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Table 2 Adaptations after centralisation of AOC mentioned by the interviewees in this study [in alphabetical order]

From: Centralisation of acute obstetric care in the Netherlands: a qualitative study to explore the experiences of stakeholders with adaptations in organisation of care

Adaptations at a national level

Adaptations at a regional level

Adaptations at a local level

Additional allowance for midwifery practices when there is reduces availability or accessibility of secondary care

Better back-up agreements between care providers

Always a room available in the hospital for emergencies in primary care


Compensation of additional travel costs for patients by the municipality

Better back-up agreements in own organisation


Harmonising protocols in the region

Discouraging homebirths when travel distance is long


Increased ambulance capacity

Early call to maternity care assistant organisation for delivery assistance


Innovative adaptations, such as antenatal CTG in primary care

Hire more staff in a midwifery practice/in the hospital


Monitoring capacity in the hospitals, for example with an app

Midwife on call in primary care sleeps in her work region


Redesigning Maternity Care Collaboration

Offer elective inductions for women with a long travel distance to the hospital


Travel distance as a factor in decision making


Triage room(s) in the hospital


Two midwifery teams in a midwifery practice


Health insurance coverage for outpatient birth