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The choice of obstetric care by low-risk pregnant women in the Netherlands: Implications for policy and management


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  • Pavlova, Milena
  • Hendrix, Marijke
  • Nouwens, Elvira
  • Nijhuis, Jan
  • van Merode, Godefridus
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    In the Netherlands, pregnant women at low risk of complications during pregnancy, have the opportunity to choose freely between giving birth at home or in a hospital maternity unit. This study analyses how various attributes of obstetric care, socio-economic characteristics and attitudes influence the decisions that these women make with regard to obstetric care. The method of discrete-choice experiment was applied in the process of data collection and analysis. The data were collected among low-risk nulliparous pregnant women. The analysis suggests that there are strong preferences among some Dutch women for a home birth. Nevertheless, the absence of a medical pain-relief treatment during home birth, might provide incentives for some women to opt for a birth in a hospital, especially at the end of their pregnancy. If the attractiveness of home birth should be preserved in the Netherlands, specific attention should be paid on the approach to pain during a home birth. Efforts could also be made in offering a domestic atmosphere during hospital births to improve hospital-based obstetric care in view of women's preferences.

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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 93 (2009)
    Issue (Month): 1 (November)
    Pages: 27-34

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    Handle: RePEc:eee:hepoli:v:93:y:2009:i:1:p:27-34

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    Keywords: Midwifery Obstetric care Preferences Discrete-choice experiment Netherlands;


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    1. De Vries, Raymond & Lemmens, Trudo, 2006. "The social and cultural shaping of medical evidence: Case studies from pharmaceutical research and obstetric science," Social Science & Medicine, Elsevier, vol. 62(11), pages 2694-2706, June.
    2. Edwin van Teijlingen & Sirpa Wrede & Cecilia Benoit & Jane Sandall & Raymond DeVries, 2009. "Born in the USA: Exceptionalism in Maternity Care Organisation Among High-Income Countries," Sociological Research Online, Sociological Research Online, vol. 14(1), pages 5.
    3. Wim Groot & Henriļæ½tte Maassen van den Brink & Erik Plug, 2004. "Money for health: the equivalent variation of cardiovascular diseases," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 859-872.
    4. Wiegers, T. A. & van der Zee, J. & Kerssens, J. J. & Keirse, M. J. N. C., 1998. "Home birth or short-stay hospital birth in a low risk population in the Netherlands," Social Science & Medicine, Elsevier, vol. 46(11), pages 1505-1511, January.
    5. Michael Veall & Klaus Zimmermann, 1994. "Evaluating Pseudo-R 2's for binary probit models," Quality & Quantity: International Journal of Methodology, Springer, vol. 28(2), pages 151-164, May.
    6. Martine M. Bellanger & Zeynep Or, 2008. "What can we learn from a cross-country comparison of the costs of child delivery?," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S47-S57.
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