[Less medicalization of obstetrics in West Frisian islands than on the mainland]

To inventory the functioning and the results of obstetrics in the West-Frisian islands in 1995 and 1996.

Retrospective.

With enquiry forms information was gathered from the six GP practices in the West Frisian islands concerning the course and results of every pregnancy with a delivery between 1 January 1995 and 31 December 1996. Of emergency transfers during labour and in the postpartum period the time span between moment of applying for a transport and arrival at the hospital ashore was noted. Results were compared with those for the total province of Friesland and the national Dutch results.

Of the 253 women 23 (9%) had a primary indication for hospital delivery under care of a gynaecologist. During pregnancy 52 patients (21%) were directed for hospital delivery. 23 (9%) of the 178 patients awaiting the home delivery were referred during labour and 155 women (61%) delivered at home. After delivery 3 patients were admitted. The median time span in emergency transfers was 77.5 min (range: 60-105) with transport by boat and 65 min (55-120) with transport by heli. The island people delivered at home in 61% compared with 37% in Friesland in 1996 and 31% in the Netherlands in 1993, had a hospital delivery under care of a gynaecologist in 39% compared with 56% in Friesland and 58% in the Netherlands in 1996, had a caesarean section in 6% compared with 10% in Friesland and the Netherlands in 1996. There were two foetal mortalities and one neonatal mortality.

In comparison with the national data the island obstetrics is characterized by a higher home delivery rate, less specialist involvement and a lower caesarean section rate.