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Empowerment and autonomy in maternity care?

A very relevant topic at the moment, especially in the Netherlands, where the government will soon make a choice regarding integrated pre- and postnatal care with integrated funding of all related disciplines. This should improve cooperation between obstetricians and gynaecologists. Sounds good right? Then what are many obstetricians and pregnant women so afraid of?


Freedom of choice

They are afraid that freedom of choice in maternity care will be jeopardized. That hospitals will ultimately determine where and therefore also how women will give birth.



Choices in pregnancy care on Curaçao


In my opinion this is also an important topic on Curaçao. On Curaçao you can opt for guidance from an independent obstetrician/midwife, the maternity hospital or the gynaecologist. With the independent, self-employed, midwife you have the choice to give birth at home or in the Antillean Adventist hospital, the maternity hospital mainly gives birth at their clinic, but it could also be at home. At the gynecologist you give birth in the hospital, mainly under the supervision of the resident physician.


"Research has shown that women give birth best with a familiar face next to them"

It is therefore a pity that you cannot go to the hospital with your own obstetrician/midwife, which is actually a very popular option. A large group of women would like to give birth in a hospital, but with the trusted guidance of their own case-load obstetrician/midwife. Why is this so important? Research by Pien Offerhaus has shown that women give birth best with a familiar face next to them, someone they have seen throughout their pregnancy and have built a bond with them. This creates a safe atmosphere, which in turn has a positive effect on the delivery, resulting in fewer interventions and complications.


What is case-load?

This is a form of very personal (birth) care in which the midwife offers 1-on-1 guidance during the entire prenatal period. Case-load is literally accepting a limited number of pregnant women, so midwives who work according to this method have enough time for their clients. They really build a bond with the pregnant woman and her partner, which is also accompanied by the 'empowering' of the pregnant woman and her partner. Their control and autonomy are therefore central.


Being pregnant doesn't mean you're sick

What we mean by this is that pregnancy care is not, or does not have to be, purely medical. Pregnancy, childbirth and maternity time are not only medical matters, but also have an essential social aspect. This social interaction not only leads to better outcomes, but it also better suits the needs of women. It provides authority and control.


A happy mom

Very important, but often terribly underestimated, is simply a happy mom. Many studies look at qualitative figures, i.e.; living mothers, living children, complications etc. But this says little about the state of mind of mother, partner and child. The road to these results has a huge effect on this. And guess what? Pregnant women who have freedom of choice, who are empowered to stand up for themselves and are respected in their choices, very positively look back at their pregnancy, labor and birth. This in turn also has a positive effect on their state of mind and the bond with their baby.


What are our own experiences with this? Read more about it in part 2 of this blog - Next week...


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