Some discussion going on in the comments at Science and Sensibility's post on the new meta-analysis of home birth in AJOG. Aaaand I let myself get drawn in. Funny how that happens when I have about six other projects I could be working on. I trace it to a moment of intrigue when one of the commenters stated that the Netherlands has poorer perinatal outcomes than the rest of Europe both at home and in the hospital because there are so many midwives that there isn't enough emergency OB care/neonatal services even in the hospital. All those midwives, taking up space, and just no room for OBs or pediatricians! So I went and looked around for some published evidence on that, and all I found was a BMJ summary of a Dutch government report that recommended, among other things, better emergency OB availability in small community hospitals. I responded pointing out that the U.S. also lacks immediate emergency OB care in many small community hospitals and we can't really attribute that to a surplus of midwives. But heck, maybe this commenter knew something I didn't? Maybe they spent years as a maternity nurse in the Netherlands! Maybe they speak fluent Dutch and this is all over the Dutch perinatal literature! Who knows!
Sadly, the reply to that was basically a lot of name-calling accusing, apparently, all midwives everywhere of being shameful liars. I know, I know. Having (hopefully) extricated myself, I'll slink back to studying for the IBCLC exam. Eleven more days, ack!
In the meantime, if anyone has any actual insights over this whole Dutch emergency OB care thing, I'd be curious to know.