The Netherlands’ world-leading postnatal care facing crisis, unions warn

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"Healthcare Unions Warn of Crisis in Netherlands' Postnatal Care System"

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The Netherlands is facing a potential crisis in its renowned postnatal care system, known as kraamzorg, which has been a cornerstone of its maternity services. This system provides in-home support from maternity care assistants for up to eight days following the birth of a child, helping mothers and newborns with essential care and guidance. However, recent warnings from healthcare unions indicate that a significant shortage of labor and competition from other healthcare sectors threaten the viability of this service. On Tuesday, five unions are set to present a petition with nearly 15,000 signatures to Dutch MPs, urging for guarantees to maintain quality kraamzorg for all new families. The unions are advocating for better pay for maternity care assistants, particularly for the time they spend on standby, which is often undercompensated despite the demanding nature of the work. Current compensation rates are approximately €11.50 per shift, which does not reflect the extensive hours of availability required for the role. The growing labor shortages have already resulted in hundreds of families being left without adequate support, a situation projected to worsen in the coming years, threatening the unique system that sets the Netherlands apart from its neighboring countries.

The kraamzorg system is integral to Dutch maternity care, with nearly one in seven babies born at home receiving immediate assistance from maternity care assistants. These professionals play a crucial role in ensuring the well-being of both mother and child, providing support with health checks and addressing challenges such as breastfeeding. However, increasing work pressure and an inadequate number of care assistants are leading to a decline in service quality, especially during peak times like summer. The job is often described as underpaid and unattractive, which contributes to the high turnover rate among workers. Former midwife and current GreenLeft MP Elke Slagt-Tichelman emphasized the challenges of scheduling care during busy periods, which can result in diminished support for families. Despite these difficulties, maternity care assistants like Daniëlle Verveen express a deep commitment to their work, highlighting the profound impact they have on families during a critical time in their lives. The unions' manifesto seeks to ensure the future of kraamzorg, advocating for both the preservation of this essential service and improved conditions for those who provide it.

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A key pillar of Dutch maternity services that has led to theNetherlandsbeing hailed as a world leader in postnatal care is under threat, healthcare unions in the country have warned.

The Netherlands has long prided itself on its unique system ofkraamzorg(maternity care), whereby a maternity care assistant comes to a new family’s home for eight days after a baby’s birth, caring for mother and infant.

But on Tuesday, five healthcare unions are expected to present a manifesto andpetitionof almost 15,000 signatures to MPs in The Hague, warning that a shortage of labour and competition from other care jobs have left the system facing crisis.

The petition calls for a guarantee of the future of goodkraamzorgfor all mothers and newborns in the Netherlands.

The unions want a dedicated ministerial representative and better pay, including for “waiting” time, where care workers have to be available in case babies are born but receive about €11.50 (£9.80) for an eight-hour shift, before tax. A typical contract of 130 hours a month includes 244 to 265 hours on standby, according to the FNV trade union.

“Last year there were 500 families without a maternity care assistant,” said Daniëlle Verveen, a care assistant from Krommenie, near Amsterdam. “And the expectation is that this will increase up to 2034, in just 10 years, to 37,000 families withoutkraamzorg.”

Marloes Kortland, from the CNV union, said thekraamzorgsystem of supporting new parents, checking babies’ health and helping with tricky newborn challenges such as breastfeeding was a one-off and deserved to be preserved.

“The Netherlands is the only country that has this care,” she said. “In the countries around us, women stay for much longer in hospital but here, the care for mother and children is taken up straight away by the maternity care assistants.

“But the problem is that there is a shortage of care assistants, the work pressure is ever greater and more people are leaving.

“Kraamzorgdemands a lot of flexibility from people because you never know when a baby will be born … and if you have a family yourself, it is very difficult to combine the two.”

Almostone in seven babiesare born at home in the Netherlands and, at such a birth, the assistant is present alongside a midwife. In a hospital or maternity unit birth, women are typically discharged within hours and the care worker then visits every day to monitor mother and baby. Thesystem, mostly paid for through health insurance, offers between 24 and 80 hours of care.

But in periods such as the summer holiday it is creaking at the seams, said GreenLeft MP and former midwife Elke Slagt-Tichelman.

“If there’s a peak with births in a region, it can be exhausting for the maternity care assistants to get the schedule organised, and sometimes parents get less assistance,” she said.

Although vital, she added, the job of maternity care assistant was challenging and “not attractive” from a remunerative point of view. “Like taking care of the elderly, it is a really underpaid job,” she said.

But Verveen – who said that in three years she had saved a 24-hour-old girl from choking and helped 200 families – said the profession had a value far beyond income.

“There is something magical about life as a maternity carer,” she said. “You help a family start up a new life.”

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Source: The Guardian