Maternity Care Flex

Maternity care is a unique type of home care for newborns and their mothers in The Netherlands, offered during the first 10 days after birth. Because of closely working together with families in their home environment, maternity care workers play an important role in the signaling of vulnerabilities. Maternity care therefore is essential for a safe and healthy start of life. Unfortunately, it is often seen that families who could benefit most from maternity care and support, choose for the minimum amount of care. Mandatory costs for maternity care possibly play a role in the amount of care chosen. In additon, 10 days often is experienced to be too short to empower and support vulnerable families. Therefore, in this pilot, newborn parents will be offered 'flexible' maternity care (free maternity care and/or additional hours of care, to be assigned to clients in a flexible way) with the main goal to increase parental empowerment. The effect of providing free and/or more care for this specific population will be evaluated using the ‘Quadruple Aim Model'. Questionnaires and interviews will be used, as well as medical files.

Flexible maternity care for high-risk pregnant women is feasible in terms maternal empowerment, stress, resilience and self-efficacy of vulnerable families, health care costs and staff and patient experience.

1) Third trimester of pregnancy, 2) at the end of maternity care, before prolonged care is started (mostly around day 7 postpartum) 3) at six months postpartum

Arm 1: refunding all costs for maternity care (obligatory deductible excess)
Arm 2: additional hours of maternity care (to be used with the first 6 months postpartum)
Arm 3: control group (maternity care as usual)