recommend increasing the competencyof critical self-reflectionof the roleof professionals’ norms, beliefs, biases, and actions in care in professional education, and in evaluations of professionals.[77,229–232] Recommendations for future research Contemporary risk selection is focused on pathology, short term, and quantitative outcomes, including referral rates, intervention rates, and morbidity and mortality rates. Future research should prioritize long term outcomes and measures of women’s social and emotional wellbeing, such as resilience, coping, and trust, which can help reveal new practices that enhance health, protect, promote, and support physiological pregnancy and birth, and prevent pathology.[100] Studies into the long term effects of medical interventions are needed to increase awareness of the risk of MNC itself and to contribute to more optimal decision making in the use of medical interventions. Examples include studies into the long term effect of operative birth,[233–237] and the use of synthetic oxytocin.[238,239] Future studies into risk selection should apply intersectional analyses to better capture the complexity of risk selection andwomen’s needs and to reveal risks fromsocial determinants and MNC itself.[240,241] For example, applying intersectional analyses may reveal racial and economic disparity,[242] which may otherwise remain hidden.[243] Intersectional analysis requires a more comprehensive registration of health determinants, including determinants suchasBMI andcigarette smoking.We recommendcautionwhenusingethnic or SES categories.[186,244] Both ethnicity and SES are socially constructed categories. They are proxies, representing multifactorial, complex and dynamic determinants of health, and therefore should not be used as biological determinants.[244,245] The social construction of SES and ethnicity makes categorization of individuals into these categories difficult. Using these categories in research may essentialize specific categories and ideas, (re) produce stereotypes and particular societal and political notions of similarity, difference and hierarchy. To be able to use ethnicity and SES as social categories in a more meaningful way in future research, determinants should be registered more precisely, underlying categories should be registered, and a distinction should be made between self-assigned and socially assigned ethnicity.[186,220,225,246–252] A large body of research indicates the presence of discrimination in MNC,[242,253– 261] including in the Netherlands.[95,206,262,263] More research is needed to better understand the scope and effect of discrimination in risk selection. For instance, bias in education,[264] and disparity in medical interventions,[265,266] has yet to be studied. More research is also necessary to increase the knowledge about anti-discrimination 174 7 CHAPTER 7