{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:13:41Z","timestamp":1788444821580,"version":"build-2803163510"},"reference-count":58,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Institute for Maternal and Child Health IRCCS \"Burlo Garofolo\u201d in Trieste","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,16]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study explored the quality of maternal and newborn care (QMNC) in Belgium, focusing on women\u2019s experience with care and their mental health (MH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a cross-sectional survey using the WHO-based IMAgiNE EURO questionnaire, updated with MH items.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All women who gave birth in a health facility in Belgium were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Data were collected from 621\u2009women who gave birth between March 2022 and January 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Descriptive statistics summarised QMNC and MH outcomes, while logistic regression examined factors associated with negative emotional childbirth experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median QMNC index was 260\/300, suggesting high adherence to WHO quality standards. However, 33.5% of respondents reported ineffective communication, 34.0%\u2009a lack of involvement in decision-making, 8.7%\u2009no emotional support from healthcare providers and 8.2% reported abuse. Overall, 40.9% of women reported emotional difficulties related to childbirth, with 10% reporting a negative impact on well-being. MH screening and support were not structurally embedded in perinatal care. Emergency caesarean deliveries (adjusted odds ratio (aOR): 14.94), instrumental births (aOR: 2.36), fundal pressure (aOR: 4.11) and abuse (aOR: 3.74) were significantly associated with emotional difficulties around childbirth. The presence of an obstetric consultant (aOR: 0.44) and higher QMNC scores (aOR: 0.97) were associated with a lower likelihood of reporting emotional difficulties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Belgium shows a high level of QMNC, yet significant gaps remain in communication, MH screening and support and adherence to evidence-based practices. Our study highlights a strong association between certain childbirth interventions and a negative emotional birth experience, emphasising the need for further research into the underlying causal patterns and contextual factors shaping women\u2019s childbirth experiences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115291","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:00:29Z","timestamp":1783594829000},"page":"e115291","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of maternal and newborn care, perinatal mental health and the emotional birth experience of women: findings of the IMAgiNE EURO study in Belgium"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1427-5067","authenticated-orcid":false,"given":"Anna","family":"Galle","sequence":"first","affiliation":[{"name":"International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium"},{"name":"Het Universitair Centrum voor Verpleegkunde en Vroedkunde, Department of Public Health and Primary Care, Ghent University, Ghent, Flanders, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Vanderschueren","sequence":"additional","affiliation":[{"name":"Het Universitair Centrum voor Verpleegkunde en Vroedkunde, Department of Public Health and Primary Care, Ghent University, Ghent, Flanders, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Vercaempst","sequence":"additional","affiliation":[{"name":"Het Universitair Centrum voor Verpleegkunde en Vroedkunde, Department of Public Health and Primary Care, Ghent University, Ghent, Flanders, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Verdecchia","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, WHO Collaborating Centre for Maternal & Child Health, Trieste, Friuli-Venezia Giulia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8260-4788","authenticated-orcid":false,"given":"Ilaria","family":"Mariani","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, WHO Collaborating Centre for Maternal & Child Health, Trieste, Friuli-Venezia Giulia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo Giovanni","family":"Cora","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, WHO Collaborating Centre for Maternal & Child Health, Trieste, Friuli-Venezia Giulia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Bomben","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, WHO Collaborating Centre for Maternal & Child Health, Trieste, Friuli-Venezia Giulia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Camanni","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, WHO Collaborating Centre for Maternal & Child Health, Trieste, Friuli-Venezia Giulia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mieke","family":"Embo","sequence":"additional","affiliation":[{"name":"Department in Nursing and Midwifery, University of Antwerp, Antwerp, Belgium"},{"name":"Department of Educational Studies, Ghent University, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Vaerewijck","sequence":"additional","affiliation":[{"name":"International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8608-2198","authenticated-orcid":false,"given":"Marzia","family":"Lazzerini","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health IRCCS Burlo Garofolo, WHO Collaborating Centre for Maternal & Child Health, Trieste, Friuli-Venezia Giulia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"2026090306252060000_16.7.e115291.1","doi-asserted-by":"crossref","unstructured":"The Lancet Global Health . Renewing our commitment to maternal and newborn survival. Lancet Glob Health 2025;13. doi:10.1016\/S2214-109X(25)00154-8","DOI":"10.1016\/S2214-109X(25)00154-8"},{"key":"2026090306252060000_16.7.e115291.2","unstructured":"Perinatale gezondheid in vlaanderen speciaal dossier inductie versus spontane start van de arbeid: wat zeggen de perinatale uitkomsten? Factsheets factsheets van spe-studies factsheets factsheets van studies op basis van SPE-data."},{"key":"2026090306252060000_16.7.e115291.3","unstructured":"Goemaes R , Fomenko L , Laubach M , et al . Perinatale gezondheid in Vlaanderen: Jaar 2021. 2022."},{"key":"2026090306252060000_16.7.e115291.4","unstructured":"COVID-birth study: perinatal impact of maternal COVID-19. Belgian Journal of Paediatrics."},{"key":"2026090306252060000_16.7.e115291.5","doi-asserted-by":"crossref","unstructured":"Sch\u00f6nborn C , Castetbon K , Spiegelaere M . Maternal birthplace and experiences of perinatal healthcare in Belgium: Evidence from a cross-sectional survey. Midwifery 2024. doi:10.1016\/j.midw.2024.104139","DOI":"10.1016\/j.midw.2024.104139"},{"key":"2026090306252060000_16.7.e115291.6","unstructured":"Accoucher \u00e0 bruxelles et en wallonie avant et pendant le COVID - Les r\u00e9sultats - Plateforme pour une naissance respect\u00e9e. Available: https:\/\/www.naissancerespectee.be\/accoucher-a-bruxelles-et-en-wallonie-avant-et-pendant-le-covid-les-resultats [Accessed 10 Mar 2026]."},{"key":"2026090306252060000_16.7.e115291.7","doi-asserted-by":"crossref","first-page":"100728","DOI":"10.1016\/j.srhc.2022.100728","article-title":"Women\u2019s experiences with being pregnant and becoming a new mother during the COVID-19 pandemic","volume":"32","author":"Vermeulen","year":"2022","journal-title":"Sexual & Reproductive Healthcare"},{"key":"2026090306252060000_16.7.e115291.8","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1080\/07399332.2023.2190591","article-title":"Perinatal women\u2019s experiences of childbirth and parenting during the COVID-19 pandemic: A qualitative descriptive study","volume":"46","author":"Chae","year":"2025","journal-title":"Health Care Women Int"},{"key":"2026090306252060000_16.7.e115291.9","doi-asserted-by":"crossref","first-page":"100295","DOI":"10.1016\/j.ijnsa.2025.100295","article-title":"Understanding the experiences of birthing care during COVID-19: A qualitative systematic review","volume":"8","author":"Macdonald","year":"2025","journal-title":"International Journal of Nursing Studies Advances"},{"key":"2026090306252060000_16.7.e115291.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-022-04637-8","article-title":"Giving birth in a pandemic: women\u2019s birth experiences in England during COVID-19","volume":"22","author":"Aydin","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026090306252060000_16.7.e115291.11","doi-asserted-by":"publisher","DOI":"10.1016\/J.MPMED.2024.07.009"},{"key":"2026090306252060000_16.7.e115291.12","unstructured":"Launch of the WHO guide for integration of perinatal mental health in maternal and child health services. Available: https:\/\/www.who.int\/news\/item\/19-09-2022-launch-of-the-who-guide-for-integration-of-perinatal-mental-health [Accessed 4 Jul 2025]."},{"key":"2026090306252060000_16.7.e115291.13","doi-asserted-by":"publisher","DOI":"10.1007\/S00737-024-01423-7"},{"key":"2026090306252060000_16.7.e115291.14","doi-asserted-by":"publisher","DOI":"10.1080\/02646838.2019.1629190"},{"key":"2026090306252060000_16.7.e115291.15","doi-asserted-by":"publisher","DOI":"10.1080\/02646838.2017.1397270"},{"key":"2026090306252060000_16.7.e115291.16","doi-asserted-by":"crossref","unstructured":"Infurna MR , Fazio L , Bevacqua E , et al . Understanding the relationship between childhood emotional abuse and neglect and psychological distress in pregnant women: the role of prenatal attachment. BMC Psychol 2024;12. doi:10.1186\/s40359-024-02024-w","DOI":"10.1186\/s40359-024-02024-w"},{"key":"2026090306252060000_16.7.e115291.17","doi-asserted-by":"crossref","first-page":"105667","DOI":"10.1016\/j.earlhumdev.2022.105667","article-title":"Childbirth related PTSD and its association with infant outcome: A systematic review","volume":"174","author":"Van Sieleghem","year":"2022","journal-title":"Early Hum Dev"},{"key":"2026090306252060000_16.7.e115291.18","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.wombi.2020.09.021","article-title":"The childbirth experience: A systematic review of predictors and outcomes","volume":"34","author":"McKelvin","year":"2021","journal-title":"Women Birth"},{"key":"2026090306252060000_16.7.e115291.19","doi-asserted-by":"crossref","unstructured":"M\u00e4kel\u00e4 T , Saisto T , Salmela-Aro K , et al . How do different childbirth experience scales predict childbirth-related posttraumatic stress symptoms and disorder? J Psychosom Obstet Gynaecol 2023. doi:10.1080\/0167482X.2023.2210750","DOI":"10.1080\/0167482X.2023.2210750"},{"key":"2026090306252060000_16.7.e115291.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-024-01921-y","article-title":"The relationship between delivery fear and childbirth experience with the level of adherence to the WHO recommendations for a positive childbirth experience in Iranian women: a cross-sectional study","volume":"21","author":"Shabani","year":"2024","journal-title":"Reprod Health"},{"key":"2026090306252060000_16.7.e115291.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2012.10.001"},{"key":"2026090306252060000_16.7.e115291.22","unstructured":"Richtlijn voor goede klinische praktijk bij laag risico bevallingen KCE reports 139a."},{"key":"2026090306252060000_16.7.e115291.23","unstructured":"WHO guide for integration of perinatal mental health in maternal and child health services. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240057142 [Accessed 24 Apr 2024]."},{"key":"2026090306252060000_16.7.e115291.24","doi-asserted-by":"crossref","unstructured":"Van Damme R , Van Parys A-S , Vogels C , et al . Leidraad voor de screening en detectie van perinatale depressieve en angststoornissen tijdens de zwangerschap tot 1 jaar na de bevalling. Tijdschr Geneeskd 2021. doi:10.47671\/TVG.77.21.183","DOI":"10.47671\/TVG.77.21.183"},{"key":"2026090306252060000_16.7.e115291.25","doi-asserted-by":"crossref","first-page":"109865","DOI":"10.1016\/j.jpsychores.2019.109865","article-title":"A mental health care protocol for the screening, detection and treatment of perinatal anxiety and depressive disorders in Flanders","volume":"128","author":"Van Damme","year":"2020","journal-title":"J Psychosom Res"},{"key":"2026090306252060000_16.7.e115291.26","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/S2215-0366(20)30467-3","article-title":"Barriers and facilitators to implementing perinatal mental health care in health and social care settings: a systematic review","volume":"8","author":"Webb","year":"2021","journal-title":"Lancet Psychiatry"},{"key":"2026090306252060000_16.7.e115291.27","doi-asserted-by":"crossref","unstructured":"Galle A , D\u2019hauwers S , Berghman H , et al . Quality of care at childbirth during the COVID-19 pandemic. In: Findings of the imagine euro study in Belgium. 2024.","DOI":"10.1101\/2024.03.25.24304838"},{"key":"2026090306252060000_16.7.e115291.28","unstructured":"STROBE - strengthening the reporting of observational studies in epidemiology. Available: https:\/\/www.strobe-statement.org [Accessed 5 Jun 2024]."},{"key":"2026090306252060000_16.7.e115291.29","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-048195","article-title":"WHO standards-based tool to measure women\u2019s views on the quality of care around the time of childbirth at facility level in the WHO European region: development and validation in Italy","volume":"12","author":"Lazzerini","year":"2022","journal-title":"BMJ Open"},{"key":"2026090306252060000_16.7.e115291.30","unstructured":"Kamer verklaart epidemiologische noodsituatie ten einde, pandemiewet wordt gedeactiveerd | VRT NWS Nieuws. Available: https:\/\/www.vrt.be\/vrtnws\/nl\/2022\/03\/10\/pandemiewet-fup [Accessed 13 Mar 2026]."},{"key":"2026090306252060000_16.7.e115291.31","doi-asserted-by":"crossref","unstructured":"Thaels E , Meermans H , Beeckman K . What influences women\u2019s experiences of childbirth in Flanders? - A quantitative cross-sectional analysis of the Babies Born Better survey. Midwifery 2023;126. doi:10.1016\/j.midw.2023.103810","DOI":"10.1016\/j.midw.2023.103810"},{"key":"2026090306252060000_16.7.e115291.32","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1002\/uog.19085","article-title":"Fundal pressure in second stage of labor (Kristeller maneuver) is associated with increased risk of levator ani muscle avulsion","volume":"53","author":"Youssef","year":"2019","journal-title":"Ultrasound in Obstet & Gyne"},{"key":"2026090306252060000_16.7.e115291.33","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.ejogrb.2022.06.010","article-title":"Fundal pressure to shorten the second stage of labor: Systematic review and meta-analysis","volume":"275","author":"Kanninen","year":"2022","journal-title":"European Journal of Obstetrics & Gynecology and Reproductive Biology"},{"key":"2026090306252060000_16.7.e115291.34","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.ejogrb.2023.06.010","article-title":"Fundal pressure in the second stage of labor is not recommended","volume":"288","author":"Youssef","year":"2023","journal-title":"European Journal of Obstetrics & Gynecology and Reproductive Biology"},{"key":"2026090306252060000_16.7.e115291.35","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1002\/ijgo.13552","article-title":"FIGO good clinical practice paper: management of the second stage of labor","volume":"152","author":"Wright","year":"2021","journal-title":"Intl J Gynecology & Obste"},{"key":"2026090306252060000_16.7.e115291.36","unstructured":"Yvonne K , Mestdagh E , Beentjes M , et al . Richtlijn voor goede klinische praktijk bij laag risico bevallingen. 2024."},{"key":"2026090306252060000_16.7.e115291.37","unstructured":"Duwen op de buik tijdens het persen | VBOV. Available: https:\/\/www.vroedvrouwen.be\/duwen-op-de-buik-tijdens-het-persen [Accessed 21 Aug 2025]."},{"key":"2026090306252060000_16.7.e115291.38","doi-asserted-by":"crossref","first-page":"1542112","DOI":"10.3389\/fpsyt.2025.1542112","article-title":"Editorial: Intergenerational impacts of perinatal mental health","volume":"16","author":"Christoforou","year":"2025","journal-title":"Front Psychiatry"},{"key":"2026090306252060000_16.7.e115291.39","doi-asserted-by":"crossref","unstructured":"Chen X , Liu M , Min F , et al . Effect of biological, psychological, and social factors on maternal depressive symptoms in late pregnancy: a cross-sectional study. Front Psychiatry 2023;14. doi:10.3389\/fpsyt.2023.1181132","DOI":"10.3389\/fpsyt.2023.1181132"},{"key":"2026090306252060000_16.7.e115291.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2014.11.013"},{"key":"2026090306252060000_16.7.e115291.41","doi-asserted-by":"crossref","first-page":"101400","DOI":"10.1016\/j.ajogmf.2024.101400","article-title":"Systematic review on music interventions during pregnancy in favor of the well-being of mothers and eventually their offspring","volume":"6","author":"Maul","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"key":"2026090306252060000_16.7.e115291.42","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.30255","article-title":"Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment: A Prespecified Analysis of the IMPACT BCN Randomized Clinical Trial","volume":"6","author":"Crovetto","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026090306252060000_16.7.e115291.43","unstructured":"Born in Belgium pro. Available: https:\/\/borninbelgiumpro.be [Accessed 21 Aug 2025]."},{"key":"2026090306252060000_16.7.e115291.44","unstructured":"Over ons - Wolk in Mijn Hoofd. Available: https:\/\/wolkinmijnhoofd.be\/over-ons [Accessed 21 Aug 2025]."},{"key":"2026090306252060000_16.7.e115291.45","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20042775","article-title":"Traumatic Childbirth Experience and Childbirth-Related Post-Traumatic Stress Disorder (PTSD): A Contemporary Overview","volume":"20","author":"Kranenburg","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2026090306252060000_16.7.e115291.46","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-06118-y"},{"key":"2026090306252060000_16.7.e115291.47","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12444"},{"key":"2026090306252060000_16.7.e115291.48","article-title":"Fundal pressure during the second stage of labour","volume":"3","author":"Hofmeyr","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2026090306252060000_16.7.e115291.49","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-021-01148-1","article-title":"The prevalence of uterine fundal pressure during the second stage of labour for women giving birth in health facilities: a systematic review and meta-analysis","volume":"18","author":"Farrington","year":"2021","journal-title":"Reprod Health"},{"key":"2026090306252060000_16.7.e115291.50","doi-asserted-by":"crossref","first-page":"100548","DOI":"10.1016\/j.ajogmf.2021.100548","article-title":"Evidence-based labor management: second stage of labor (part 4)","volume":"4","author":"Gimovsky","year":"2022","journal-title":"Am J Obstet Gynecol MFM"},{"key":"2026090306252060000_16.7.e115291.51","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2393-14-103","article-title":"Continuity of care: what matters to women when they are referred from primary to secondary care during labour? a qualitative interview study in the Netherlands","volume":"14","author":"de Jonge","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026090306252060000_16.7.e115291.52","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12884-017-1615-y","article-title":"Continuity of care is an important and distinct aspect of childbirth experience: findings of a survey evaluating experienced continuity of care, experienced quality of care and women\u2019s perception of labor","volume":"18","author":"Perdok","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026090306252060000_16.7.e115291.53","doi-asserted-by":"publisher","DOI":"10.1016\/J.MIDW.2018.08.003"},{"key":"2026090306252060000_16.7.e115291.54","doi-asserted-by":"crossref","first-page":"e118","DOI":"10.1016\/j.wombi.2020.02.009","article-title":"Exploring the medicalisation of childbirth through women\u2019s preferences for and use of pain relief","volume":"34","author":"Westergren","year":"2021","journal-title":"Women Birth"},{"key":"2026090306252060000_16.7.e115291.55","unstructured":"Goemaes R , Fomenko E , Laubach M , et al . Perinatale gezondheid in Vlaanderen \u2013 Jaar 2023. Brussel, 2024."},{"key":"2026090306252060000_16.7.e115291.56","doi-asserted-by":"crossref","first-page":"100930","DOI":"10.1016\/j.lanepe.2024.100930","article-title":"Support not stigma: redefining perinatal mental health care","volume":"40","year":"2024","journal-title":"The Lancet Regional Health - Europe"},{"key":"2026090306252060000_16.7.e115291.57","doi-asserted-by":"crossref","first-page":"1704484","DOI":"10.1080\/17482631.2019.1704484","article-title":"Women\u2019s experiences of fear of childbirth: a metasynthesis of qualitative studies","volume":"15","author":"Wigert","year":"2020","journal-title":"Int J Qual Stud Health Well-being"},{"key":"2026090306252060000_16.7.e115291.58","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-023-05692-5","article-title":"Measuring resilience and stress during pregnancy and its relation to vulnerability and pregnancy outcomes in a nulliparous cohort study","volume":"23","author":"Alves","year":"2023","journal-title":"BMC Pregnancy Childbirth"}],"updated-by":[{"DOI":"10.1136\/bmjopen-2025-115291corr1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000}}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-115291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:25:54Z","timestamp":1788441954000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-115291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":58,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,9]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2025-115291"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-115291","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}