Erasmus MC Press Release Rotterdam, 05 July 2010
Care given during pregnancy and childbirth can and should be improved
Erasmus MC studies the causes of the poor performance of Dutch perinatal care
The organization of the care in pregnancies and childbirth is the main cause of the relatively poor European position of the Netherlands regarding health at the time of birth. Differences between larger cities and the rest of the Netherlands are predominantly the result of ethnicity, social deprivation and the living environment. These are preliminary conclusions of research carried out by Erasmus MC and commissioned by the ZonMw (Dutch organization for health research and development). A research agenda, now supported by the Dutch Minister of Health, Welfare and Sports (Mr. Klink),  is aimed at improving and introducing good initiatives at national level.
The Netherlands has a relatively poor position in Europe when it comes to health at the time of birth, in other words, perinatal health. Approximately 10 out of every 1000 children die around the time of birth. In similar other countries this mortality rate can be as much as 30% lower. Of the perinatal deaths in the Netherlands, 70% are stillbirths when counted from the 22nd week of pregnancy. Thirty percent of the perinatal deaths take place in the first week after birth. In Flanders, that is socio-democratically and economically comparable to the Netherlands, the perinatal death rate has been two-thirds of that in the Netherlands for at least 10 years. This means that instead of 1700 cases of perinatal death that occur per year among the 175,000 newborns in the Netherlands, only 1150 cases should occur; an unprecedented large difference. Moreover, within the Netherlands, and particularly in the larger cities such as Rotterdam and The Hague, there are distinct differences between groups of pregnant women.

The ZonMw has commissioned Erasmus MC to carry out the Descriptive study Pregnancy and Childbirth. The aim of the study is to determine knowledge questions and research opportunities to improve the perinatal care in the Netherlands. Aspects studied include patient-related risk factors such as diseases already present, lifestyle and social factors on the one hand and the role of the midwife practices including use of care, risk selection, and quality of care in the Netherlands on the other. The preliminary conclusion is that the unfavorable European position is probably mainly caused by factors in the care system while the differences within the Netherlands and the larger cities are linked to large risk differences between groups on the basis of ethnicity, social deprivation and the neighborhood in which people live. A research agenda has been formulated based on this. 

The Dutch Minister Klink supports this research agenda which focuses on new concepts for care organizations based on eliminating barriers between the care lines, medical research on the period just before and just after conception and long-term studies on the effects on children of being born under poor circumstances.
Erasmus MC is the largest University Medical Center in the Netherlands. Our primary goal is a healthy population. Nearly 13,000 employees devote themselves every day to providing outstanding care, facilitating world-class education and conducting pioneering research. These professionals are instrumental in developing expertise on health and illness. They link the latest scientific insights to practical treatments and prevention measures to provide maximum benefit to patients and to enable healthy people to stay healthy longer. Being visibly better and leading the way in the areas of complex, innovative and acute care by collaborating with others: these are key ambitions at Erasmus MC.