[Obstetrics and gynecology in the last 40 years]

In the Netherlands the last 40 years have seen major changes in obstetrics and gynaecology: Progressive expansion of evidence-based medicine. A measurable, greatly improved quality policy during gynaecologists' training and the subsequent period. Increase of diagnostic possibilities during pregnancy (such as real-time echography, Doppler measurements, amniocentesis and umbilical-cord puncture). Foundation of the Landelijke Verloskunde Registratie (LVR. National Obstetrical Registry) in 1982, in which by now 90% of the specialists and 80% of the midwives are participating. Implementation of the 'Dutch model' of obstetrical care. Decrease of the number of home deliveries and increase of the obstetrical interventions. More attention for sex problems. Better results in the treatment of gynaecological tumours. Great progress in the field of reproduction endocrinology (both pharmaceutical and surgical).