Towards integrated antenatal care for low-risk pregnancy
Authors: Benahmed Nadia , Lefevre Mélanie , Christiaens Wendy , Devos Carl , Stordeur Sabine 
Published: January 2025

1 INTRODUCTION 12 -- 1.1 ANTENATAL CARE: OBJECTIVES AND COMPONENTS 12 -- 1.2 SCOPE OF THE REPORT 13 -- 2 METHODS 14 -- 2.1 A MULTIMODAL APPROACH 14 -- 2.2 FORMULATION OF RECOMMENDATIONS 14 -- 3 ANTENATAL CARE IN BELGIUM 15 -- 3.1 CLINICAL FOLLOW-UP OF THE PREGNANCY: SETTINGS, ACTORS AND USE OF SERVICES 15 -- 3.1.1 Antenatal care settings engaged in the clinical follow-up of the pregnancy 15 -- 3.1.2 Antenatal care providers engaged in the clinical follow-up of the pregnancy 16 -- 3.1.3 Adherence to the KCE guideline6 21 -- 3.2 BIRTH PREPARATION AND PARENTHOOD EDUCATION (BPPE) 25 -- 3.2.1 Birth preparation sessions financed by the NIHDI 25 -- 3.2.2 Antenatal interventions financed by the Communities 27 -- 3.2.3 Additional actors engaged in non-clinical interventions 28 -- 3.2.4 How to improve BPPE: Literature review and stakeholders consultation 28 -- 3.3 ICT INNOVATIONS FOR INFORMATION EXCHANGE 31 -- 4 LEGAL FRAMEWORK OF ANC AND PROTECTIVE MEASURES FOR PREGNANT WOMEN IN BELGIUM 33 -- 4.1 LEGAL FRAMEWORK OF ANC IN BELGIUM 33 -- 4.2 PROTECTIVE MEASURES FOR (VULNERABLE) PREGNANT WOMEN 34 -- 5 PROVISION AND UPTAKE OF ROUTINE ANC: PARENTS AND HEALTHCARE PROFESSIONALS PERSPECTIVES 36 -- 5.1 PARENTS PERSPECTIVE 36 -- 5.1.1 Design, sampling and recruitment 36 -- 5.1.2 Data analysis 37 -- 5.1.3 Results 37 -- 5.1.4 Parents expectations, choices and involvement in ANC 41 -- 5.2 HEALTHCARE PROFESSIONALS PERSPECTIVE 42 -- 5.2.1 Methods 42 -- 5.2.2 Results 43 -- 5.2.3 Professionals opinions regarding clinical follow-up, birth and postpartum preparation 44 -- 5.2.4 Professionals opinions regarding preconception care 45 -- 5.2.5 Professionals opinions about quality of ANC 46 -- 5.2.6 Professionals opinions about collaboration, communication and interprofessional tensions 47 -- 5.2.7 Challenges and issues expressed by healthcare professionals 49 -- 5.3 QUALITATIVE EVIDENCE: KEY MESSAGES 51 -- 6 ANTENATAL CARE: MODELS AND PATHWAYS ADOPTED ABROAD 54 -- 6.1 MIDWIFE-LED CONTINUITY MODELS COMPARED TO DOCTOR-LED MODELS OF ANTENATAL CARE 54 -- 6.1.1 Midwife-led continuity models of care (MLCC) 54 -- 6.1.2 Doctor-led and shared models of care 54 -- 6.1.3 Comparison between models of care 55 -- 6.2 GROUP ANTENATAL CARE MODEL COMPARED TO INDIVIDUAL ANTENATAL CARE (ONE-TO-ONE) 56 -- 6.2.1 Traditional individual antenatal care 56 -- 6.2.2 Group antenatal care 56 -- 6.2.3 Comparison between models of care 57 -- 6.3 LESSONS FROM ABROAD: ANTENATAL CARE ORGANISATION, PATHWAYS AND FINANCING 58 -- 6.3.1 Common challenges 58 -- 6.3.2 An Integrated Birth Care 58 -- 6.3.3 Care pathways to answer specific risks 60 -- 6.3.4 Particular attention for vulnerable women (dedicated pathways) 60 -- 6.3.5 Preparation for birth and parenthood 61 -- 6.3.6 Antenatal consultations: schedule of appointments and content 61 -- 6.3.7 Free choice of birth place (discussed during ANC) 62 -- 6.3.8 Antenatal care financing 62 -- 7 CONCRETE PROPOSALS FOR INTEGRATED ANTENATAL CARE 64 -- 7.1 INTRODUCTION 64 -- 7.2 SHORTCOMINGS IN THE ORGANISATION OF ANTENATAL CARE 64 -- 7.3 CONCRETE PROPOSALS FOR INTEGRATED ANC 65 -- 7.3.1 Main achievement of ANC 66 -- 7.3.2 Universal ANC 68 -- 7.3.3 Integrated ANC 78 -- 7.3.4 High quality antenatal care 81 -- 7.3.5 Recommendations 82