Maternity care in the Brussels Capital Region: Towards a paradigm shift?

The shift towards midwifery-led care, and the recognition of midwives as autonomous primary health professionals reflects a global trend towards safe and quality women-centered care1,2. In Belgium, this trend was not apparent within the medicalized maternity care context3. To date, 98% of the births take place in a hospital setting, of which the majority are attended by an obstetrician. Nowadays, midwives have a decisive role, primarily in the ante- and post-natal period. The Common Community Commission, in charge with the policy on healthcare in Brussels, approved a revolutionary law of 25 May 2023, aiming to optimize perinatal care in the Brussels Capital Region4. The aim of the law is to promote both the accessibility and quality of welfare and care trajectories. Additionally, it seeks to redesign the welfare and healthcare landscape to provide integrated services in neighborhoods and to reposition the hospital within the broader care landscape. The law outlines the following specific regulations for maternity care: continuity of perinatal care, and postnatal follow-up at home and alongside midwifery units. Current developments not only signify an innovative approach to healthcare policy in Belgium, but could also serve as a model for improving maternal and infant health outcomes on an international scale5. Here, we emphasize the measures of the Brussels' model related to guaranteeing accessibility of perinatal care and alongside midwifery units.