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Birthing Outside the System: Trauma and Autonomy in Maternity Care PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/201204 Please be advised that this information was generated on 2021-10-07 and may be subject to change. Birthing outside the system: system: the Birthing outside Uitnodiging voor het bijwonen van de openbare verdediging van mijn proefschrift Birthing outside the system: trauma and autonomy in maternity care op dinsdag 19 maart 2019 om 14:30 uur in de Aula van de Radboud Universiteit trauma and autonomy in maternity care in maternity autonomy and trauma Comeniuslaan 2, Nijmegen. U bent van harte welkom bij deze plechtigheid en de aansluitende receptie. Martine Hollander [email protected] | Martine Helene Hollander Martine Helene Birthing outside the system: trauma and autonomy in maternity care Paranimfen Lianne Holten [email protected] Martine Helene Hollander Claire Stramrood [email protected] Birthing outside the system: trauma and autonomy in maternity care Martine Helene Hollander 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 1 ISBN 978-94-028-1373-9 Design/lay-out Promotie In Zicht, Arnhem Print Ipskamp Printing, Enschede © M.H. Hollander, 2019 All rights are reserved. No part of this book may be reproduced, distributed, stored in a retrieval system, or transmitted in any form or by any means, without prior written permission of the author. 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 2 Birthing outside the system: trauma and autonomy in maternity care Proefschrift ter verkrijging van de graad van doctor aan de Radboud Universiteit Nijmegen op gezag van de rector magnificus prof. dr. J.H.J.M. van Krieken, volgens besluit van het college van decanen in het openbaar te verdedigen op dinsdag 19 maart 2019 om 14.30 uur precies door Martine Helene Hollander geboren op 11 januari 1975 te Leiderdorp 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 3 Promotoren Prof. dr. F.P.H.A. Vandenbussche Prof. dr. J.A.M. van der Post (Amsterdam UMC) Copromotoren Dr. J. van Dillen Dr. E. de Miranda (Amsterdam UMC) Manuscriptcommissie Prof. dr. A.E.M. Speckens Prof. dr. S.A. Scherjon (Universitair Medisch Centrum Groningen) Dr. A. de Jonge (Amsterdam UMC) 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 4 Contents Chapter 1 General introduction 7 Chapter 2 :RPHQUHIXVLQJVWDQGDUGREVWHWULFFDUHPDWHUQDOIHWDOFRQÁLFW 19 RUGRFWRUSDWLHQWFRQÁLFW"/HJDODQGHWKLFDOFRQVLGHUDWLRQV Chapter 3 Women’s motivations for choosing a high risk birth setting 31 against medical advice in the Netherlands: a qualitative analysis Chapter 4 )XOÀOOLQJDQHHG+ROLVWLFPLGZLIHU\LQWKH1HWKHUODQGV 59 a qualitative analysis Chapter 5 ‘She convinced me’- Partner involvement in choosing a high 91 risk birth setting against medical advice in the Netherlands: a qualitative analysis. Chapter 6 /HVVRUPRUH"0DWHUQDOUHTXHVWVWKDWJRDJDLQVWPHGLFDODGYLFH 121 Chapter 7 When the hospital is no longer an option: A multiple case 143 VWXG\RIGHÀQLQJPRPHQWVIRUZRPHQFKRRVLQJKRPHELUWK in high-risk pregnancies in the Netherlands. Chapter 8 Preventing traumatic childbirth experiences: 2192 women’s 177 perceptions and views Chapter 9 Psychosocial predictors of postpartum posttraumatic stress 197 disorder in women with a traumatic childbirth experience. Chapter 10 Women who desire less care than recommended during 221 childbirth: results of three years dedicated clinic. Chapter 11 General discussion and conclusions 237 Chapter 12 Developments since the start of this project 255 Chapter 13 Summary | Samenvatting 261 Chapter 14 List of abbreviations and terminology 277 List of publications 279 List of co-authors 283 PhD portfolio 285 Dankwoord 291 Curriculum vitae 295 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 5 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 6 1 General introduction 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 7 8 | Chapter 1 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 8 General introduction | 9 General introduction 1 -HVNHLVH[SHFWLQJKHUÀUVWFKLOG6KHKDVKDGDGL΀FXOWFKLOGKRRGDQGQRWPDQ\IULHQGV RUIDPLO\7KHSUHJQDQF\LVFRPSOLFDWHGE\VHYHUHSHOYLFSDLQDQGVKHKDVGL΀FXOW\ ZDONLQJ$URXQGWKHGXHGDWHODERUVWDUWVVXGGHQO\DQGRQHFRQWUDFWLRQTXLFNO\IROORZV DQRWKHU6KHFDOOVKHUPLGZLIHU\SUDFWLFHDQGDORFXPPLGZLIHZKRPVKHKDVQHYHUVHHQ EHIRUHFRPHVWRKHUKRXVH$IWHUVHYHUDOKRXUVDQGRQO\WZRFHQWLPHWHUVRIGLODWLRQVKH DVNVKHUPLGZLIHIRUSDLQUHOLHIDQGVKHLVWUDQVSRUWHGWRWKHKRVSLWDOIRUDQHSLGXUDO-HVNH IHHOVWKDWWKHDQHVWKHWLVWLVLQDKXUU\´,ZDVIRUFHGWRVLWFURVVOHJJHGDQGFRXOGQ·WPRYH 0HDQZKLOHLWZDVRQHFRQWUDFWLRQDIWHUDQRWKHUµ3DLQUHOLHILVVXERSWLPDODQG-HVNHLV VXUURXQGHGE\XQNQRZQSHRSOH6KHUHPHPEHUVEHLQJWROGWROD\RQKHUEDFNZLWKRXW PXFK H[SODQDWLRQ DQG DQ HOHFWURGH LV SODFHG RQ WKH EDE\·V KHDG :KHQ VKH UHDFKHV FRPSOHWHGLODWLRQVKHLVWROGWRVWDUWSXVKLQJHYHQWKRXJKVKHIHHOVQRXUJH6KHLVOHIW SXVKLQJZLWKDQXUVHIRUPLQXWHVDIWHUZKLFKDQREVWHWULFLDQHQWHUV$OOVKHUHPHPEHUV RIWKLVLVKLPVD\LQJ¶,DPKHUHWRKHOS\RX·7KHQH[WWKLQJVVKHUHPHPEHUVLVWKDWKH ´SXVKHVWKHYHQWRXVHLQµZLWKRXWPXFKLQWKHZD\RIH[SODQDWLRQ6KHKDVQRLGHDZKDW WRGREXWWULHVWRSXVK,WLVLQYDLQ6KHLVWDNHQWRWKHRSHUDWLQJURRPIRUDQHPHUJHQF\ FHVDUHDQVHFWLRQ $WWKHIROORZXSDSSRLQWPHQWVL[ZHHNVODWHU-HVNHKDVUHFRYHUHGZHOOSK\VLFDOO\ EXWQRERG\DVNVKHUKRZVKHIHHOVDERXWWKHELUWK6KHKDVUHFXUULQJQLJKWPDUHVDQGKDV EHHQH[SHULHQFLQJYDJLQLVPHYHUVLQFHZKLFKZDVQHYHUDQLVVXHIRUKHUEHIRUH ¶-HVNH·ZKLFKLVQRWKHUDFWXDOQDPHKDVUHDGKHUVWRU\DVSUHVHQWHGKHUHDQGKDV JLYHQSHUPLVVLRQIRULWWREHXVHG Jeske’s story is an example of how maternity care, conducted according to guidelines and protocols and carried out by maternity care providers with the very best intentions, can result in trauma for the women involved. This trauma may cause some women to decide to avoid future medical care, or decline certain parts of recommended care for their next pregnancy and birth. These phenomena gained national attention in the Netherlands in 2013, when three community midwives were tried by the medical disciplinary committee for delivering assistance during home births in high risk pregnancies1. Home births in high risk pregnancies were not unheard of in the Netherlands, even prior to this court case. Also in 2013, the Amsterdam UMC, AMC had started a designated clinic for women who planned to go against medical advice in their choices surrounding birth, including those planning a home birth in a high risk 1 KWWSV]RHNR΀FLHOHEHNHQGPDNLQJHQQOVWFUWKWPO 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 9 10 | Chapter 1 pregnancy2,3,4,5 +RZHYHU WKH FRXUW FDVH UHIHUHQFHG KHUH ZDV WKH ÀUVW WLPH midwives were prosecuted for attending home births in high risk pregnancies, since this was considered an undesirable development by both the Health Care Inspection, who initiated the court case, and many maternity care providers in WKHFRXQWU\$OOWKUHHPLGZLYHVZHUHUHSULPDQGHGDQGRQHZDVVWUXFN RͿ although the latter verdict was overturned on appeal and converted to a one-year’s license suspension. The reasoning by the court of appeals in this case was that second best care, for instance a midwife attending a high risk home birth, was preferable to no care at all, providing the woman in question had been adequately counseled. The reprimands and suspension were, among other UHDVRQVGXHWRWKHIDFWWKDWLQVX΀FLHQWFDVHQRWHVZHUHPDGHE\WKHPLGZLYHV to prove that they had recommended hospital care and that the women in this case had been adequately counseled about the risks they were taking. The ruling of the court of appeals was cause for concern for many community midwives in WKH1HWKHUODQGVEHFDXVHLWZDVPDGHFOHDUWKDWFRQÁLFWLQJLQWHUHVWVFRXOGRFFXU in situations where women ‘demand’ care outside protocols and midwives don’t feel comfortable providing such ‘second best care’, for which they may feel XQHTXLSSHGXQTXDOLÀHGDQGZKLFKFDQPDNHWKHPIHHOHPRWLRQDOO\YXOQHUDEOH This ruling stressed the urgency of further research into the phenomenon of women disregarding medical advice and giving birth at home in a high risk pregnancy, or choosing unassisted childbirth (UC), and led to the inception of this thesis. 2 https://www.amc.nl/web/ik-heb-een-afspraak-1/mijn-afspraak-in-het-amc/poli-ondersteuning- maatwerk-zwangerschap-geboorte-pom-polikliniek.htm 3 https://www.trouw.nl/home/goed-gesprek-helpt-bij-weigermoeder-die-per-se-thuis-wil-bevallen~ ab1f0831/ KWWSZZZPDLDYHUORVNXQGLJHQQOJHOGHUVHYDOOHLBVLWHÀOHVÀOH'H*UDDI 172*UHFKWRSYHUORVNXQGLJH]RUJ SGI 5 https://www.nataal.nl/artikelen/artikelen/zwangerschap-bevalling/rek-in-de-richtlijn-de-poli- op-maat-3827/ 528107-L-sub01-bw-Hollander Processed on: 23-1-2019 PDF page: 10 General introduction | 11 Magnitude of the problem: what is known? 1 It is currently unknown exactly how many women choose to have an unassisted childbirth in the Netherlands each year, although this number has been estimated to be around 2006ZKLFKPDNHVXSDSSUR[LPDWHO\RIDOOELUWKV There are no data at all on the number of Dutch women choosing home birth in a high risk pregnancy. Why women would make these choices has also never before been investigated in the Netherlands. However, several studies from other countries have been published on the motivations of women to choose high risk birth options, which are summarized in a recent scoping review of 15 studies by Holten and De Miranda.7 The themes found in this review were: resisting the biomedical model of birth by trusting intuition, challenging the dominant discourse on risk by considering the hospital
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