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Abstract
Introduction In Europe, the social inequalities in perinatal health are usually found to be to the disadvantage of non-European immigrants and women with lower levels of education and income. Among the possible underlying mechanisms are inadequate access to healthcare services and suboptimal care. To explore this hypothesis in the Belgian context, our research will describe detailed maternal socioeconomic and migration characteristics, explore how these factors relate to each other, and how they relate to women’s perinatal care trajectories and experiences of care.
Methods Using a modified version of the Migrant-Friendly Maternity Care Questionnaire, we will survey 900 mothers of Belgian nationality or a nationality from a North or Sub-Saharan African country, and having given birth in four maternity wards in Brussels. The questionnaire has been adapted to the study objectives and the Belgian context. Interviewers will administer the 116-item questionnaire to all women agreeing to participate and meeting inclusion criteria, within 14 days of having given birth. Clinical information will be extracted from hospital records.
Analysis We will estimate the associations of women’s socioeconomic and migration characteristics with:
Women’s antenatal care trajectories (timing of first antenatal consultation, minimum recommended number of consultations, and problems accessing care).
Obstetric practices such as episiotomies, emergency caesarean sections, and inductions.
Patient experience such as feelings of discrimination, respect, and understanding of information.
We will use descriptive statistics, multiple correspondence analysis, and simple and multiple logistic regressions.
Ethics and dissemination Ethical approval has been obtained from the hospital Ethics Committees and from the Université libre de Bruxelles (No: P2017/055/B406201730877). Written informed consent will be sought from all participants.
In addition to disseminating findings and recommendations to the scientific community through open-source journal articles and conferences, we will also address local organisations and healthcare professionals via a written report and seminars.
- perinatology
- social medicine
- public health
- quality in health care
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Footnotes
Contributors CS and MDS designed the study. CS, MDS and KC adapted the Migrant-Friendly Maternity Care Questionnaire, CS piloted the questionnaire and is coordinating the data collection. CS drafted this article and MDS, KC, MS and JR revised it critically for important intellectual content.
Funding This work was supported by an FNRS (Fund for Scientific Research https://www.frsfnrs.be/en/) FRESH doctoral grant for the first author, and a FER (Fonds d’Encouragement à la Recherche) grant from the Université libre de Bruxelles to carry out the data collection.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer-reviewed.
Data availability statement Data are available upon reasonable request. The data consists of anonymised participant data, and is available from the corresponding author upon reasonable request.