Much ado is made about the Dutch and their “amazing” homebirth system. Even if you’re willing to ignore the fact that they have some of the worst outcomes in Europe, they have much, much stricter homebirth standards than we have here in Oregon. The relative safety of the Dutch system stems from several factors:

  1. Dutch midwives are required to have training on par with American CNMs. You MUST have a university degree from a real university in order to practice midwifery in the Netherlands. Because they have adequate training, Dutch midwives are able to work in both the home and hospital environments, with those hospital privileges allowing for smooth transfer and continuity of care in case it is needed.
  2. There is a dedicated transport system in place for homebirths, enabling a speedy transfer  if necessary.
  3. Probably most importantly, the Netherlands has strict criteria for homebirth eligibility, ensuring only the most low-risk women attempt homebirths.
Consider the differences between the Dutch criteria and Oregon’s criteria. An absolute risk is one in which both areas require transfer to a medical doctor. In the Netherlands, a non-absolute risk is one where the midwife must consult with and the patient must see a medical doctor. In Oregon, a non-absolute risk means that the midwife must at least consult with another licensed midwife or naturopathic doctor. You can see that the Dutch have many absolute risk criteria that Oregon doesn’t even mention, even in the non-absolute columns.


State statutes:

Direct Entry Midwifery ORS 687.405-495 and 687.895, 991 (Scroll down to find the related section.)

OHLA ORS 676.605-625 and 676.990-992 (Scroll down to find the related section.)


Administrative rules:

Direct Entry Midwifery OAR Chapter 332, Divisions 015-040 (effective 10-15-2011)

Click on Administrative Rules – by OAR Chapter Division then click 332, scroll down to find the related section 015-040.

The above rules link directly to the Secretary of State and may not reflect recently adopted rules.  OHLA offers the most recently adopted rules in PDF file format below.

Board of Direct Entry Midwifery OAR Chapter 332, Division 15-40 (10/15/2011 PDF Version) 

Oregon Health Licensing Agency (OHLA)  OAR Chapter 331, Divisions 001-030 (effective 3-01-2011)

Certificate and Order for Filing Permanent Administratrive Rules – As of 9/26/11 (except fees moved to Division 40)

Marked-up Copy of Permanent Administrative Rules – As of 9/26/11 (except fees moved to Division 40)

Certificate and Order for Filing Permanent Administratrive Rules Fees – As of 9/26/11

Marked-up Copy of Permanent Administrative Rules Fees – As of 9/26/11

Licenses, Permits and Registrations

Birth Centers

Health Care Regulation and Quality Improvement Program

Oregon Administrative Rules re: Birth Centers