Abstract

The German poet Heinrich Heine is reported to have said, “When the world comes to an end, I shall go to Holland, for everything there happens fi fty years later.” For some, this Dutch “quaintness” explains the unusual system of obstetric care found in the Netherlands, a system where nearly one-third of births occur at home and where midwives have a degree of professional independence unrivaled by midwives in any other country. Heine’s observation about the Netherlands suggests that the unique Dutch way of birth is a vestige from a bygone era—a credible conclusion if you believe that humans are helpless in the face of technology. But the stubborn persistence of midwifery and home birth in the Netherlands, in spite of the declaration of medical professionals elsewhere that midwife-attended birth at home is a dangerous anachronism, forces us to conclude that Dutch obstetrics can be the vanguard of the future.

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