A comparison between the organization of obstetrics in Denmark and The Netherlands.

A comparison was made between two types of obstetric organization: total hospitalization as in Denmark, and a system that allows a choice between hospital and home delivery, provided there are no medical contra-indications, as in The Netherlands. Until the end of the 1950s, the current Dutch view prevailed in Denmark; Denmark changed its organization in the late 1960s and followed the international preference for total hospitalization. This change was not caused by disappointing obstetric results, nor was it the result of strong pressure from pregnant women. The change was associated with a considerable increase in instrumental deliveries. In both countries the perinatal mortality rate decreased continuously but in Denmark the improvement in early neonatal mortality was slightly faster. This difference may have occurred because of insufficient referral in The Netherlands of high-risk pregnancies and deliveries to the fully equipped obstetric departments. The Dutch acceptance of a high proportion of home-confinements is unlikely to be the explanation.