Wednesday, April 28, 2010

More Dutch women have epidurals - now that they can

Radio Netherlands Worldwide has reported that a growing number of Dutch women are opting to have an epidural during childbirth, according to a survey of teaching hospitals by free daily newspaper Spits.

It says that since January 2009, "All hospitals have been obliged to make the procedure available 24 hours a day – a new development in Dutch obstetrics."

Can you imagine - up until just a few months ago, in a developed European country, an epidural was not readily available as a standard of care for all laboring women?? Obviously, there are plenty of cases in other developed countries where resources are so stretched or disorganized that an epidural is not necessarily available for all women either (the anesthetist is busy with other patients for example), but in The Netherlands, an epidural has been traditionally viewed as an "unnecessary" medical intervention.

Pandora's Box
As the report states, even with a rate increase from 25% at a Maastricht teaching hospital in 2008 to 30% just one year later, "the Dutch epidural rate has a long way to go before it matches that of many other countries" (e.g. the United States, which can be as high as 85% in some hospitals).

But my guess is that the rate is only going to climb further in the coming years. Some might say that Pandora's box may well have been opened in Holland by 'allowing' women access to epidurals; after all, if more women are going to choose epidurals, it's surely a slippery slope to that other infamous medical intervention - the cesarean delivery on maternal request...

I, on the other hand, would say that access to this perfectly legitimate pain relief should be available for every laboring woman, and likewise, legitimate cesarean surgery should be available for every pregnant woman too.

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