Prins Marianne, van Dillen Jeroen, de Jonge Ank
VUmc, EMGO+ en Academie Verloskunde Amsterdam Groningen, afd. Midwifery Science, Amsterdam.
Ned Tijdschr Geneeskd. 2014;157:A7070.
In the Dutch maternity care system women at low risk of complications in pregnancy and birth are distinguished from women at an increased risk. Primary care midwives are responsible for the care in the low-risk group, whereas obstetricians are responsible for care when the risk is increased. Most professionals and stakeholders agree that more continuity of care is warranted but there is no consensus on the ideal organization of care. A midwife-led continuity model of care has been shown to offer several health benefits compared with other models, such as 'shared care'. We argue that this model would be appropriate for the Netherlands. Midwives should provide care where possible and obstetricians where necessary in order to use the expertise of both professions most effectively. This requires an extension of the scope of practice for primary care midwives. This model requires good cooperation between midwives and obstetricians.
在荷兰的孕产妇保健系统中,将怀孕和分娩并发症低风险的女性与风险增加的女性区分开来。初级保健助产士负责低风险组的护理,而产科医生负责风险增加时的护理。大多数专业人员和利益相关者都认为需要更多的护理连续性,但对于理想的护理组织方式尚未达成共识。与其他模式(如“共享护理”)相比,由助产士主导的连续性护理模式已被证明具有多项健康益处。我们认为这种模式适用于荷兰。助产士应尽可能提供护理,产科医生在必要时提供护理,以便最有效地利用两个专业的专业知识。这需要扩大初级保健助产士的执业范围。这种模式需要助产士和产科医生之间良好的合作。