Home or hospital birth: a prospective study of midwifery care in the Netherlands.

A large scale study on maternity care in the Netherlands, describing many facets of midwifery care in relation to the preferred place of birth (at home or in hospital), the obstetric result, and the experiences of childbirth. In the Netherlands only women with low risk pregnancies are free to choose where to give birth, at home or in hospital, assisted by an midwife (or general practitioner). The study showed that for these women the outcome of planned home births is at least as good as that of planned hospital births. The choice to give birth at home or in hospital was found to be based primarily on social factors, such as the confidence of family and friends in home birth and the expected influence of the hospital environment on childbirth. The study also showed, contrary to expectations, that an unplanned transfer from a planned home birth to hospital (due to referral to an obstetrician) has little influence on the experience of childbirth.