Hermus M A A, Boesveld I C, Hitzert M, Franx A, de Graaf J P, Steegers E A P, Wiegers T A, van der Pal-de Bruin K M
Department of Child Health, TNO, PO Box 2215, 2301 CE, Leiden, the Netherlands.
Department of Obstetrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands.
BMC Pregnancy Childbirth. 2017 Jul 3;17(1):210. doi: 10.1186/s12884-017-1375-8.
During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics.
International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care.
From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all freestanding and alongside birth centres. Birth centres varied in their reason for establishment and their characteristics.
Twenty-three Dutch birth centres were identified and divided into three different types based on location according to the situation in September 2013. Birth centres differed in their reason for establishment, facilities, philosophies, staffing and service delivery.
在过去十年间，荷兰出现了除传统产科病房之外的低风险分娩地点的快速增加。在国际上，其中一些地点被称为分娩中心。分娩中心的国际定义各不相同，无法直接应用于荷兰的产科系统。荷兰缺乏分娩中心的标准定义。本研究旨在制定适用于荷兰的分娩中心定义，识别这些中心并描述其特征。
分析分娩中心的国际定义以找出共同描述。2013年7月，荷兰分娩中心调查问卷被发送至46个选定的可能符合分娩中心条件的荷兰分娩地点。问题包括：地点、设立原因、服务的女性群体、理念、支持自然分娩的设施、酒店设施、管理、环境以及转诊时的转诊程序。走访了各分娩中心以确认荷兰分娩中心调查问卷的结果，并测量转诊至产科护理时的距离和时间。
收到了所有46个分娩地点的问卷。基于这些信息构建了荷兰分娩中心的定义。该定义如下：“分娩中心是由助产士管理的场所，在分娩期间为低风险女性提供护理。它们拥有家庭般的环境，并提供支持自然分娩的设施。社区助产士承担主要的护理专业责任。转诊时，产科护理人员接管护理的专业责任。”在46个选定的分娩地点中，有23个符合该定义。根据与最近产科病房的位置关系，区分出三种类型的分娩中心：独立式（n = 3）、附设式（n = 14）和内设式（n = 6）。所有独立式和附设式分娩中心在转诊时都需要转诊。各分娩中心在设立原因和特征方面存在差异。
根据2013年9月的情况，确定了23家荷兰分娩中心，并根据位置分为三种不同类型。各分娩中心在设立原因、设施、理念、人员配备和服务提供方面存在差异。
