Objective: To investigate differences among pregnant women from various ethnic groups in terms of pregnancy care and the place of delivery.
Design: Descriptive, retrospective study.
Method: Data from the Dutch Perinatal Registries during the period 1995-2002, representing a total of 1,401,892 pregnancies, were linked and analysed for perinatal care, the place of the delivery and the ethnic group of the mother. The ethnic categories defined in the registries were: Dutch, Mediterranean, other European, African, Hindu, Asian and unknown.
Results: Other European women and Asian women often started pregnancy care with a midwife and were not often referred to secondary care with an obstetrician. These two groups most often completed the delivery under the care of a midwife (45.3% of other European women and 44.6% of Asian women). As Hindu and African women often started pregnancy care directly with an obstetrician due to medical reasons and were often referred to secondary care during pregnancy or birth, these two groups were least likely to complete their births under the primary care of a midwife (33.1% and 28.0%, respectively). 39% of the Dutch women completed delivery with a midwife. Of those women who started the delivery under the care of a midwife, 3 out of 4 Dutch women, 1 out of 3 Mediterranean women and only 1 out of 5 Hindu women ultimately elected for a home birth.
Conclusion: Large ethnic differences exist in both pregnancy care and preference for place of delivery and, ultimately, place of birth. This should be taken into account in policy-making and in the provision of information regarding the Dutch midwifery system.