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Could be. I'm not an expert (I haven't even looked up the statistics), and I suspect that neither was the person who I heard crediting the kraamzorg system for

by SJSque 7y ago

Could be. I'm not an expert (I haven't even looked up the statistics), and I suspect that neither was the person who I heard crediting the kraamzorg system for the low infant mortality rate. I certainly get the impression that giving birth at home is quite 'trendy' here, but my wife and I decided that there was no way that we were going to opt for that. My wife would much rather give birth in a building full of experts and specialised equipment than in the "relaxed, familiar atmosphere" of home.

markus92 7y ago
Not really trendy, but more the way it has always been done. Childbirth isn't a disease and shouldn't be treated as such, is the rationale behind it.
- lotsofpulp 7y ago
  Seems like a silly rationale to me. It’s not like evolution has optimized bodies to be amazing at childbirth. There are many possible complications that modern equipment and expertise can help with that aren’t available at home. You can do the same thing you do at home, with the security of having medical care immediately if things get complicated.
  - daliusd 7y ago
    Despite all modern equipment and expertise „Intrapartum and neonatal mortality was 0.15% for planned home births, 0.18% for planned hospital births“ (source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465453/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465453/). Something to think about. Disclaimer: my wife gave birth at home (but not in Netherlands)
    - rimliu 7y ago
      There is nothing to think about. Most serious cases would be treated in hospitals and, alas, sometimes there is nothing medics can do. If you want to think, think about, what those numbers would be if everyone was giving birth at home. https://www.15min.lt/naujiena/aktualu/lietuva/vilniuje-ivyko-nesekmingas-gimdymas-namuose-56-1191524 https://www.15min.lt/naujiena/aktualu/lietuva/vilniuje-ivyko...
      - daliusd 7y ago
        What do you think about 60 baby birth deaths in hospitals this year alone in Lithuania? And it is shitty attitude to counter argument science with single really unhappy incident.
        TeMPOraL 7y ago
        You can't just post a random paper and call the case closed. Some points from the paper: - The populations studied were preselected to be low risk, because "Dutch guidelines prescribe a hospital delivery with their midwife-led delivery (no choice of planned home birth)" to women with medium risk levels. So we're not talking home vs. hospital for any women, just for those where the doctors say everything is double-plus super fine with the mother and the baby. The study did adjust for the fact that "either due to self-selection or due to the midwife’s proposal, the healthiest and most affluent women are more likely to undertake a home birth". - From the conclusion, "the benefit of substantially fewer interventions in the planned home group seems to be counterbalanced by substantially increased mortality if intervention occurs". Etc. So what the study says is generally, if you and your doctors are double-plus sure you're low-risk, then you can go for either home or hospital birth; but if an intervention turns out to be needed, you're in big trouble.
        daliusd 7y ago
        I agree that case is not closed, however I was responding to very specific short sighted comment. About your points: Yes, you should understand if you or your relative is in low risk group. Honestly, if possible you should always understand and evaluate risks, whatever you are doing. Problem that humans are really bad with statistics (recommended reading "Thinking, Fast and Slow"). Lastly, you have actually read what I have posted and this is awesome. You can find more scientific sources about positive benefits of home birth. Lastly, I'm not saying that you should do it. My problem is that home births are semi-legal in my country ;-) Shortsighted comment was written by person from my country :-(
  - markus92 7y ago
    You have to keep in mind that there's quite extensive screening on eligibility and low barrier to refer to a hospital, as well as medical care will be available (experienced and well-trained midwifes are present during birth, GP will usually be on stand-by). If there is any major risk of complication, it will be a hospital birth. Living too far from a hospital? You better go there to give birth. Midwife and/or GP doesn't trust it anymore during birth? An ambulance is called and hospital it is (and you'll be there in time, as you live close enough). The distances in The Netherlands are extremely small compared to the USA, it's not like you're giving birth in the middle of nowhere. A more recent trend is that of the 'geboortehuizen' (birth houses), which are literally what the name says: special places just for giving birth. Instead of the clinical atmosphere, it is more like a home but advanced medical care is close-by, as most of them are affiliated with the hospitals. It's seen as a good balance/compromise between the risks of giving birth at home, while still having a more quiet, 'gezellige' atmosphere.
- rimliu 7y ago
  For many many years (basically up to XX century) the most dangerous thing a woman could do health-wise was to get pregnant. Being pregnant is not a disease, but childbirth is a very high risk.
  - daliusd 7y ago
    Less than 1% of stillbirth and possibility of mother's death is even lower. I'm pretty sure there are things that are more dangerous a woman can do. "Stillbirth rates never exceed 70 per 1,000 total births." (source https://www.cairn-int.info/article-E_POPU_804_0683--late-fetal-mortality-historical-perspect.htm https://www.cairn-int.info/article-E_POPU_804_0683--late-fet...)
- tomp 7y ago
  it's a disease as much as aging is a disease... extremely risky and often (always in case of aging) leathal.
  - TeMPOraL 7y ago
    Disagree. Aging is a disease as much as cancer is a disease - you'll eventually die of it if nothing else gets you before. The difference between pregnancy and aging is that the former is desirable, the latter is something to get rid of.

by SJSque 7y ago

markus92 7y ago

Not really trendy, but more the way it has always been done. Childbirth isn't a disease and shouldn't be treated as such, is the rationale behind it.

lotsofpulp 7y ago
Seems like a silly rationale to me. It’s not like evolution has optimized bodies to be amazing at childbirth. There are many possible complications that modern equipment and expertise can help with that aren’t available at home. You can do the same thing you do at home, with the security of having medical care immediately if things get complicated.
- daliusd 7y ago
  Despite all modern equipment and expertise „Intrapartum and neonatal mortality was 0.15% for planned home births, 0.18% for planned hospital births“ (source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465453/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465453/). Something to think about. Disclaimer: my wife gave birth at home (but not in Netherlands)
  - rimliu 7y ago
    There is nothing to think about. Most serious cases would be treated in hospitals and, alas, sometimes there is nothing medics can do. If you want to think, think about, what those numbers would be if everyone was giving birth at home. https://www.15min.lt/naujiena/aktualu/lietuva/vilniuje-ivyko-nesekmingas-gimdymas-namuose-56-1191524 https://www.15min.lt/naujiena/aktualu/lietuva/vilniuje-ivyko...
    - daliusd 7y ago
      What do you think about 60 baby birth deaths in hospitals this year alone in Lithuania? And it is shitty attitude to counter argument science with single really unhappy incident.
      - TeMPOraL 7y ago
        You can't just post a random paper and call the case closed. Some points from the paper: - The populations studied were preselected to be low risk, because "Dutch guidelines prescribe a hospital delivery with their midwife-led delivery (no choice of planned home birth)" to women with medium risk levels. So we're not talking home vs. hospital for any women, just for those where the doctors say everything is double-plus super fine with the mother and the baby. The study did adjust for the fact that "either due to self-selection or due to the midwife’s proposal, the healthiest and most affluent women are more likely to undertake a home birth". - From the conclusion, "the benefit of substantially fewer interventions in the planned home group seems to be counterbalanced by substantially increased mortality if intervention occurs". Etc. So what the study says is generally, if you and your doctors are double-plus sure you're low-risk, then you can go for either home or hospital birth; but if an intervention turns out to be needed, you're in big trouble.
        daliusd 7y ago
        I agree that case is not closed, however I was responding to very specific short sighted comment. About your points: Yes, you should understand if you or your relative is in low risk group. Honestly, if possible you should always understand and evaluate risks, whatever you are doing. Problem that humans are really bad with statistics (recommended reading "Thinking, Fast and Slow"). Lastly, you have actually read what I have posted and this is awesome. You can find more scientific sources about positive benefits of home birth. Lastly, I'm not saying that you should do it. My problem is that home births are semi-legal in my country ;-) Shortsighted comment was written by person from my country :-(
- markus92 7y ago
  You have to keep in mind that there's quite extensive screening on eligibility and low barrier to refer to a hospital, as well as medical care will be available (experienced and well-trained midwifes are present during birth, GP will usually be on stand-by). If there is any major risk of complication, it will be a hospital birth. Living too far from a hospital? You better go there to give birth. Midwife and/or GP doesn't trust it anymore during birth? An ambulance is called and hospital it is (and you'll be there in time, as you live close enough). The distances in The Netherlands are extremely small compared to the USA, it's not like you're giving birth in the middle of nowhere. A more recent trend is that of the 'geboortehuizen' (birth houses), which are literally what the name says: special places just for giving birth. Instead of the clinical atmosphere, it is more like a home but advanced medical care is close-by, as most of them are affiliated with the hospitals. It's seen as a good balance/compromise between the risks of giving birth at home, while still having a more quiet, 'gezellige' atmosphere.
rimliu 7y ago
For many many years (basically up to XX century) the most dangerous thing a woman could do health-wise was to get pregnant. Being pregnant is not a disease, but childbirth is a very high risk.
- daliusd 7y ago
  Less than 1% of stillbirth and possibility of mother's death is even lower. I'm pretty sure there are things that are more dangerous a woman can do. "Stillbirth rates never exceed 70 per 1,000 total births." (source https://www.cairn-int.info/article-E_POPU_804_0683--late-fetal-mortality-historical-perspect.htm https://www.cairn-int.info/article-E_POPU_804_0683--late-fet...)
tomp 7y ago
it's a disease as much as aging is a disease... extremely risky and often (always in case of aging) leathal.
- TeMPOraL 7y ago
  Disagree. Aging is a disease as much as cancer is a disease - you'll eventually die of it if nothing else gets you before. The difference between pregnancy and aging is that the former is desirable, the latter is something to get rid of.