Practice variation in induction of labor: A critical document analysis on the contribution of regional protocols.

Rationale: Despite national guidelines with recommendations on induction of labor (IOL), large variation in the use of this intervention exists between regions in the Netherlands. Guidelines are translated into protocols, which give a contextual description of medical practice provided in a given region. Possibly, protocols developed by regional multidisciplinary maternity care networks (MCNs) contribute to the regional variation in IOL.

Validation of the Birth Beliefs Scale for maternity care professionals in The Netherlands.

Objectives: To validate the Birth Beliefs Scale (BBS) for maternity care professionals by testing: (1) content validity; (2) internal reliability; (3) known-group discriminant validity; and examine potential relationships between regions and birth beliefs.

Methods: First, content validity was tested. Before distribution of the questionnaire among maternity care professionals of six maternity care networks (MCNs), adjustments in the statements were made whenever content validity was too low.

Knowledge and skills used for clinical decision-making on childbirth interventions: A qualitative study among midwives in the Netherlands.

Introduction: Appropriate use of interventions in maternity care is a worldwide issue. Midwifery-led models of care are associated with more efficient use of resources, fewer medical interventions, and improved outcomes. However, the use of interventions varies considerably between midwives.

Associations of severe adverse perinatal outcomes among continuous birth weight percentiles on different birth weight charts: a secondary analysis of a cluster randomized trial.

Objective: To identify neonatal risk for severe adverse perinatal outcomes across birth weight centiles in two Dutch and one international birth weight chart.

Background: Growth restricted newborns have not reached their intrinsic growth potential in utero and are at risk of perinatal morbidity and mortality. There is no golden standard for the confirmation of the diagnosis of fetal growth restriction after birth.

Change in primary midwife-led care in the Netherlands in 2000–2008: A descriptive study of caesarean sections and other interventions among 807,437 low-risk births.

Objective: to study whether an increase in intrapartum referrals in primary midwife-led care births in the Netherlands is accompanied by an increase in caesarean sections.

Design: nationwide descriptive study.

Setting: The Netherlands Perinatal Registry.

Variation in referrals to secondary obstetrician-led care among primary midwifery care practices in the Netherlands: a nationwide cohort study.

Background: The primary aim of this study was to describe the variation in intrapartum referral rates in midwifery practices in the Netherlands. Secondly, we wanted to explore the association between the practice referral rate and a woman's chance of an instrumental birth (caesarean section or vaginal instrumental birth).

Methods: We performed an observational study, using the Dutch national perinatal database.

Variation in intrapartum referral rates in primary midwifery care in the Netherlands: a discrete choice experiment.

Objective: in midwife-led care models of maternity care, midwives are responsible for intrapartum referrals to the obstetrician or obstetric unit, in order to give their clients access to secondary obstetric care. This study explores the influence of risk perception, policy on routine labour management, and other midwife related factors on intrapartum referral decisions of Dutch midwives.

Design: a questionnaire was used, in which a referral decision was asked in 14 early labour scenarios (Discrete Choice Experiment or DCE).

Effects of induction of labour versus expectant management in women with impending post-term pregnancies: the 41 week - 42 week dilemma.

Background: Post-term pregnancy, a pregnancy exceeding 294 days or 42 completed weeks, is associated with increased perinatal morbidity and mortality and is considered a high-risk condition which requires specialist surveillance and induction of labour. However, there is uncertainty on the policy concerning the timing of induction for post-term pregnancy or impending post-term pregnancy, leading to practice variation between caregivers. Previous studies on induction at or beyond 41 weeks versus expectant management showed different results on perinatal outcome though conclusions in meta-analyses show a preference for induction at 41 weeks.

Persisting rise in referrals during labor in primary midwife-led care in the Netherlands.

Background: There are concerns about the Dutch maternity care system, characterized by a strict role division between primary and secondary care. The objective of this study was to describe trends in referrals and in perinatal outcomes among labors that started in primary midwife-led care.

Methods: We performed a descriptive study of all 789,795 labors that started in primary midwife-led care during 2000 to 2008 in The Netherlands.

Change in primary midwife-led care in the Netherlands in 2000-2008: a descriptive study of caesarean sections and other interventions among 789,795 low risk births.

Objective: to study whether an increase in intrapartum referrals in primary midwife-led care births in the Netherlands is accompanied by an increase in caesarean sections.

Design: nationwide descriptive study.

Setting: the Netherlands Perinatal Registry.