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Study reveals bottlenecks in Dutch maternity care

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31 March 2026
Dutch maternity care is among the best in the world and is generally rated positively. However, collaboration between healthcare providers can be improved. This is evident from a study by maternity care researcher Sarah Lips, which shows that poor coordination and structural barriers are putting pressure on the quality and equality of care.

During pregnancy, childbirth, and the postpartum period, multiple healthcare providers are often involved, ranging from midwives to gynecologists and maternity care assistants. This collaboration does not always run smoothly. According to the reearch of Lips, this leads to differences in approaches, loss of important information, and reduced continuity of care. As a result, care does not always align well with the wishes and needs of (expecting) parents.

‘Integrated maternity care’

To address this, efforts have long been focused on so-called “integrated maternity care”: a system in which healthcare providers work more closely together and better respond to individual situations. Although there is broad agreement on this goal, implementation in practice remains challenging. Differences in organization, interests, and positions within the healthcare system hinder collaboration and perpetuate inequality - both among healthcare providers and between providers and families.

Notably, Lips emphasizes that the issue is not unwillingness. “Public debates sometimes suggest that healthcare providers are unwilling to collaborate, but my study actually points to inability as the main cause. Policy measures have so far mainly focused on financial and organizational reforms, while the relationships between those involved remain underexposed.”

Parents also experience the consequences. They indicate that care could better match their personal situations. This includes improved communication between healthcare providers, more room for individual preferences, and a more active role for partners during pregnancy and childbirth.

‘Reflexive dialogues’

Lips shows that so-called “reflexive dialogues”- conversations in which healthcare providers and parents jointly reflect on experiences and expectations - can contribute to better collaboration and more equal relationships. Based on this, she and her colleagues developed practical tools, such as a ‘‘Toolbox Reflectie en Actie’ and a ‘Intervisie Toolkit’. These tools offer concrete steps to collaboratively improve maternity care in daily practice.

Better collaboration and greater attention to interpersonal relationships can not only enhance the quality of care, but also contribute to greater equality and a more positive experience for families during one of the most significant periods of their lives.. Deze tools bieden concrete stappen om in de dagelijkse praktijk samen te werken aan verbetering van de geboortezorg.

Lips defends her thesis April 14 at Vrije Universiteit Amsterdam

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