Diversity in the Scope and Practice of Hospital‐Based Midwives in the Netherlands

Not all midwives in the Netherlands are independent practitioners. One in 4 midwives registered to practice is employed in the hospital setting, where 67% of all births occur. There has not yet been an in‐depth examination of hospital‐based midwives’ practice in the Netherlands, in the context of care in a higher‐risk environment. The primary aims of this study were to describe the diversity and scope of practice of hospital‐based midwives in the Netherlands. Methods: This was an online survey of all hospitals throughout the Netherlands with labor/birthing rooms and employing hospital‐based midwives. The survey covered 5 topic areas: demographic/organizational details, duties, responsibilities, experience/additional qualifications, and how the midwife functioned within the multidisciplinary hospital team. Descriptive statistics are provided. Results: A total of 59 secondary and tertiary level hospitals from a possible total of 98 were included for analysis (60% national response rate). Forty percent of all births occurring during the study period were managed solely by a hospital midwife. The provision of midwifery care in the hospital setting was not universal, and where present, hospital‐based midwives were not necessarily available 24 hours a day or 7 days a week. Hospital‐based midwives reported a high level of autonomy. Discussion: Currently there is no universal provision of midwifery care in the hospital setting in the Netherlands. Where there are hospital‐based midwives, they appear to manage the majority of births. However, there are no nationally agreed‐upon standards for midwifery practice in the hospital setting, and no agreement exists over minimum requirements relating to additional education for midwives in these settings. A national evaluation and setting of minimum standards is needed.