Friday Fallacy: The Netherlands Are a Fantastic Model When it Comes to Birth

It’s on every birth blog and pregnancy forum out there: the claim that, because the Netherlands has a high rate of homebirth, the country is some sort of exemplar for how birth should be done.

Case in point:

(side note: I love how not only do they delete any information that doesn’t fit their world view on their pages, but they flounce whenever they find a page that doesn’t delete it.)

First of all, the homebirth rate in Hollandthe Netherlands is nowhere near 92%. In fact, it’s currently around 29% and rapidly declining. Why is it declining you ask? Maybe it’s because they have some of the worst birth statistics in all of Europe.

According to a 2010 study published in the British Medical Journal, The Netherlands has a shockingly high perinatal mortality rate, one of the highest among European nations. In the study, the researchers found that infants of LOW RISK pregnant women whose labor started in primary care under the supervision of a midwife in the Netherlands had a higher risk of delivery related perinatal death and the same risk of admission to the NICU compared with infants of HIGH RISK pregnant women whose labor started in secondary care under the supervision of an obstetrician. Doesn’t sounds like all those Dutch homebirths are lowering the perinatal mortality rate to me.

And what about maternal health? That’s an indicator of the level of maternity care, too, right? Well, even with it’s relatively heterogeneous population and universal access to healthcare, the Netherlands has consistently had one of the highest maternal mortality rates in Europe as well, especially in the last 10 years.

You’ll notice that even though the Netherlands has by far the lowest c-section rate in Europe, they have a much higher maternal mortality rate than, say, Italy, whose rate of cesarean delivery exceeds 40%.

So…the next time you see someone lauding the Netherlands for their fabulous statistics, ask them for their proof. Chances are they don’t have any, because this country’s stats SUCK when it comes to maternity care.

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7 thoughts on “Friday Fallacy: The Netherlands Are a Fantastic Model When it Comes to Birth

  1. Well, in their defense….they did get the “9” and the “2” right in their percentage. Just not in the correct order. 😉

  2. This one is so sticky. I remember reassuring my family with “they do it in the Netherlands!” when I had my homebirth and since we are so used to thinking of those European countries are more safe, civilized, and advanced, it was a winner every time. Too bad it’s not actually true! Of course I didn’t know that at the time and was just passing on what I heard from everyone else.

  3. I will point out that the Netherlands’ perinatal mortality rate is only slightly worse than ours, and their maternal mortality rate, while on the higher side for Europe, is lower than ours. This is not to say their maternity care system is better, your point stands that the natural birthing myth that “in Europe they have high rates of homebirths and much better stats” *is* simply a myth and not a fact.

    • They have universal health coverage though, don’t they? So they don’t have anyone going without prenatal care because they can’t afford it, or going “UC” because they are uninsured and afraid of getting stuck with a big bill from the hospital. They have a lot less general social inequality and a smaller gap between their richest and their poorest. Given that, it’s pretty amazing that their perinatal mortality rate STILL manages to be higher.

  4. Healthcare coverage in the Netherlands is increasingly going private pay, not universal. I have also known women who’ve given birth there (relatives) and one was an unintended UC; another lost a baby because the doctor didn’t do a cesarean quickly enough (even at the urging of the nursing staff, apparently). As far as healthcare goes, though, I’m not sure you can completely assess the equation just by looking at the figures – their healthcare system is not perfect, either. Euthanasia is also routinely practiced there, both from what I’ve read and heard second-hand from terminally ill family members who lived there but chose not to commit suicide.

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