Proefschrift

relative. The subjectivity of risk can lead to ineffective risk selection due to blind spots that impede optimal alignment between women’s’ needs and MNC. This misalignment is visible in (1) the lack of women-centred care, (2) the disregard for overuse of care, and (3) the little attention to primary prevention. These undesirable outcomes of MNC point to the pressing need for further studies of the scope and effect social determinants of health and discrimination on birth outcomes. It is also imperative that we move beyond the assumption that risk emerges only from the pregnant and birthing body and begin to examine the risks created by MNC itself and its framing and managing of pregnancy and birth as risky. Studies into the subjective and complex character of risk selection must use intersectional analyses taking into account the impact of converging determinants and the role of power on MNC outcomes. Our research points the way to the optimization of risk selection via a broader conception of the sources of risk, an appreciation of the subjective and complex character of risk, a move to centring the focus on women and on prevention, and finally, by giving strong support to physiological approaches to pregnancy and birth. This broader conception of risk selection will offer the possibility to deploy the advancements in MNC to further reduce maternal and perinatal morbidity and mortality by avoiding preventable risks and improving care equitably, not offering some children a better start, but all children an equal start. 13 SUMMARY

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