Social obstetrics as niche-development in addressing health inequities

Abstract

We apply a transition research perspective to the Dutch obstetric care system to analyze historic, current, and future shifts and find ways to overcome persistent health inequities. We present social obstetrics as an emerging niche that addresses perinatal health inequities by acknowledging their multifaceted origins and fostering collaborations across the medical, social, and public health sectors. We conducted desk research, in-depth semi-structured expert interviews, and interactive group sessions with change-inclined professionals that are relevant for the implementation of social obstetrics in six Dutch municipalities. The outcomes are synthesized in a historical narrative and perspectives on current obstacles and future systemic shifts. We argue that social obstetrics can be considered a sustainable addition to what is already present, instead of a disruptive transformation of the current system. Social obstetrics is innovative as it connects various societal systems and offers a framework for cross-sectoral collaboration. These collaborations, in turn, can be the starting point for the transformation of the obstetric care system as well as other relevant societal systems.