dear Stephanie
Maternal age & caregiver: The Dutch health care system focuses on
primary health care for the low- risk population. Secondary care is only
available when medically indicated. Entrance into secondary care needs
an assessment by the GP or –in case of obstetric care- a midwife.
(www.minvws.nl/images/Health Insurance in the
Netherlands_tcm11-53018.pdf ). Maternal age in itself is no indication
for referral to an obstetrician.
maternal age & screening: reimbursement of prenatal screening on Down
is restricted to women who are 36 or older. Younger women are to be
informed on the availability of testing for Down, but don't get the
(initial) testing reimbursed.
figures on sectio-rates and other interventions by age (or other
perinatal data): you can apply for them through
http://www.perinatreg.nl/files/Applicationform_for_data2004.doc [in
English]

More information on the Dutch obstetric system:
the basic assumptions of Dutch obstetric care: see chapters 1 and 2 of
the Obstetric Manual,
http://europe.obgyn.net/nederland/default.asp?page=/nederland/richtlijnen/vademecum_eng
(version: 1999). The Manuel has been updated in 2003, but without an
update of the English version. The assumptions have not been changed
Articles on Dutch perinatal care (Pubmed) mostly open with a description
of the Dutch perinatal system
books and articles by de Vries (Dutch Midwifery: A pleasing Birth,
midwives and maternity care in the Netherlands, or Birth by Design).

adja waelput

Rijksinstituut voor Volksgezondheid en Milieu / Research for man and
environment (RIVM)
Department for Public Health Forecasting
Postbus 1, 3720 BA BILTHOVEN
tel: + 31 (0)30) 274 31 96
email: [log in to unmask]



Jane sandall
<[log in to unmask]>
Sent by: "A forum for To
discussion on midwifery [log in to unmask]
and reproductive health cc
research."
<MIDWIFERY-RESEARCH@JISCMA Subject
IL.AC.UK> Fw: Book projekt: pregnant over 35


08-02-2006 17:20


Please respond to
"A forum for discussion on
midwifery and reproductive
health
research."
<MIDWIFERY-RESEARCH@JISCMA
IL.AC.UK>











From: [log in to unmask]
To : [log in to unmask]
Date: 07.02.2006 10:57:57

To prof. Sandall,
yesterday I interviewed Dr. CHristine Loytved (uni Osnabrück, Germany). She
told me about your research projekt of medwifes.
I am looking for information about women being pregnant at the age of 35
and over. Because I am writing a book fpr a big publishing company in
Germany (Graefe and Unzer, munich).
To know, how are they 'treated' in other countries (risk factors, when to a
midwife, when to gynecol., sectio-rates, location of giving birth, ...)
could give us a wider view. Interessing is also, how should these women
live to avoid complications ( such as incontinence, early abortion,
gestosis,..) and if this is different from younger women - in other
countries.
Perhaps your network of widwifes could help me.

Thank you very much,
Dr. Stefanie Schmid-Altringer



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