Photo courtesy of The Salt Lake Tribune
Mother loss in Belgium is low thanks in part to policies that demonstrate concern for quality prenatal and postnatal care.
Low levels of maternal mortality prevail in Belgium, with around 8 deaths per 100,000 live births in 2010–down from around 10 deaths in the 1990s ((World Health Organization, World Health Statistics 2012, Part III: Global Health Indicators (Geneva 2012).)). Belgium’s health initiatives thus focus on equal access to health care for women from all socioeconomic backgrounds rather than on improving maternal mortality rates directly. Since at least 1997, when the government held a preventive health congress, the political agenda has concentrated on issues related to preventing health problems for women, including access to appropriate, affordable, and high quality health care ((Committee on the Elimination of Discrimination Against Women, Consideration of Reports Submitted by States Parties Under Article 18 of the Convention on the Elimination of All Forms of Discrimination Against Women, Third and fourth periodic reports of States parties: Belgium, U.N. Doc. CEDAW/C/BEL/3-4 (1998), pp. 71-72.)).
Prenatal and postnatal care are well funded and organized in Belgium, and two main organizations supervise and set the national standards: Office de la Naissance et de l’Enfance (ONE), or the “Office of Birth and Childhood,” for the French speaking community, and Kind en Gezin (K&G), or “Child and Family,” for the Dutch speaking community. ONE and K&G provide their services free of charge, and compulsory medical insurance (required of all employees and the self-employed) covers most other costs associated with pregnancy, birth and postnatal care. However, even when a pregnant woman lacks insurance, a Public Social Welfare Center will pay for her care, and one Center is located in each municipality to increase accessibility to all communities ((AngloINFO, Having a Baby in Belgium (accessed 4 February 2015).)).
ONE and K&G provide a range of useful services. Through ONE, a woman’s health care provider issues her a maternity booklet on her first prenatal visit that she will bring to all subsequent visits. Moreover, an expectant mother will likely spend time with a Medical Social Worker during her pregnancy, provided by ONE. Medical Social Workers are professional nurses or are qualified in the field of social work and their consultations, whether in office or at home, help prepare the mother physically and psychologically for birth and breastfeeding, as requested. They help explain medical terminology to the mother and can advise on her eligibility and application for the full range of social security benefits available to her ((Ibid.)). K&G provides subsidies to prenatal care centers to offer support during pregnancy, especially in districts with a high rate of disadvantaged families. K&G also sends nurses to visit postpartum mothers in the hospital, and local nurses make home visits several times during the first three months after birth (four visits for a first child or three for subsequent children) ((Economic and Social Council, Implementation of the International Covenant on Economic, Social and Cultural Rights, Third periodic reports submitted by States parties under articles 16 and 17 of the Covenant: Belgium, U.N. Doc. E/C.12/BEL/3 (2006), pp. 85, 139.)). Additionally, K&G offers information evenings and other guidance to expectant parents and families with children under the age of three ((AngloINFO, Having a Baby in Belgium (accessed 4 February 2015).)).
Finally, certain laudable policies demonstrate how important prenatal care is to the Belgian government. For example, once an employee informs her employer of her pregnancy, she is entitled to paid leave in order to attend any prenatal care appointments that must occur during normal working hours. Additionally, pregnant workers can request exemption from night work for up to three months before childbirth (or more, with presentation of a medical certificate), and pregnant or nursing employees may not work overtime ((Economic and Social Council, Implementation of the International Covenant on Economic, Social and Cultural Rights, Third periodic reports submitted by States parties under articles 16 and 17 of the Covenant: Belgium, U.N. Doc. E/C.12/BEL/3 (2006), pp. 85, 139.)). Such caution in prenatal and postnatal care is commendable, and likely contributes to the fact that, in 2010, the lifetime risk of maternal death in Belgium was a mere 1 in 7,500 ((UN Maternal Mortality Estimation Inter-agency Group, Trends in Maternal Mortality: 1990 to 2013 (Geneva 2014), pp. 31-43.)).
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