Dutch model limits choice

doi:10.1136/bmj.308.6924.342b

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L Mascarenhas,
F Biervliet,
H Gee,
M Whittle

Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham Maternity Hospital, Birmingham B15 2TG.

EDITOR, - A paper1 and an editorial2 have commented favourably on low risk care led by midwives in the Netherlands, and the editorial suggested that this might reduce the number of unnecessary caesarean sections performed in Britain for fear of litigation.

The main reason for the difference between caesarean section rates in Britain and the Netherlands is that women's choice is denied in the Netherlands because the midwife decides when and to whom to refer the …