There is still a lot to be gained in primary care around childbirth, both in terms of approach and in support of women. This is stated by TNO student Marlies Rijnders, who will be awarded a PhD for effective interventions in primary obstetrics on Wednesday, 1 June.
Few women referred during childbirth
In the Netherlands, relatively many women are referred to a gynecologist for specialist care during pregnancy and childbirth. For example, for a cesarean section. The research by Marlies Rijnders shows that this percentage of referrals is still increasing. Afterwards, after a referral, women often look back more negatively on their childbirth.
Rijnders points out two interventions in her thesis, which can often prevent referrals: the turning of the baby if it is in a breech presentation at the end of the pregnancy. And breaking the membranes at home to introduce the delivery.
Safe and effective
Turning the baby is a time-honored and safe operation that can prevent hospitalization. In a quarter of pregnant women with a breech presentation, however, the baby is not turned. Breaking the membranes at home more often triggers a spontaneous delivery and prevents hospitalization. Rijnders is certain: "More research is needed into effective interventions that are in line with the wishes of women and that prevent unnecessary referrals".
Women deserve good guidance
If referral is necessary, good preparation and supervision of pregnant women is essential. A delivery does not always happen as expected. Dutch women seem to have high expectations with regard to childbirth. "There is no need to focus on dampening those expectations, but rather on tailoring the care to the expectations of women" according to Rijnders.
Marlies Rijnders works at TNO as a senior researcher in obstetrics and maternity care and will be awarded a PhD today at the UvA in the Lutheran Church at Singel 411 in Amsterdam on Wednesday 1 June at 1:00 pm. She then defends her thesis'Interventions in midwife led care in the Netherlands to achieve optimal birth outcomes: effects and women's experiences.'