Midwives in the Netherlands

Mary C. Zwart, Dutch Midwife 

Editor's Note: I met Mary at the International Midwifery Today Paris 2001 Conference. I was very interested in why midwifery seemed to work so extremely well for the Dutch (for both mothers and midwives) while we have so many problems here in the US. Mary presented an oral version of this history of Dutch midwifery at a workshop at the Paris conference. faith ^O^

As far back as the 15th century our area has know legislation for midwives and other medical care providers. The midwife has always been within the system.

In the 15th century towns were the institutions for legislation. The earliest know is Dordrecht in Holland.

After the towns the legislative authority went to the provinces and after the shaping of the Netherlands in1813 the national government took over this role.

Till 1865 it was possible to be legislated in a part of the medical profession, such as surgeon, medicine woman/man, and midwife.

In 1865 new legislation was made by Thorbecke creating a new profession -- that of the general practitioner. The GP took on the role of three providers: midwife, surgeon and medicine man (pharmacist). The only partial legislated profession which remained was that of the midwife and the medicine man now called the pharmacist. Later on the dentist was invented. Specialist developed all after an academic education except the midwife.

The midwife got a separate schooling in cooperation with the University but did not have a separate faculty. The teachers were the same till the end of the 19th century. After that they got their own staff of teachers. So Professor Kloosterman started at the midwifery school and returned to the University afterwards.

The midwife was permitted to provide perinatal care up to the standards of the days with exception of using instruments for extracting the baby during birth. But given the fact that some midwives worked in remote areas where the general practitioner could only be reached after two hours or more and than also were not very eager to help, many midwives also performed birth by forceps.

Professionalism and new ways of practice always were reflected in the legislation of the midwife. So her duties expended throughout the 20th century.

Essential in this legislation is that she always has been a member of the medical legislation. That is to say the midwife has always been entitled to handle of her own professional responsibility and so there is an unique combination between social and medical guidance for women

Her domain remained outside the hospital setting.

After more than a century of duty the old law of Thorbecke is replaced by The LAW ON THE INDIVIDUAL CARE PROVIDER. (1995)

Again the midwife is recognized as THE care provider for the perinatal (pregnancy, labor and birth and the postpartum) care and for keeping birth, as much as possible, outside the hospital.

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