467 Access to antenatal care in europe

Abstract

Introduction: Differences in the way healthcare is delivered across countries or populations may have important impacts on health outcomes, and can result in inequalities. The European Board & College of Obstetrics and Gynaecology (EBCOG), the European Association of Perinatal Medicine (EAPM), and the European Network of Trainees in Obstetrics and Gynaecology (ENTOG) formed a study group to investigate and review existing differences in the provision of antenatal care throughout Europe. Materials and methods: A questionnaire of 37 questions was developed by the study group and shared via email with the representatives of EAPM and EBCOG national scientific societies. Results: A total of 53 responses were received from 26 countries. The majority of countries [18/26] routine antenatal care is primarily delivered by medical staff, involving obstetric specialists or family doctors. Delivery of care in government-run facilities constitutes the largest proportion of antenatal care in most countries, usually combining peripheral and hospital outpatient clinics. Twenty countries had provision whereby the women could self-refer themselves for antenatal care in the government-run facilities. Almost all countries reported that women from minority groups can access public sector antenatal care services easily. Less than 10% women did not attend antenatal care throughout pregnancy. The larger majority of those booking for antenatal care [>60%] do so in the first trimester. The majority of countries provide antenatal care opportunities with 6-10 reported routine visits for low-risk nulliparous and multiparous cases. Life-style advice is generally given to the mother at her first antenatal visit. Conclusion: While antenatal care is relatively standardized throughout Europe, important differences still exist in the healthcare providers involved, access to care, and in the frequency of routine antenatal visits. Despite variations, antenatal care is primarily provided by medical practitioners across many European nations. Factors leading nonattendance require further exploration.