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Table 2 Maternity care organizations

From: Client-tailored maternity care to increase maternal empowerment: cluster randomized controlled trial protocol; the healthy pregnancy 4 All-2 program

Maternity care organizations

There are around 120 maternity care organizations in the Netherlands that function as independent enterprises. Women can sign up during pregnancy with any maternity care organization that provides care in their neighborhood. On average, 95% of all women make use of some amount of maternity care.

During pregnancy a MCA will assess a woman’s expected care requirements during a scheduled home visit around 25–37 weeks of gestation. For primiparous women this intake is scheduled as a home visit, whereas for multiparous women this intake is conducted per telephone. Compensation from health insurers to maternity care organizations differs according to this policy. The intensity of care provision during the postpartum period is based on the indications denoted in the Dutch national indication protocol (abbreviated by LIP in Dutch). Examples of indications that add to the intensity of care are: not being physically self-sufficient, having a psychological illness, and having other children under the age of four years. An example of an indication that will downscale the intensity of care is planning to bottle feed rather than breastfeed the newborn.

The minimum volume of care at home is set at 24 h over eight days, the recommended volume is set at 49 h, and its maximum amount is set at 80 h, depending on specific indications, spread out over eight to ten days. Maternity care is covered by the general health care insurance (which is mandatory for every Dutch inhabitant) with exception of an out-of-pocket payment of €4.30 per hour (2017).