If you’re an expat thinking of giving birth in Belgium, our guide has everything you need to know about prenatal care, delivery, aftercare, birth registration, child benefits, and maternity and paternity leave.
With public and private healthcare systems that are both highly regarded, moms-to-be have plenty of choice if they’re thinking of having a baby in Belgium. What’s important, however, is to make sure you have the healthcare cover you need well in advance before having your baby. Partena, a Belgian company offering health and social security coverage and advice to expats, expands on what to expect when having a baby in Belgium.
The majority of births take place in maternity hospitals, overseen by a midwife, nurses, gynecologist and a physiotherapist (to assist with pain relief). Specialist clinics (maison de la naissance) and private hospitals are also delivery options in Belgium, as are home births — although the latter remain fairly uncommon across the country.
Given its status as host to EU headquarters, there’s a large expat community in Belgium. Naturally, the general standard of healthcare is excellent and there is a range of support services available that are designed to make the pre- and post-natal process as safe and comfortable as possible. Expatica’s guide to healthcare in Belgium explains how to navigate the system for newcomers to this multicultural nation.
Expatica’s inclusive guide to childbirth in Belgium covers a range of topics:
- An overview of pregnancy and childbirth in Belgium
- Finding a gynecologist
- Insurance for maternity costs
- Pregnancy testing in Belgium
- Pre-natal care in Belgium
- Getting an abortion
- Giving birth: what to expect
- Post-natal care in Belgium
- Naming and registering a baby
- Giving birth as a tourist or non-resident – and citizenship in Belgium
- Maternity and paternity leave in Belgium
- Child benefits
- Useful links
Partena Business & Expats health insurance
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Expat-heavy Belgium is clearly a great place to have a baby. In 2016, nearly a quarter of all births were to foreign mothers, Statista reports, putting the total at 29,000. Approximately 92,000 children were born to a Belgian mother. Naturally, citizenship isn’t easy for those foreign babies – one of their parents must have been born in the country and lived there for at least five years in the decade preceding their birth.
Nevertheless, Belgium has a lot going for it. Its child benefits packages are perceived to be among the most generous in Europe, with a birth grant of over €1,200 for the first child and more than €930 for subsequent children (the amounts differ in Flanders and Wallonia and Brussels). In general, women will find that all their pregnancy costs are covered, thanks to a combination of insurance and social welfare.
Women can choose to give birth in a hospital, at home, or at a birth house, which brings together the comforts of home with a more professional environment. Throughout your pregnancy, your gynaecologist remains your main point of contact, though in Flanders, your doctor also plays an important role.
When it comes to parental leave, however, Belgium lags the Nordics. New dads in Belgium only get 10 days’ paternity leave, for instance, while Norway entitles them to 15 weeks, while moms have 46 weeks at full pay in Norway but only 15 weeks in Belgium.
Other interesting statistics? Women who give birth in Belgium are 30.5 years old on an average, and as of 2015, more babies have been born to unmarried couples than to those who are married.
Your GP can refer you to a gynecologist. Someone who hasn’t nailed down a doctor will need to first be registered with Belgian social security and a state health insurance scheme in order to be reimbursed for doctors’ visits and medical treatments. Expatica’s guide to insuranc has more details on how to go about this.
Alternatively, you’re free to choose your own gynecologist, and there are plenty of organizations for those looking for help on this front. Reach out to the French-speaking ONE (Office de la Naissance et de l’Enfance), Dutch-speaking K&G (Kind en Gezin), Kaleido in Ostbelgien, or the Brussels Childbirth Trust (BCT). These organizations are able to provide you with a gynecologist free of charge, similar to other essential pregnancy services, such as the birth itself and subsequent hospital stay. These services will all be covered by mandatory health insurance paid by anyone working in Belgium.
Anyone who’s employed in Belgium needs to pay for mandatory health insurance; this covers all birth-related consultations and services. Dependent spouses also automatically receive cover if they don’t have their own. In Belgium, even women who aren’t covered by insurance will find that their pregnancy costs are covered, courtesy of the Public Social Welfare Centre (Les Centres Publics d’Action Sociale, CPAS, in French, or Openbaar Centrum voor Maatschappelijk Welzijn, OCMW, in Dutch ).
For non-EU residents, the country also has agreements with more than 20 countries outside Europe, including Canada, Australia, USA and Japan, which enables the same healthcare access as Belgian citizens. Visit Coming2belgium.be for information in several languages.
Both public and private health insurers in Belgium provide maternity coverage. Check with your insurer to find out exactly what is and isn’t included in your plan. International insurance companies providing maternity coverage to expats in Belgium include:
There are two ways to determine if you’re pregnant. A urine test, available over the counter at pharmacies, chemists and supermarkets for between €10 and €20, yields a result within five minutes. It’s best to perform these after your period has been late for several days. If the test is positive, head to a doctor for a blood test – or head there directly if you want. He or shell will draw a blood sample and send it to a lab, and you’ll get the results the next day. You’ll need to pay a portion of the lab costs, but the exact percentage depends on your insurance policy and sometimes, your personal situation.
An appointment with a doctor or midwife at your medical centre is the first port of call for those looking to confirm their pregnancy. The degree of contact you have with your doctor throughout the pregnancy period will vary according to which region of the country you reside in. Doctors in the Flemish region tend to play a key role throughout the pregnancy, as do gynaecologists. In the French-speaking areas of Belgium, however, women generally only see their gynaecologist.
In the French-speaking regions, expectant mothers will have regular check-ups with a Medical Social Worker (travailleur medico-social or TMS) who will be employed by the ONE organization. Once pregnancy is confirmed you will receive a maternity booklet, known as the Carnet de la Mere in French. You must bring this booklet with you to all future consultations with your GP or TMS.
In the Flemish region, meanwhile, mothers receive regular home visits from a nurse and have the opportunity to attend prenatal courses, some of which are available in English.
In Ostbelgien, the German-speaking part of the country, Kaleido is your point of contact for pregnancy services, although administrative matters are handled by the region’s department for family affairs.
Antenatal and Baby Brussels organises antenatal classes in English as well as mother and baby groups.
Scans, tests and checks
During your first visit to the gynecologist or midwife, you may be offered an initial ultrasound to confirm the pregnancy and the number of embryos, to rule out ectopic complications (where the embryo is growing outside the uterus) and to determine a due date. Regular monthly check-ups will follow until the seventh month. After week 28, you’ll consult fortnightly, moving to weekly visits from week 36. Typically at these examinations, the medical professional will check your blood pressure, your weight, your baby’s heartbeat (with a doppler or ultrasound), and your fundal height, which measures the size of your uterus. Over the course of your pregnancy, your care provider will ask you to run some blood tests. Among the areas tested are your blood group and rhesus factor, iron levels, toxoplasmosis and the cytomegalovirus. Tests may be requested more frequently depending on whether there’s a cause for concern.
Your provider will also offer a screening for chromosomal abnormalities, including Down’s Syndrome and tests for gestational diabetes, Group B streptococcus and more.
Insurance (mutuelles in French and ziekenfonds in Dutch) typically covers three ultrasounds over the course of the pregnancy, a combined test for chromosomal abnormalities between 11 and 14 weeks, and streptococcus. Coverage varies, however, so it’s worth checking with your insurer, or buying private insurance to be prepared for any eventualities.
The non-invasive Harmony prenatal test (NIPT) that offers close to 100% accuracy for Down’s (trisomy 21) and an indicative risk assessment for Edward’s (trisomy 18) and Patau’s (trisomy 13) are not reimbursed and cost between €450-600.
It’s worth remembering that under the Belgian Law of 22 August 2002, patients have the right to give their free and informed consent before beginning any intervention or procedure. The reason and urgency for any procedure must always be explained to you, as well as any risks and side-effects. You’ll be within your rights to ask about these.
More information on tests and checks when you’re pregnant is available from the Belgian Healthcare Knowledge Center (PDF).
In 1990, Belgium legalized abortion within 12 weeks of conception, instituting a mandatory six-day period of counselling and reflection to allow women time to change their minds. In line with other European countries, however, Brussels struck abortion from the nation’s penal code in 2018. In practice, however, the procedure must still be carried out within 12 weeks. Doctors are allowed to refuse the procedure on grounds of conscience but must provide patients with the name of a colleague who will operate.
Abortion after 12 weeks is allowed if the woman’s life is in danger or the fetus shows signs of a severe and incurable illness or disability.
By law, nobody’s allowed to try and prevent a woman from having an abortion, the 2018 law criminalized attempts to prevent access to abortion, whatever the methods used.
Women can ask their doctors to recommend an abortion clinic or hospital, or head to one directly, armed with proof of identity, social security card, and if available, a blood group card and ultrasound test. To contact an abortion clinic, visit the Fédération Laïque de Centres de Planning Familial in Brussels and Wallonia, LUNA in Flanders and Kaleido in East Belgium.
The abortion pills Mifepristone (also known as RU 486, Mifegyn, Mifeprex) and Misoprostol (also known as Cytotec, Arthrotec, Oxaprost, Cyprostol, Mibetec, Prostokos or Misotrol), are also available for early-stage pregnancies and can be administered up until to 49 days of amenorrhea, or seven weeks after the first day of the last period. The pills are available from gynecologists or family planning centers.
Since 2001, abortions are reimbursed by state insurance if the clinic has an agreement with the national institute for social security (INAMI/RIZIV), in which case women only need to pay €3.08. Abortions carried out in hospitals or one-day clinics are not fully reimbursed and could incur charges of between €32 to €250, depending on the facility and type of room.
Just under 20,000 abortions are carried out each year in Belgium, according to the World Health Organization.
In contrast to countries such as the Netherlands, where women are often released from hospital within 24 hours of giving birth, the Belgian system usually involves remaining in hospital for at least five days. In addition to doctors and midwives, the delivery process will also involve a physiotherapist. The latter will be on hand to ensure the mother is able to recuperate physically in the period after the birth. Your gynaecologist of choice will also be in attendance.
If you opt for a home birth it will only be granted if you are deemed to be in good health, and the process will generally be overseen by two midwives. The midwives will remain at your home for several hours after the birth to ensure there are no unexpected developments. One midwife will then drop by for a visit every day for up to two weeks after the birth in order to assist and offer advice, and a visit to the GP is also required within the first week after delivery. Midwives for the Flemish region and Brussels can be found at Sage-femme.be and for the Dutch region at Vroedvrouwen.be.
Alternative birth locations include so-called ‘birth houses’ (maison de la naissance) which are designed to provide more home comforts, with a midwife overseeing the birth. The houses offer a range of post-natal care services and classes, while some also allow the father to stay overnight during the birth. Some insurers cover the costs of birth houses.
As of 2019, one in five births in Belgium are by cesarean section, a relatively high number compared wiith other countries. Around 20% of gynecologists agree to requests for a Cesarean birth without medical grounds, prompting the KCE to advise the procedure only when necessary. Insurers may not cover the costs of planned C-sections, so it’s wise to consult your relevant provider prior to making a final decision about where and what kind of birth you choose.
Doulas as birth companions and post-birth supporters give help, advice and other support during pregnancy, during birth and after the birth. While they have received general nurse training, their role lies more within the practitioner and emotional aspects of pregnancy. Visit the following sites to find a doula in your region (although listed by language, many of these doulas speak English):
Need to know: Labor, when to go to the hospital and birth
Before labor, moms-to-be may want to come up with an ideal birthing plan. Although these are a great help to get your team of supporters, midwives and gynecologist on the same page of your needs while in labor, be aware that they’re still not very common in Belgium. However, if you do have one, consider getting it translated into Dutch, French or German as applicable.
When it comes to labor, modern advice recommends staying at home once you go into labor until the time your contractions are regular and strong, and are coming every four or five minutes or so. At this point, you should call your doula or the delivery ward at your hospital. The nurse will take you through a series of questions and recommend a course of action.
Head to hospital immediately if you’re bleeding, your waters have broken and the fluid is green, brown or yellow, if you’re in unbearable pain or are vomiting or the baby isn’t moving. Call 112 and ask for an ambulance. Phone ahead before arrival to ensure the hospital is ready and that your birth plan – such as a tub for a water birth – will be carried out.
When you arrive at the hospital, you will need an identity card, healthcare card, blood group card, the name of your pediatrician, and any extra insurance documents. Bring your own towels, pajamas and comfortable clothing, slippers, disposable undergarments and breast pads, toiletries and tools for relaxation.
At the hospital, standard procedures and monitoring are handled by midwives, and their initial questions about you contractions and water break will help them determine in how far into labor you are. A vaginal examination might be requested to see how dilated your cervix is and see your baby’s position They will check your vitals, lightly push and use a Doppler monitor to determine your baby’s heart rate.
You will also be asked about group B strep tests and may be offered to be fitted with an IV for possible administration of antibiotics or an epidural later on. Belgian maternity staff still routinely suggest shaving, so be prepared to be asked about it. If your labor is being induced, you’ll probably be fitted with syntocinon drip to help contractions quickly after arrival.
By now you may already be in your own labor room – in Belgium, these are not shared, but depending on how busy the hospital is, you may have to move to another room when birth is imminent.
In a low-risk pregnancy, your baby’s heartbeat will be monitored intermittently with a CTG machine, in line with Belgian KCE guidelines (PDF). The KCE protocol also okays drinking clear liquids (possibly with sugar) as long as there is no medical counter-indication. Some hospitals try to restrict food and drink, while others leave the decision to you.
In the event that your perineum, the area between your vagina and anus, isn’t stretching enough, medical staff may want to make an episiotomy, a cut from the lower side of the vaginal opening. Episiotomy rates for first-time mothers giving birth in hospitals were more than half in 2010 (and 35% for all mothers), but no new data is available to see how much progress has been made. The WHO deems a total national rate of 10% rate as acceptable. Ask your care provider about this in advance so you’re prepared on the day. Massages, upright delivery positions and other pain relief techniques can help.
Immediately after birth, the baby’s health will be evaluated agaist the Apgar scale, and any resulting recommendations will be made at this timeif needed.
In line with common practice in many other countries, babies in Belgium are required to attend fairly regular check-ups with GPs during the first couple of years of their lives, primarily through ONE, Kaleido or the K&G. The TMS (social worker) remains the new mother’s main point of contact for help on dietary advice and general development, visiting the family at home or meeting with mom and baby at an access point in a hospital or clinic.
The new baby will be issued with a record book that needs to be taken along to any consultation. It is used to track the child’s development through measures such as weight and height and sight and hearing. It also lists any required vaccinations with a slip for each. These slips need to be handed over to the medical practitioner administering the vaccination.
Parents can also choose from a range of nursery services – including au pair services –aimed at newborns up until the age of three. Nurseries can be found in many local community halls or run by the Public Social Welfare Centers and you may be eligible for a government subsidy to cover some of the costs, depending on your personal situation. You can read more information in our guide to childcare in Belgium.
Vaccinations in Belgium
Vaccinations are provided free of charge at the following stages of the new-born’s life: 2 months, 3 months, 4 months, 12 months and 15 months.
The polio vaccine is the only mandatory shot in Belgium and is given before the child is 18 months old – however, nurseries may require that several other shots are administered before allowing children into their premises.
Breastfeeding in Belgium
Although women are legally allowed to breastfeed in Belgium, the country has some of the lowest breastfeeding rates in Europe, with mothers returning to work within about three months.
The rules are different for public sector workers, with restrictions regarding type and hours of work. Public sector workers also benefit from lactation leave in certain conditions, read more about it at Debakermat.be.
Private-sector workers may interrupt their work for half an hour twice a day to feed or pump milk on days they work more than 7.5 hours a day. In both cases, you may need to tell your employer and may be asked for a doctor’s certificate.
Traditionally conservative attitudes are also changing and moms can breastfeed in public, although you may be stared at in crowded cafes or restaurants. Look for venues that advertise that they display a breastfeeding-friendly sticker.
Belgian law states that the birth of a child must be registered at a town hall within 15 days of the birth. The registry must take place at the town hall (maison communale) which is located closest to the place of birth, as opposed to where the parents live. You can find the details of your local town hall in Belgium on the official government website. To complete the registration, parents must bring a medical certificate provided by the hospital, a marriage certificate (if applicable) and ID cards for both parents.
Upon completion of the registration you will be issued with documents which can be used to apply for child benefits. Expats are advised to also register the birth with their relevant consulate as soon as possible in order to ensure the child receives citizenship to their relevant country.
It is important to note that babies born in Belgium will only be eligible for Belgian citizenship if the parents have spent a minimum of five consecutive years living in the country in the 10 year period prior to the birth.
Up until recently, all newborns in Belgium were required by law to take the surname of their father. In early 2014, however, a government bill was passed which enables parents to choose whether the baby takes the surname of the father or the mother – or both.
Non-residents visiting Belgium are required to have medical insurance covering any health eventuality. If you’re pregnant and think there’s a chance you may need to deliver while on holiday, check with your insurer to see if you’re covered. Most travel insurance policies do not cover expenses beyond the first trimester, except in cases of an emergency.
Delivery costs in Belgium are estimated to range between €2,500-4,000.
European citizens who are having a baby in France while on holiday can benefit from the reciprocal privileges provided by the European Health Insurance Card (EHIC). Belgium has reciprocal social security arrangements with 25 non-EU countries, including Australia, Canada and the US. Under these arrangements, you can claim and be awarded many of the same benefits as Belgian citizens, provided you carry out the necessary paperwork (i.e. registering with your town hall or getting your residence visa, if applicable).
Should you find you need to give birth earlier than planned in an emergency, ring Belgium’s emergency helpline at 112. You’ll be directed to one of the hospitals on this page, and the procedures are as outlined above.
Will my child get Belgian citizenship?
A child is automatically given Belgian citizenship only if at least one parent is Belgian. Alternatively, if one parent was born in Belgium and has lived in the country for at least five years in the decade preceding their birth. Read our guide to getting Belgian citizenship.
If you are working, you need to tell your employer no later than eight weeks before the due date. Mothers can take up to 15 weeks maternity leave (or 19 weeks in the case of multiple births), receiving benefits equivalent to 82% of full salary for the first 30 days and 75% for the remainder (subject to a maximum amount currently set at €104.80 per day). You’re allowed six weeks of prenatal leave, five of which are optional and can be taken after your baby’s birth, although one the week preceding delivery is a mandatory period of time off. The nine weeks of postnatal leave begin on the day of birth, or on the first working day after the birth.
Self-employed mothers can take 12 weeks of maternity leave in Belgium (13 weeks with multiple births), paid at a flat rate of €475.41 per week for leave at full-time and €237.71 for those working part-time. Unemployed mothers are entitled to their basic benefits plus an additional allowance of 19.5% of gross capped salary at €111.09 for the first 30 days, with the top-up dropping to 15% of gross capped salary at € 104.80 starting from the 31st day.
Maternity benefits are paid by the insurer. Applications should be sent to your insurance fund supported by a medical certificate stating the presumed date of the delivery as well as the start date of the maternity leave.
Mothers can also opt to take eight months part-time leave, meaning they take on part-time hours at their place of work for the eight month period.
Fathers can take 10 days paternity leave, seven of which are paid at 82% of the salary within the first four months of the birth. The first three days are paid by the employer, with the rest being reimbursed by the insurer, subject to a maximum of €114.59 per day.
Parents in Belgium are entitled to a birth allowance (startbedraag/allocation de naissance), which can be claimed after 24 weeks of pregnancy and up to five years after the birth of the child. Normally the allowance is paid to the biological mother but it can be paid to the father, or a step-parent or oldest person in the household if neither biological parent is able to do so.
Applications need to be made through the National Office for Family Benefits for Salaried Persons, although those in employment usually apply via their employer. The medical experts providing the pre-natal care will provide the relevant documentation and the actual pay-out will be made directly to the mother. You can expect to receive the money at some point after the eighth month of pregnancy, with the amount depending on how many children you already have.
The self-employed must approach the fund for independent workers, NISSE (confusingly referred to as INASTI in French, SZZO in Dutch and SSSU in German.) If you don’t fit either of these categories, ask your social worker (TMS) how you can apply for a guaranteed family benefit via the social assistance scheme.
For a detailed breakdown of Belgian child benefit rates visit: www.kids.partena.be.
- Belgium.be: Official information and services website
- Brussels Childbirth Trust
- Office de la Naissance et de l’Enfance (ONE)
- Kind & Gezin (K&G)
- Belgian Healthcare Knowledge Centre
- Abortions: in Wallonia and Brussels, and in Flanders
- Midwives: Brussels and the French-speaking region and the Dutch region
- Social Security Office
- Office for Family Benefits for Salaried Persons
- Community Help Service
- Adoption for same-sex couples (in Dutch)
- Information about Belgian citizenship