Mothers’ experiences of perinatal care in Belgian public hospitals: exploring the social inequalities. Protocol for a cross-sectional survey

Schönborn, Claudia; Castetbon, Katia; Sow, Mamadou Mouctar; Racapé, Judith; Spiegelaere, Myriam De

doi:10.1136/bmjopen-2020-038400

Cited by 3 publications

(3 citation statements)

References 39 publications

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“…Our analysis of the research findings has highlighted that there is no universally acknowledged approach regarding the management of intrapartum phase, and some manoeuvres frequently used in the obstetric-gynaecological field could be perceived from the women as dangerous on the psycho-physical integrity of the pregnant women and unborn children [8][9][10][11][12][13][14][15][16]. However, some of the authors [4,[15][16][17][18][19][20] believe that universally recognized guidelines are needed in order to provide guidance and legitimize the activity of the obstetrician in intrapartum management.…”

Section: Resultsmentioning

confidence: 99%

The highly complex phase of intrapartum management: when clinical and medico-legal aspects overlap

Negro¹,

Signore²,

Varone³

et al. 2023

It Journ Gyn Obs

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Objective. Some intrapartum obstetrical practices, such as episiotomy or Kristeller Maneuver, are highly controversial within the scientific community, from the ethical, political and social perspectives. Guidelines or recommendations for the management of intrapartum care, revolving around a thorough informed consent process, can be decisive to avoiding deeply conflicting situations, where the phrase "obstetric violence" has unfortunately become relatively widespread. In this paper, the authors aimed to highlight how the use of intrapartum obstetric practices is, at times, necessary and instrumental in ensuring the well-being of the mother as well as the foetus. Materials and Methods. A broad-ranging search has been conducted, using the scientific search engines PubMed, Google Scholar, Medscape, Medline Plus and Scopus, via the following search string: "obstetric violence", "gender violence", "intrapartum care", "episiotomy", "caesarean section", "Kristeller", "childbirth", "informed consent", taking into consideration the articles from 2015 to February 2021. Results. Results of our research point to the fact that the woman's need for information on obstetric procedures is often not adequately met by health professionals, and the informed consent process is therefore not thoroughly implemented. Conclusions. The authors argue in favour of adopting an informed consent model to be submitted to the pregnant women regarding any intrapartum obstetrical procedure that may become necessary before and during labour, in order to make professional conduct more transparent and protect health care personnel from claims and lawsuits arising from unwarranted practices.

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Section: Resultsmentioning

confidence: 99%

The highly complex phase of intrapartum management: when clinical and medico-legal aspects overlap

Negro¹,

Signore²,

Varone³

et al. 2023

It Journ Gyn Obs

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“…Nevertheless, it is imperative to consider the seriousness of this vulnerability, since it will be added, for some parents, to psychopathology and/or traumas experienced in childhood. The interplay between socioeconomic factors, migration history and perinatal health is widely described in the literature ( 56 , 57 ). However, unlike what has been shown in previous studies ( 58 ), none of the economic or social variables considered individually, is associated with a pejorative outcome of hospitalization in our study.…”

Section: Discussionmentioning

confidence: 99%

A 5 years’ experience of a parent-baby day unit: impact on baby’s development

Moureau,

Cordemans,

Gregoire

et al. 2023

Front. Psychiatry

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IntroductionPsychiatric Mother-Baby Units are well established in France, United Kingdom, and Australia, mostly in full-time hospitalization. Inpatient units are considered as best practice for improving outcomes for mothers and babies when the mother is experiencing severe mental illness and many studies have showed the effectiveness of care for the mother or the mother-infant relationship. Only a limited number of studies have focused on the day care setting or on the development of the baby. Our parent-baby day unit is the first day care unit in child psychiatry in Belgium. It offers specialized evaluation and therapeutic interventions focused on the baby and involves parents with mild or moderate psychiatric symptoms. The advantages of day care unit is to reduce the rupture with social and family living.AimsThe objective of this study is to evaluate the effectiveness of parent-baby day unit in prevention of babies’ developmental problems. First, we present the clinical characteristics of the population treated in the day-unit in comparison to the features presented in the literature review about mother-baby units, which usually receive full-time treatment. Then, we will identify the factors that might contribute to a positive evolution of the baby’s development.Materials and methodsIn this study, we retrospectively analyze data of patients admitted between 2015 and 2020 in the day unit. Upon admission, the 3 pillars of perinatal care – babies, parents, and dyadic relationships – have systematically been investigated. All the families have received a standard perinatal medico-psycho-social anamnesis, including data on the pregnancy period. In this unit, all the babies are assessed at entry and at discharge using the diagnostic 0 to 5 scale, a clinical withdrawal risk, and a developmental assessment (Bayley). Parental psychopathology is assessed with the DSM5 diagnostic scale and the Edinburgh scale for depression. Parent–child interactions are categorized according to Axis II of the 0 to 5 scale. We have evaluated the improvement of children symptomatology, the child development and the mother–child relation between the entrance (T1) and the discharge (T2) and we have compared two groups of clinical situations: a group of patients with a successful evolution (considering baby’s development and the alliance with the parents) and a group of unsuccessful evolution during hospitalization.Statistical analysisWe use descriptive statistics to characterize our population. To compare the different groups of our cohort, we use the T-test and non-parametric tests for continue variables. For discrete variables, we used the Chi2 test of Pearson.DiscussionThe clinical population of the day unit is comparable to the mother-baby units in terms of psychosocial fragility but the psychopathological profile of the parents entering the day unit shows more anxiety disorder and less post-partum psychosis. The babies’ development quotient is in the average range at T1 and is maintained at T2. In the day unit, the number of symptoms as well as the relational withdrawal of the babies is reduced between T1 and T2. The quality of parent–child relationship is improved between T1 and T2. The children of the group of pejorative evolution had a lower developmental quotient at the T1 and an overrepresentation of traumatic life events.ConclusionThese results indicate that parent-baby day unit lead to positive outcomes in clinical situations with anxio-depressive parents, relational withdrawal of the babies, functional problems of the babies but not when a significant impact on the development of the baby already exists. The results of this study can guide therapeutic approaches for the benefit of care in parent-baby day units, and improve the development of the child and of the dyadic relationships.

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“…This observational cross-sectional study included 932 women interviewed in hospital within two weeks of having given birth. The detailed methodology has been published elsewhere [18].…”

Section: Population and Toolsmentioning

confidence: 99%

Country of birth as a potential determinant of inadequate antenatal care use among women giving birth in Brussels. A cross-sectional study

2022

Self Cite

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Background One of the mechanisms explaining perinatal health inequalities could be inadequate antenatal care among some immigrant groups. Few European studies compared antenatal care use between different groups of immigrants taking into account individual characteristics. This research investigates the associations of three birth regions with the use of antenatal care, by also considering socioeconomic and migration-related determinants. Methods We included 879 mothers born in Belgium, North Africa, and Sub-Saharan Africa, and interviewed them in four Brussels hospitals after they gave birth, using an adapted version of the Migrant-Friendly Maternity Care Questionnaire. We additionally collected clinical data from hospital records. We carried out descriptive analyses and ran univariate and multivariable logistic regression models to estimate the associations of socioeconomic and migration characteristics with a) late start of antenatal care and b) less than minimum recommended number of consultations. Results The vast majority of women in this study had adequate care in terms of timing (93.9%), frequency of consultations (82.2%), and self-reported access (95.9%). Region of birth was an independent risk factor for late initiation of care, but not for infrequent consultations. Women born in Sub-Saharan Africa were more prone to accessing care late (OR 3.3, 95%CI 1.5–7.7), but were not more at risk of infrequent consultations. Women born in North Africa, had similar adequacy of care compared to the Belgium-born population. The three groups also differed in terms of socioeconomic profiles and socioeconomic predictors of antenatal care use. Housing type, professional activity, and health insurance status were important predictors of both outcomes. Conclusions This study showed that the region of birth was partly associated with adequacy of care, in terms of initiation, but not number of consultations. Further dimensions of adequacy of care (content, quality) should be studied in the future. Socioeconomic factors are also key determinants of antenatal care use.

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Mothers’ experiences of perinatal care in Belgian public hospitals: exploring the social inequalities. Protocol for a cross-sectional survey

Cited by 3 publications

References 39 publications

The highly complex phase of intrapartum management: when clinical and medico-legal aspects overlap

The highly complex phase of intrapartum management: when clinical and medico-legal aspects overlap

A 5 years’ experience of a parent-baby day unit: impact on baby’s development

Country of birth as a potential determinant of inadequate antenatal care use among women giving birth in Brussels. A cross-sectional study

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