Two Approaches to Birth: Midwivery vs. Medical Model of Care

When preparing for birth, understanding the type of care you’ll receive can make a big difference in your experience. Two main approaches exist: the midwifery model and the medical model of care.

I’m Anna, a registered nurse, childbirth educator, lactation counselor, and birth doula supporting expat families in the Eindhoven region of the Netherlands. Here’s what you need to know about these models and how they shape birth experiences.

1. The Midwifery Model of Care

The midwifery model views birth as a normal, healthy process:

Focuses on holistic, personalized support for physical, emotional, and psychological well-being
Encourages informed choice and partner involvement in decision-making
Avoids unnecessary interventions unless complications arise
In the Netherlands, midwives guide low-risk pregnancies and births at home, birth centers, or as outpatient hospital births
Care is transferred to a gynecologist or obstetrician only if needed

This model emphasizes empowerment, trust in the birthing person’s body, and minimal interventions.

2. The Medical Model of Care

The medical model treats pregnancy and birth as conditions requiring management:

Frequent testing, ultrasounds, continuous fetal monitoring, and inductions
Standardized protocols often override individualized care
Managed by gynecologists or obstetricians in hospitals
Essential for high-risk pregnancies and emergencies, but overuse in low-risk cases can lead to unnecessary interventions

3. Why the Netherlands Stands Out

The Netherlands has one of the highest rates of midwifery-led care in the world:

Around 13% of births occur at home with midwife support
Research shows midwifery-led care reduces cesarean rates and increases birthing satisfaction
Low-risk births at home or birth centers are as safe as hospital births
Informed choice and trust in the body are central to the experience

4. Takeaways for Expats

The midwifery model may feel new, especially if you come from countries dominated by the medical model
Focus on personalized, low-intervention care fosters confidence and better outcomes
Understanding these models helps you navigate your options and advocate for the birth experience you want

Final Thoughts

Choosing the right model of care isn’t just about location—it’s about feeling supported, informed, and empowered throughout pregnancy and birth.

References

Hutton, E. K., Reitsma, A., Simioni, J., Brunton, G., & Kaufman, K. (2016). Perinatal or neonatal mortality among women intending to give birth at home versus in hospital: A systematic review and meta-analyses. The Lancet, 388(10044), 1317-1325. https://doi.org/10.1016/S0140-6736(16)30323-1
Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews, 2016(4). https://doi.org/10.1002/14651858.CD004667.pub5
Perined. (2022). Perinatal care in the Netherlands: Facts and figures. Retrieved from https://www.perined.nl