4 |
 Midwife | 19.8 | 19.5 | 14.2 | 7.9 | 19.8 | 8.7 | 20.9 | 24.4 | 16.0 | 17.9 | 13.0 | 28.8 | 26.2 |
 Obstetrician without prelabour CS | 38.1 | 33.1 | 30.0 | 17.7 | 39.3 | 20.1 | 38.7 | 42.4 | 32.6 | 38.5 | 27.7 | 48.4 | 46.3 |
Other pharmacological pain relief, % | |||||||||||||
 All women without prelabour CS | 21.6 | 20.1 | 20.6 | 38.2 | 16.2 | 43.0 | 17.6 | 14.8 | 24.6 | 22.3 | 25.6 | 17.2 | 27.9 |
 Midwife | 17.7 | 14.7 | 16.5 | 30.0 | 13.0 | 35.4 | 14.8 | 13.1 | 21.2 | 17.6 | 19.0 | 14.8 | 20.9 |
 Obstetrician without prelabour CS | 27.1 | 27.1 | 27.6 | 48.0 | 20.8 | 53.1 | 22.0 | 17.7 | 29.8 | 28.0 | 34.8 | 20.1 | 34.7 |
Spontaneous vaginal birth, % | |||||||||||||
 All women | 65.2 | 62.4 | 64.0 | 66.0 | 64.1 | 64.6 | 67.4 | 66.8 | 64.6 | 64.1 | 66.2 | 66.2 | 64.9 |
 Midwife | 74.3 | 72.0 | 72.7 | 74.5 | 73.1 | 71.8 | 75.6 | 75.2 | 73.2 | 74.3 | 75.9 | 75.7 | 75.8 |
 Obstetrician | 53.6 | 51.2 | 51.2 | 56.6 | 51.9 | 55.9 | 54.9 | 53.9 | 51.8 | 53.0 | 53.9 | 55.4 | 55.4 |
Instrumental vaginal birth, % | |||||||||||||
 All women (without prelabour CS) | 17.9 | 19.3 | 17.8 | 17.5 | 19.4 | 18.5 | 17.1 | 17.2 | 18.3 | 19.1 | 17.0 | 16.2 | 16.6 |
 Midwife | 17.0 | 18.5 | 17.1 | 17.7 | 18.3 | 18.5 | 16.4 | 16.3 | 17.5 | 17.3 | 15.6 | 15.9 | 15.9 |
 Obstetrician (without prelabour CS) | 19.2 | 20.2 | 18.9 | 17.4 | 21.1 | 18.5 | 18.2 | 18.7 | 19.7 | 21.1 | 18.9 | 16.5 | 17.3 |
Caesarean Section, % | |||||||||||||
 All women | 17.8 | 19.3 | 19.0 | 17.2 | 17.4 | 17.6 | 16.3 | 16.7 | 17.9 | 17.7 | 17.6 | 18.5 | 19.4 |
Prelabour CS, % | |||||||||||||
 All women | 4.5 | 4.6 | 4.7 | 4.1 | 4.4 | 3.6 | 4.1 | 4.2 | 4.3 | 4.4 | 4.6 | 5.2 | 5.8 |
 Obstetrician | 10.2 | 10.0 | 11.5 | 8.6 | 10.2 | 7.9 | 10.2 | 10.6 | 10.7 | 9.2 | 10.4 | 11.1 | 10.8 |
Intrapartum CS, % | |||||||||||||
 All women (without prelabour CS) | 13.9 | 15.4 | 15.1 | 13.7 | 13.6 | 14.6 | 12.7 | 13.1 | 14.2 | 13.9 | 13.7 | 14.0 | 14.4 |
 Midwife | 8.6 | 9.6 | 10.2 | 7.7 | 8.5 | 9.7 | 7.9 | 8.5 | 9.3 | 8.4 | 8.5 | 8.3 | 8.2 |
 Obstetrician (without prelabour CS) | 21.2 | 23.0 | 23.3 | 20.9 | 21.2 | 21.0 | 20.7 | 21.1 | 22.3 | 20.5 | 21.0 | 21.2 | 20.6 |
Involvement paediatrician < 24 h, % | |||||||||||||
 All women | 50.4 | 59.6 | 49.9 | 51.1 | 47.7 | 48.3 | 55.9 | 60.0 | 36.9 | 50.8 | 46.9 | 53.0 | 60.3 |
 Midwife | 38.1 | 45.6 | 37.9 | 37.2 | 34.8 | 38.1 | 43.4 | 49.0 | 26.9 | 36.5 | 32.5 | 42.5 | 47.0 |
 Obstetrician | 65.8 | 76.3 | 67.6 | 66.5 | 64.8 | 60.8 | 74.7 | 76.9 | 51.6 | 66.4 | 65.6 | 64.5 | 71.9 |
Multiparous women, total and by care setting at the onset of labour (abbreviated as ‘midwife’ or ‘obstetrician’) | |||||||||||||
 | Total | GR | FR | DR | OV | FL | GD | UT | NH | ZH | ZL | NB | LB |
Total n | |||||||||||||
 All women | 338,029 | 10,540 | 13,004 | 9090 | 24,818 | 10,228 | 40,325 | 29,231 | 56,366 | 75,788 | 6474 | 45,643 | 16,522 |
 Midwife | 174,918 | 5186 | 7200 | 4334 | 13,630 | 4963 | 22,842 | 16,308 | 30,470 | 37,206 | 3373 | 21,821 | 7585 |
 Obstetrician | 161,286 | 5331 | 5765 | 4735 | 11,070 | 5246 | 17,324 | 12,812 | 25,414 | 37,940 | 3082 | 23,705 | 8862 |
Induction of labour, % | |||||||||||||
 All women | 19.7 | 23.8 | 19.0 | 25.4 | 20.2 | 22.2 | 17.7 | 16.6 | 18.0 | 21.1 | 20.6 | 20.1 | 21.2 |
 Obstetrician | 41.1 | 47.0 | 43.0 | 48.8 | 44.8 | 43.3 | 41.1 | 37.6 | 39.4 | 41.7 | 43.3 | 38.8 | 39.7 |
Augmentation after spontaneous onset of labour, % | |||||||||||||
 All women | 17.3 | 14.5 | 14.8 | 18.0 | 14.0 | 22.6 | 17.2 | 16.1 | 17.9 | 18.4 | 12.4 | 18.8 | 16.6 |
 Midwife | 11.2 | 8.8 | 9.5 | 12.0 | 8.6 | 14.2 | 11.3 | 11.5 | 12.1 | 11.6 | 7.1 | 11.7 | 10.1 |
 Obstetrician | 33.2 | 29.3 | 32.5 | 33.2 | 30.9 | 41.3 | 34.3 | 29.4 | 34.6 | 33.9 | 27.2 | 33.8 | 30.2 |
Intrapartum oxytocin use, % | |||||||||||||
 All women | 44.7 | 47.0 | 47.6 | 51.7 | 44.5 | 51.7 | 46.3 | 43.4 | 45.4 | 45.6 | 41.4 | 40.1 | 39.7 |
 Obstetrician | 45.8 | 50.3 | 50.0 | 54.2 | 46.6 | 54.3 | 47.8 | 43.9 | 45.8 | 45.9 | 42.9 | 41.0 | 41.5 |
Epidural, % | |||||||||||||
 All women without prelabour CS | 9.6 | 8.9 | 7.0 | 4.6 | 8.4 | 4.9 | 9.3 | 10.4 | 8.0 | 9.7 | 7.6 | 13.8 | 13.8 |
 Midwife | 3.0 | 2.7 | 2.0 | 0.8 | 2.2 | 1.6 | 3.0 | 4.2 | 2.6 | 2.6 | 2.3 | 4.8 | 4.3 |
 Obstetrician without prelabour CS | 18.1 | 16.0 | 14.5 | 8.6 | 17.5 | 8.6 | 18.7 | 19.9 | 15.8 | 18.1 | 14.7 | 23.8 | 23.6 |
Other pharmacological pain relief, % | |||||||||||||
 All women without prelabour CS | 14.5 | 12.4 | 14.3 | 22.9 | 11.7 | 26.8 | 11.2 | 9.8 | 14.5 | 15.1 | 14.4 | 15.0 | 19.9 |
 Midwife | 6.6 | 5.0 | 5.6 | 9.5 | 5.2 | 12.6 | 5.3 | 5.1 | 7.2 | 6.5 | 4.7 | 7.9 | 8.4 |
 Obstetrician without prelabour CS | 24.6 | 20.8 | 27.3 | 37.3 | 21.3 | 42.5 | 20.0 | 17.0 | 25.0 | 25.1 | 26.8 | 23.0 | 31.7 |
Spontaneous vaginal birth, % | |||||||||||||
 All women | 83.7 | 82.9 | 82.5 | 83.8 | 83.6 | 84.9 | 86.1 | 84.2 | 82.8 | 83.4 | 83.9 | 83.6 | 81.7 |
 Midwife | 96.9 | 96.6 | 96.2 | 97.3 | 96.6 | 96.9 | 97.2 | 97.1 | 96.8 | 96.8 | 97.1 | 96.9 | 97.1 |
 Obstetrician | 69.3 | 69.7 | 65.2 | 71.5 | 67.5 | 73.6 | 71.5 | 67.9 | 66.0 | 70.1 | 69.4 | 71.1 | 68.6 |
Instrumental vaginal birth, % | |||||||||||||
 All women (without prelabour CS) | 3.5 | 3.7 | 4.1 | 3.5 | 4.2 | 3.1 | 3.3 | 3.1 | 3.1 | 3.8 | 3.7 | 3.1 | 3.5 |
 Midwife | 1.8 | 1.7 | 2.1 | 1.7 | 2.2 | 1.6 | 1.6 | 1.7 | 1.6 | 1.9 | 1.8 | 1.7 | 1.7 |
 Obstetrician (without prelabour CS) | 5.7 | 6.0 | 7.0 | 5.5 | 7.2 | 4.8 | 5.9 | 5.3 | 5.4 | 6.0 | 6.1 | 4.6 | 5.4 |
Caesarean Section, % | |||||||||||||
 All women | 13.2 | 13.7 | 13.8 | 13.0 | 12.6 | 12.2 | 10.8 | 12.9 | 14.3 | 13.2 | 12.7 | 13.6 | 15.2 |
Prelabour CS, % | |||||||||||||
 All women | 7.8 | 7.9 | 7.8 | 7.7 | 7.7 | 7.2 | 5.8 | 8.0 | 8.5 | 7.9 | 7.7 | 8.2 | 9.8 |
 Obstetrician | 16.4 | 15.6 | 17.6 | 14.7 | 17.1 | 14.0 | 13.4 | 18.2 | 18.8 | 15.6 | 16.3 | 15.9 | 18.0 |
Intrapartum CS, % | |||||||||||||
 All women (without prelabour CS) | 5.8 | 6.2 | 6.4 | 5.7 | 5.3 | 5.4 | 5.3 | 5.4 | 6.3 | 5.8 | 5.4 | 5.9 | 6.0 |
 Midwife | 1.3 | 1.7 | 1.6 | 1.0 | 1.2 | 1.5 | 1.2 | 1.2 | 1.5 | 1.4 | 1.1 | 1.4 | 1.1 |
 Obstetrician (without prelabour CS) | 11.6 | 11.4 | 13.8 | 10.7 | 11.4 | 9.6 | 11.5 | 11.8 | 13.4 | 11.0 | 11.2 | 10.9 | 11.0 |
Involvement paediatrician < 24 h, % | |||||||||||||
 All women | 35.6 | 41.1 | 34.5 | 36.3 | 33.9 | 34.0 | 37.8 | 41.9 | 25.6 | 37.0 | 36.0 | 37.0 | 42.7 |
 Midwife | 14.6 | 16.6 | 14.2 | 13.7 | 13.1 | 14.8 | 16.4 | 19.6 | 9.2 | 14.4 | 11.7 | 16.8 | 19.2 |
 Obstetrician | 58.2 | 65.0 | 59.9 | 57.0 | 59.3 | 52.0 | 66.1 | 70.2 | 45.2 | 59.1 | 62.7 | 55.5 | 62.7 |