{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T14:23:05Z","timestamp":1771078985882,"version":"3.50.1"},"reference-count":49,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,29]],"date-time":"2020-11-29T00:00:00Z","timestamp":1606608000000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>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\u2019s perinatal care trajectories and experiences of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Analysis<\/jats:title><jats:p>We will estimate the associations of women\u2019s socioeconomic and migration characteristics with:<\/jats:p><jats:list list-type=\"bullet\"><jats:list-item><jats:p>Women\u2019s antenatal care trajectories (timing of first antenatal consultation, minimum recommended number of consultations, and problems accessing care).<\/jats:p><\/jats:list-item><jats:list-item><jats:p>Obstetric practices such as episiotomies, emergency caesarean sections, and inductions.<\/jats:p><\/jats:list-item><jats:list-item><jats:p>Patient experience such as feelings of discrimination, respect, and understanding of information.<\/jats:p><\/jats:list-item><\/jats:list><jats:p>We will use descriptive statistics, multiple correspondence analysis, and simple and multiple logistic regressions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>Ethical approval has been obtained from the hospital Ethics Committees and from the Universit\u00e9 libre de Bruxelles (No: P2017\/055\/B406201730877). Written informed consent will be sought from all participants.<\/jats:p><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2020-038400","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T16:10:26Z","timestamp":1606752626000},"page":"e038400","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Mothers\u2019 experiences of perinatal care in Belgian public hospitals: exploring the social inequalities. Protocol for a cross-sectional survey"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4524-7192","authenticated-orcid":false,"given":"Claudia","family":"Sch\u00f6nborn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katia","family":"Castetbon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8038-6326","authenticated-orcid":false,"given":"Mouctar","family":"Sow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Racape","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myriam","family":"De Spiegelaere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"2020113013102082000_10.11.e038400.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.06.027"},{"key":"2020113013102082000_10.11.e038400.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2005.08.017"},{"key":"2020113013102082000_10.11.e038400.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7467.675"},{"key":"2020113013102082000_10.11.e038400.4","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.arcped.2015.07.006","article-title":"[Social inequalities in perinatal health]","volume":"22","author":"Azria","year":"2015","journal-title":"Arch Pediatr"},{"key":"2020113013102082000_10.11.e038400.5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s10903-019-00897-3","article-title":"Urgent medical aid and associated obstetric mortality in Belgium","volume":"22","author":"Vanneste","year":"2020","journal-title":"J Immigr Minor Health"},{"key":"2020113013102082000_10.11.e038400.6","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckq060"},{"key":"2020113013102082000_10.11.e038400.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029683"},{"key":"2020113013102082000_10.11.e038400.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61690-6"},{"key":"2020113013102082000_10.11.e038400.9","doi-asserted-by":"publisher","DOI":"10.1126\/science.1251872"},{"key":"2020113013102082000_10.11.e038400.10","unstructured":"World Health Organization . Resolution WHA61.17. Health of Migrants. In: Sixty-first World health assembly. Resolutions and decisions, annexes. Geneva: World Health Organization, 2008: 19\u201324. http:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA61-REC1\/A61_REC1-en.pdf, accessed 18 November 2020"},{"key":"2020113013102082000_10.11.e038400.11","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2007.064535"},{"key":"2020113013102082000_10.11.e038400.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-018-2043-3","article-title":"Is the socioeconomic status of immigrant mothers in Brussels relevant to predict their risk of adverse pregnancy outcomes?","volume":"18","author":"Sow","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"2020113013102082000_10.11.e038400.13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0220856","article-title":"Influence of time since naturalisation on socioeconomic status and low birth weight among immigrants in Belgium. A population-based study","volume":"14","author":"Sow","year":"2019","journal-title":"PLoS One"},{"key":"2020113013102082000_10.11.e038400.14","doi-asserted-by":"publisher","DOI":"10.1177\/0884217504270595"},{"key":"2020113013102082000_10.11.e038400.15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1306"},{"key":"2020113013102082000_10.11.e038400.16","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2001.01964.x"},{"key":"2020113013102082000_10.11.e038400.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0120765","article-title":"The role of prenatal care and social risk factors in the relationship between immigrant status and neonatal morbidity: a retrospective cohort study","volume":"10","author":"Paz-Zulueta","year":"2015","journal-title":"PLoS One"},{"key":"2020113013102082000_10.11.e038400.18","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s10995-013-1238-5","article-title":"Racial\/ethnic and nativity differences in birth outcomes among mothers in New York city: the role of social ties and social support","volume":"18","author":"Almeida","year":"2014","journal-title":"Matern Child Health J"},{"key":"2020113013102082000_10.11.e038400.19","doi-asserted-by":"publisher","DOI":"10.1080\/00016340802603805"},{"key":"2020113013102082000_10.11.e038400.20","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-7-268"},{"key":"2020113013102082000_10.11.e038400.21","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.wombi.2017.09.017","article-title":"A tale of two pregnancies: a critical interpretive synthesis of women's perceptions about delayed initiation of antenatal care","volume":"31","author":"Haddrill","year":"2018","journal-title":"Women Birth"},{"key":"2020113013102082000_10.11.e038400.22","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.puhe.2015.03.008","article-title":"Predictors of late initiation for prenatal care in a metropolitan region in Belgium. A cohort study","volume":"129","author":"Fobelets","year":"2015","journal-title":"Public Health"},{"key":"2020113013102082000_10.11.e038400.23","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.annepidem.2011.12.005","article-title":"Differences in preterm and low birth weight deliveries between Spanish and immigrant women: influence of the prenatal care received","volume":"22","author":"Castell\u00f3","year":"2012","journal-title":"Ann Epidemiol"},{"key":"2020113013102082000_10.11.e038400.24","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.socscimed.2015.11.030","article-title":"Migrant maternity in an era of superdiversity: new migrants' access to, and experience of, antenatal care in the West Midlands, UK","volume":"148","author":"Phillimore","year":"2016","journal-title":"Soc Sci Med"},{"key":"2020113013102082000_10.11.e038400.25","unstructured":"Shortall C , McMorran J , Taylor K , et al . Experiences of pregnant migrant women receiving Ante\/Peri and postnatal care in the UK: a doctors of the world report on the experiences of attendees at their London drop-in clinic. 2015."},{"key":"2020113013102082000_10.11.e038400.26","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-27"},{"key":"2020113013102082000_10.11.e038400.27","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1016\/j.wombi.2016.04.001","article-title":"International migration as a determinant of emergency caesarean","volume":"29","author":"Merry","year":"2016","journal-title":"Women Birth"},{"key":"2020113013102082000_10.11.e038400.28","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-019-2364-x","article-title":"Differential rates of cesarean delivery by maternal geographical origin: a cohort study in France","volume":"19","author":"Linard","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"2020113013102082000_10.11.e038400.29","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.midw.2018.09.008","article-title":"Recency of migration, region of origin and women's experience of maternity care in England: evidence from a large cross-sectional survey","volume":"67","author":"Henderson","year":"2018","journal-title":"Midwifery"},{"key":"2020113013102082000_10.11.e038400.30","doi-asserted-by":"crossref","unstructured":"Hennegan J , Redshaw M , Miller Y . Born in another country: Women\u2019s experience of labour and birth in Queensland, Australia 2014;27:91\u20137.","DOI":"10.1016\/j.wombi.2014.02.002"},{"key":"2020113013102082000_10.11.e038400.31","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-152"},{"key":"2020113013102082000_10.11.e038400.32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0127489","article-title":"Caesarean section frequency among immigrants, second- and third-generation women, and Non-Immigrants: prospective study in Berlin\/Germany","volume":"10","author":"David","year":"2015","journal-title":"PLoS One"},{"key":"2020113013102082000_10.11.e038400.33","unstructured":"Hercot D , Mazina D , Verduyckt P , et al . Na\u00eetre Bruxellois(e); Indicateurs de sant\u00e9 p\u00e9rinatale des Bruxellois(es) 2000-2012. Brussels: Observatoire de la Sant\u00e9 et du Social de Bruxelles-Capitale, Commission communautaire commune, 2015."},{"key":"2020113013102082000_10.11.e038400.34","unstructured":"Racape J , De Spiegelaere M , eds. Profil socio-d\u00e9mographique et sant\u00e9 autour de la naissance des m\u00e8res invisibles. 2020 Quetelet Seminar: Invisibilities and Uncertainties in Population Sciences; 2020 2-4 December. Belgium: Louvain-la-Neuve, 2020."},{"key":"2020113013102082000_10.11.e038400.35","unstructured":"INAMI, M\u00e9decins du Monde . White paper on access to care in Belgium. INAMI, 2014. Available: https:\/\/www.inami.fgov.be\/SiteCollectionDocumentsSiteCollectionDocuments\/white-paper.pdf [Accessed 18 Nov 2020]."},{"key":"2020113013102082000_10.11.e038400.36","unstructured":"Obs\u00e9rvatoire Europ\u00e9en de M\u00e9decins du Monde . L'acc\u00e8s aux soins des personnes SANS autorisation de s\u00e9jour dans 11 pays d'Europe. M\u00e9decins Du Monde, 2009 [Accessed Sep 2009]."},{"key":"2020113013102082000_10.11.e038400.37","unstructured":"Leeuw V , Daelemans C , Ch D , et al . .Sant\u00e9 p\u00e9rinatale en R\u00e9gion bruxelloise \u2013 Ann\u00e9e 2017. Centre d\u2019\u00c9pid\u00e9miologie P\u00e9rinatale 2019."},{"key":"2020113013102082000_10.11.e038400.38","unstructured":"Beeckman K . Antenatal care in Brussels. Determinants of care trajectories. Vrije Universiteit Brussel, 2011."},{"key":"2020113013102082000_10.11.e038400.39","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2393-14-200","article-title":"Development of the migrant friendly maternity care questionnaire (MFMCQ) for migrants to Western societies: an international Delphi consensus process","volume":"14","author":"Gagnon","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"2020113013102082000_10.11.e038400.40","unstructured":"ROAM . Reproductive outcomes and migration. An international collaboration. Available: https:\/\/www.roamscicoll.org\/"},{"key":"2020113013102082000_10.11.e038400.41","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/s00404-019-05227-4","article-title":"The influence of migration on women's satisfaction during pregnancy and birth: results of a comparative prospective study with the migrant friendly maternity care questionnaire (MFMCQ)","volume":"300","author":"G\u00fcrb\u00fcz","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"2020113013102082000_10.11.e038400.42","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/birt.12476","article-title":"The influence of migration on women's use of different aspects of maternity care in the German health care system: secondary analysis of a comparative prospective study with the migrant friendly maternity care questionnaire (MFMCQ)","volume":"47","author":"Seidel","year":"2020","journal-title":"Birth"},{"key":"2020113013102082000_10.11.e038400.43","unstructured":"ROAM . MFMCQ translation and cultural validation protocol 2014."},{"key":"2020113013102082000_10.11.e038400.44","unstructured":"United States Census Bureau . Census and survey processing system (CSPro), 2019. Available: https:\/\/www.census.gov\/data\/software\/cspro.html"},{"key":"2020113013102082000_10.11.e038400.45","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1016\/j.jclinepi.2014.06.012","article-title":"Open-source electronic data capture system offered increased accuracy and cost-effectiveness compared with paper methods in Africa","volume":"67","author":"Dillon","year":"2014","journal-title":"J Clin Epidemiol"},{"key":"2020113013102082000_10.11.e038400.46","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-019-4338-z","article-title":"National surveillance using mobile systems for health monitoring: complexity, functionality and feasibility","volume":"19","author":"Singh","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2020113013102082000_10.11.e038400.47","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.ssresearch.2017.02.007","article-title":"The effect of sociodemographic (mis)match between interviewers and respondents on unit and item nonresponse in Belgium","volume":"67","author":"Vercruyssen","year":"2017","journal-title":"Soc Sci Res"},{"key":"2020113013102082000_10.11.e038400.48","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-019-2302-y","article-title":"Exploring English speaking Muslim women's first-time maternity experiences: a qualitative longitudinal interview study","volume":"19","author":"Hassan","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"2020113013102082000_10.11.e038400.49","doi-asserted-by":"publisher","DOI":"10.1054\/midw.1999.0197"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-038400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T16:11:42Z","timestamp":1606752702000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-038400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":49,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11,30]]},"published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1136\/bmjopen-2020-038400"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-038400","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}