The Dutch Home Birth Culture

Certain groups of obstetricians, maternity nurses and (prospective) parents make efforts to safeguard the Dutch culture of home births, because of cultural aspects and for medical reasons.

Midwives who are affiliated with the Koninklijke Nederlandse Organisatie van Verloskundigen (KNOV) (Royal Dutch Organisation of Midwives) and maternity carers who are affiliated with the Nederlandse Beroepsvereniging voor Kraamverzorgenden (NBvK) (Dutch Professional Association of Maternity Carers) supervise home births and provide support during the maternity period.

These two professional organisations recognise the home birth as part of the Dutch identity and culture, and they are committed to safeguarding this practice in a safe and responsible manner, in cooperation and coordination with midwifes’ and gynaecologists’ organisations. The aim is to prevent a natural process from being unnecessarily medicalised, and to interpret the medical and cultural values of home birth. Many midwives and maternity nurses experience their contribution to home birth and the postpartum period as a vocation.

Furthermore, women and their partners in the fertile phase of life who wish to have children are, of course, practitioners of this heritage when they consciously choose a home birth.

In the Middle Ages, midwives attended births at home on a 'birthing chair' or couch, and maternity care was provided by 'monthly nurses' who were often attached to old tried and tested methods.

In the seventeenth century, training in midwifery came into being; in 1865, the Thorbecke Act regulated that medicine and midwifery could only be practised by people who were trained for it. As in neighbouring countries, maternity clinics were set up in the Netherlands, but thanks to the well-trained and independent midwives, most women could still give birth at home in the Netherlands. At the beginning of the twentieth century a new course in maternity care was offered, which led to what is now the profession of maternity care.

With the establishment of the midwife's competences in Dutch law, the seeds were sown for a strongly independent position of midwives compared to other Western countries. The difference with the rest of the world was that midwives in the Netherlands were trained as independent medical professionals, while elsewhere they fell under the responsibility of doctors. The independent position of midwives goes hand in hand with a certain degree of freedom in supervising deliveries at home.

The combination of obstetrics with a period of maternity care at home is also unique to the Netherlands. Here, the midwives form an autonomous profession within birth care, from which the KNOV, among others, derives its right to exist.

2020-2023

• Counterbalance the culture of fear and control among (prospective) pregnant women and their partners by highlighting the medical benefits of home birth and explaining the physiology of the birth process, In order to be able to make a well-considered choice, expectant parents must be informed about the safety of giving birth at home.
• Convey that home birth is part of the Dutch intangible culture and indicate the importance of the underlying values, namely: freedom of choice, autonomy, 'being at home' and not medicalise unnecessarily.
• Create awareness that there is a real risk of home births disappearing as a result of increasing medicalisation of births, which puts the freedom of choice of women at risk.
• Clarify scientific articles on home birth by 'translating' them to the public, and disseminate positive birth experiences through social media and journalists.
• Provide more information on safe home births, both to our own professional groups and in schools and training courses. Draw up an action plan for the next few years including visits to schools, dissemination of information through social media (Facebook, Instagram) etc.