[Home delivery in Italy and the Netherlands. Experience and comparison]

The study of the emerging "phenomenon" of home birth calls, to a greater extent than for other forms of assistance provided by health workers, for a sophisticated analysis capable of integrating a knowledge of legal norms, economic and sociocultural aspects, technical assistance procedures, professional and corporative aspects, and in particular medicolegal aspects. The first part of this study outlines the legislative evolution of assistance in a hospital setting and the professional training of midwives and other operators involved in the birth process in Italy. These dispositions reveal the distinct characteristics and responsibility of the various types of health operators in this specific area of the health service, as well as the formulation and development of legislation on home birth, with special reference to Piedmont Region. This is followed by an analysis of home birth in Holland, giving a description of the context, the professional figures involved and the organisational and procedural set-up (based on economic considerations and on a territorial health planning through a series of very detailed networks that differ considerably from the form of obstetric and gynecological assistance in Italy related to pregnancy and birth). In the discussion the authors examine the evolution and topicality of informed consent, which is then referred to the specific theme of assistance for pregnant women opting for a home birth; they comment on the current state of affairs and highlight the lacunae in the proposed regional legislation that correctly offers a choice between hospital and home birth, but does not present the instruments for the prior verification of the midwife's capacity to perform the specific method or even the indications for providing an adequate level of information and collaboration from the pregnant woman. The authors conclude by presenting a series of suggestions and hypotheses regarding both training aspects for those assisting home birth in obstetric schools and for the institution of control mechanisms regarding this particular freelance profession within the context of the appropriate guild.