Advanced Midwifery 2: Vulnerable Groups


Course Objective

After finishing this course students have specialized knowledge to ask
relevant research questions and contribute to answers to the
developments and challenges in the actual midwifery care in the
This course will focus on analysing and reducing perinatal mortality in
vulnerable groups in the Netherlands.
The final report of the IGZ (2014) titled: "Opportunities for
improvement of birth care still underused" shows that there is room for
improvement in maternity care among vulnerable groups in the
Netherlands. Vulnerable groups of women in the Netherlands are migrants,
asylum seekers and undocumented migrants, women with low socio-economic
status, low literacy, teenage mothers and residents of deprived areas.
The profession of midwifery has become increasingly more concerned with
social problems that affect the quality of pregnancy and childbirth. In
this module, a medical sociological approach is used to analyze the
social reality of illness, health and care in relation to the medical-
biological reality.
Attention will be paid to: social inequality and health, social causes
of disease and the cultural dimension of disease and pregnancy.

Learning objectives
1. explain, analyse and evaluate philosophical aspects of and
theoretical approaches to the concept of vulnerability and the
consequences of these theoretical approaches for care during the
perinatal period.
2. describe and discuss the fundamental aspects of and theoretical
approaches to diversity responsiveness and to apply this knowledge to
maternity care in the Netherlands
3. .describe, discuss and explain: 1] the causes of perinatal morbidity
and mortality among vulnerable groups and 2] the role played by
socio-economic status in health disparity and to apply this knowledge to
maternity care in the Netherlands
4. . describe and explain the causes, effects and various aspects of
maternal perinatal psychological distress and psychopathology, and apply
this knowledge to public health interventions and research design.
5. describe and discuss women’s perception and experience of
psychological vulnerability during pregnancy and childbirth and the
consequences this has for maternity care interventions.
6. analyse and apply knowledge of parent-child attachment, physical
and/or intellectual disability and the determinants and consequences of
domestic violence during pregnancy to maternity care for vulnerable
7. . describe and explain different communication theories and tools and
how they apply to vulnerable groups in the context of maternity care

Literature study (paper)
8. write and present a scientific paper on one of the following topics:
(1) risk factors and other correlates of being in a vulnerable group;
(2) the consequences of being in a vulnerable group for maternal health
during pregnancy, pregnancy outcomes and/or foetal or child development
from a physical, behavioural or cognitive perspective; and (3) an aspect
of maternal and/or child care in vulnerable groups.

Course Content

Vulnerable groups among pregnant women in the Netherlands
• Women with low SES / living in disadvantaged district / poverty / low
• Non-western non-Dutch women
• Teens
• Asylum seekers / refugees / undocumented women
• Pregnant women with (severe) psychological or psychiatric problems /
• Women who prefer maternity care outside existing protocols (VIL) and
women with somatic insufficient unexplainable symptoms (SOLK)

Teaching Methods

Lectures (approximately) 16 hours, workgroup 48 hours, individual study
104 hours 6EC = 168 sbu
Advanced Midwifery Science module is a part-time course of 8 weeks. The
total study time is 168 hours.

Method of Assessment

The final grade is being determined by :
A theoretical Individual exam (40%)
Scientific paper/written assignment (40 %)
Oral presentation(s) (20%)
All exams need to be passed (minimum 6.0)

Entry Requirements

Bachelor Midwifery plus premaster Health Sciences.


Blackburn, S. T. (2013). Maternal, Fetal, & Neonatal Physiology: A
Clinical Perspective (4th ed.). Maryland Heights, MO: Elsevier Saunders.
ISBN: 9781437716238
Principles of Biomedical Ethics (Beauchamp and Childress; 2013)
A selection of literature will be made on the basis of lectures and
state of the art research.

Target Audience

Bachelor Midwifery students.

Additional Information

Dr. Janneke Gitsels (midwife, theologist, lecturer)
Dr. Jens Henrichs (psychologist, researcher)
Dr. Lianne Holten (midwife, cultural anthropologist, lecturer)
Dr. Ank de Jonge (midwife, associated professor)
Dr. Trudy Klomp (midwife, researcher, lecturer and coördinator of the
Dr. Linda Martin (psychologist, researcher and lecturer)

General Information

Course Code AM_1189
Credits 6 EC
Period P2
Course Level 400
Language of Tuition English
Faculty Faculty of Science
Course Coordinator dr. G.M.T. Klomp MSc
Examiner dr. G.M.T. Klomp MSc
Teaching Staff

Practical Information

You need to register for this course yourself

Last-minute registration is available for this course.

Teaching Methods Lecture, Study Group, Practical
Target audiences

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