Staying Home: Modernity, Science, and the Absence of Hospital Birth in the Netherlands, 1918–1940

Around 1900, almost all European and American births happened at home, but soon after, birth moved into the hospital. Historians such as Judith Leavitt have analyzed the role of obstetrical science in this shift. New scientific insights on how to prevent infections favoured the strictly controlled birth environment only the hospital could offer. Furthermore, pregnant women strongly believed modern science could make birth safe and comfortable – a modern, 'scientific' hopsital birth was seen as a good birth; a traditional home birth was not. Thus, in the 1920s and the 1930s, birth started to move into the hospital in most western countries – with one major exception: the Netherlands. Although trust in science was high in the interwar Netherlands, the number of hospital births remained low, a remarkable contrast still visible today. In this paper, I investigate this difference, which so far, I argue, has not been sufficiently addressed. Most historical work on the Dutch birthing system focuses on the strong position of Dutch midwives, but although midwives are necessary for home births, their presence is in itself not a sufficient explanation for the lack of hospital births. In other European countries with similar numbers of midwives, home births did decline nonetheless. To figure out what made the Netherlands different, I analyze scientific textbooks, practical handbooks, medical case notes, and women's diaries. Together, these sources help me explain why, in the interwar Netherlands, the 'scientific' hospital birth did not acquire the same popularity as elsewhere.