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

Abstract

BackgroundDuring the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics.MethodsInternational definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care.ResultsFrom all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: “Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care.” Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all freestanding and alongside birth centres. Birth centres varied in their reason for establishment and their characteristics.ConclusionsTwenty-three Dutch birth centres were identified and divided into three different types based on location according to the situation in September 2013. Birth centres differed in their reason for establishment, facilities, philosophies, staffing and service delivery.

Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: results of the Dutch Birth Centre study

“…Three types of birth-centre locations can be distinguished: 1) freestanding from a hospital, 2) alongside an obstetric unit and 3) on-site at an obstetric unit. 24 We also distinguished three integration profiles: monodisciplinary-oriented birth centres (MOBC), multidisciplinary-oriented birth centres (MUBC) and a mixed group of birth centres (MIBC). Integrated care is increasingly encouraged in maternity care systems.…”

Quality improvement opportunities for handover practices in birth centres: A case study from a process perspective

“…They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care, assisted by maternity care assistants …”

“…Reasons for referral are defined in the List of Obstetric Indications, which is a multidisciplinary guideline . Birth centres are often located close to the obstetric care unit of a hospital but can be freestanding from a hospital as well …”

“…Community midwives take primary professional responsibility for care, assisted by maternity care assistants. 10 Most Dutch community midwives work in group practices in the community. They are autonomous in their decisions during birth care.…”

“…11 Birth centres are often located close to the obstetric care unit of a hospital but can be freestanding from a hospital as well. 10,12 The clear segmentation in primary and secondary care requires the pregnant women to move often from 1 type of service to another. During the birth process, health care is essential to guarantee the health and life of the mother and her baby.…”