Dutch midwives: relational care and birth location

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Abstract
The objective of this study was to investigate whether midwives’ care is influenced by their work setting, i.e. place of birth: at home or in the hospital. The design was a random sample survey, the setting was primary obstetrical care in the Netherlands. Some 150 independently practising midwives were interviewed as the subjects for the study. And variables of behaviour of midwives towards labouring women were covered by a questionnaire consisting of 19 relevant elements of that behaviour; behaviour which shapes their relational care. Results show that all midwives indicate differences in their behaviour according to the place where they provide the relational care towards the labouring woman; at home or in the hospital. However, the amount in which they indicate their functioning is affected by their work setting is not the same. The most striking findings are that midwives say to be more relaxed whilst providing care in a home situation, they take on a more informal approach and the interaction with the birthing woman is easier. Home birth is more time consuming than hospital birth: more visits and longer presence. During a home birth more activity of the expectant parents is to be expected regarding small domestic jobs than at a hospital birth. This study confirms that the location of a delivery has consequences for the professional functioning of midwives in case of home births. Their relational care is more intense and woman‐centred.

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