Home births in the Netherlands: midwifery-related factors of influence.

Objective: Identification of midwifery-related factors influencing the varied percentage of home births in the practices of Dutch midwives. Design: Cross-sectional study. Setting: Independent midwifery practices in the Netherlands. Participants: 115 independent midwives. Measurements: Recording of time spent on professional activities over three weeks. Questionnaires were completed on practice characteristics and opinion regarding the place and risks of birth. Findings: Attending home births is no more time consuming for midwives than assisting at short-stay hospital births. The percentage of home births in a practice is not related to the average number of hours worked per week, nor to the size or type of practice. The percentage of home births is lowest in major cities. Midwives who think more positively about home births and do not consider these to involve greater risks assist at more home births. Implications for practice: The assumption that a heavy workload will interfere with the policy and de-medicalising birth is found to be false. The opinion of a midwife about the desirability and safety of home confinement has a slight positive effect on the percentage of home births in her practice. Those attempting to promote an increase in births at home must take these factors into account. (aut.ref.)