Urgent Medical Aid and Associated Obstetric Mortality in Belgium

Most Belgian citizens are covered by comprehensive medical insurance (AMI). Due to recent and significant undocumented immigration, an increasing number of patients have no health coverage. They may, however, qualify for “Urgent Medical Aid” (AMU). Still, some patients have no health insurance of any kind (no coverage). This study, conducted in a hospital which cares for a large number of undocumented immigrants, looked at the proportion of women benefiting from either “AMI” or “AMU” and those who have “No coverage” and addressed obstetrical outcomes in each of the three groups. Design: retrospective observational study. We collected data of all singleton pregnancies and deliveries from the CHU St Pierre maternity ward, between 1.10.2015 and 31.3.2016. Women were classified, prospectively, by our social workers, as having access to AMI, AMU or having “No coverage”. Demographic, obstetrical and perinatal data were systematically collected and validated on a day-to-day basis and comparisons were then made between the three groups of women. During the follow up period, 1.439 women had access to regular social security (AMI) (87%), 142 women (10%) to AMU and 38 (3%) had no coverage. Women who benefited from AMU were younger and their first prenatal consultation occurred later in the pregnancy than it did for women with AMI. There were no significant differences in obstetrical outcomes between the three groups of women. Urgent medical aid (AMU) confers a certain normalisation of obstetrical care to pregnant women who would otherwise have no access to health care coverage.