Maternity care not available everywhere in Netherlands, especially disadvantaged areas
Women in the Netherlands are entitled to at least 24 hours of maternity care after the birth of a child, but that is no longer available everywhere in the country, Nieuwsuur discovered. The main reason is that some large healthcare organizations are closing operations in certain areas, particularly in socioeconomically disadvantaged neighborhoods, the program found.
In the city of Utrecht, for example, only a few maternity care organizations are still active. While just outside the city, there is a much wider choice. As a result, women in Utrecht city face long waiting lists and, in some cases, no maternity care at all. Women in disadvantaged neighborhoods are particularly affected.
Koen Jansen of Bo, the trade association for maternity care, confirmed to Nieuwsuur that some providers decide not to provide care in certain postal codes. According to him, agencies avoid some neighborhoods because travel time isn’t reimbursed or because of parking problems. It is up to the health insurers to address this, he said.
Health insurer Zilveren Kruis told the program that it can’t force maternity care organizations to work somewhere.
The Healthcare Inspectorate published a report this week showing that vulnerable families receive less maternity care. The report attributed this partly to these families being less likely to apply, but the Inspectorate also noticed that care providers exclude certain postcodes. “These are often postal codes where more people in vulnerable situations live, so that further exacerbates the problem.” The inspectorate did not investigate the extent of this problem, but intends to do so.
The municipality of Utrecht did map out the availability of maternity care in its various neighborhoods. It found a shortage throughout the municipality, but particularly in the neighborhoods of Kanaleneiland and Overvecht - neighborhoods where many families live in vulnerable situations.
“Where a relatively large number of families requiring a lot of care live, there is actually less maternity care than in neighborhoods where the opposite is true. And that is due to cherry-picking by maternity care organizations,” Utrecht alderman Eelco Eerenberg (public health) told Nieuwsuur.
The shortage in Utrecht arose when two large companies withdrew from the city three years ago. Eerenberg suspects that the two agencies, which were acquired by private equity investors, did not make enough profit in the city. “You see that market forces are really not beneficial here, because they lead to looking for places where you can get the most out of the least amount of work. Perhaps we should pay maternity nurses better if they work in families where there’s more to do?”
Gwendolyn van Strien, who works as a midwife in Kanaleneiland and Overvecht, told the program that they increasingly have to cover maternity care. “As midwives, we often have to explain more basic things now: how to prepare a bottle, how to breastfeed. But postpartum check-ups and the mother’s medical check-ups aren’t being done either,” she said. “Everyone has the right to good medical care; there shouldn’t be a commercial motive behind it. We know that good maternity care has a huge impact in the long run.”
