Women's perspectives on the quality of hospital maternal and newborn care around the time of childbirth during the <scp>COVID</scp>‐19 pandemic: Results from the <scp>IMAgiNE EURO</scp> study in Slovenia, Croatia, Serbia, and <scp>Bosnia‐Herzegovina</scp>

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Objective: To investigate the quality of maternal and newborn care (QMNC) during childbirth in Luxembourg from women's perspectives. Methods: Women giving birth in facilities in Luxembourg between March 1, 2020, and July 1, 2021, answered a validated online WHO standards-based questionnaire as part of the multicountry IMAgINE EURO study. Descriptive and multivariate quantile regression analyses were performed.Results: A total of 493 women were included, representing 5.2% of women giving birth in the four maternity hospitals in Luxembourg during the study period. Most quality measures suggested high QMNC, although specific gaps were observed: 13.4% (n = 66) of women reported not being treated with dignity, 9.1% (n = 45) experienced abuse, 42.9% (n = 30) were not asked for consent prior to instrumental vaginal birth, 39.3%(n = 118) could not choose their birth position, 27% (n = 133) did not exclusively breastfeed at discharge (without significant differences over time), 20.5% (n = 101) reported an insufficient number of healthcare professionals, 20% (n = 25) did not receive information on the newborn after cesarean, and 41.2% (n = 203) reported lack of information on newborn danger signs before discharge. Multivariate analyses highlighted higher reported QMNC indexes among women born outside Luxembourg and delivering with a gynecologist, and significantly lower QMNC indexes in women with the highest education levels and those delivering in the hospital offering some private services.Conclusions: Despite maternal reports suggesting an overall high QMNC in Luxembourg, improvements are needed in specific aspects of care and communication, mostly related to maternal autonomy, respect, and support, but also number and competencies of the health workforce.

Section: Discussionsupporting

confidence: 80%

Quality of maternal and newborn care around the time of childbirth in Luxembourg during the COVID‐19 pandemic: Results of the IMAgiNE EURO study

Arendt¹,

Tasch

Conway

et al. 2022

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“…However, it is alarming that in a very high percentage of cases (57.7%–77.8%), women did not receive information about maternal or newborn danger signs, with a higher frequency in the prelabor cesarean group and no significant changes between 2020 and 2021. Notably, quality measures were substandard in many other countries surveyed for the IMAgiNE EURO study 23,28,29,42‐45 …”

Section: Discussionmentioning

confidence: 99%

“…Notably, quality measures were substandard in many other countries surveyed for the IMAgiNE EURO study. 23,28,29,[42][43][44][45] Overall results from this survey in Latvia show that there is room The main strengths of this study are the relatively high number of respondents, approximately 4%-7% out of all births in each year and the validated tools used for data collection, allowing comprehensive assessment of the QMNC. 25 Limitations of the IMAgiNE EURO survey have been acknowledged elsewhere.…”

Section: Discussionmentioning

confidence: 99%

Womenʼs perspectives on the quality of maternal and newborn care in childbirth during the COVID‐19 pandemic in Latvia: Results from the IMAgiNE EURO study on 40 WHO standards‐based quality measures

Pumpure

Jakovicka

Mariani

et al. 2022

Self Cite

Objective To investigate women's perspectives on the quality of maternal and newborn care (QMNC) around the time of childbirth during the COVID‐19 pandemic in Latvia, comparing the years 2020 and 2021, among women who went into labor or had a prelabor cesarean. Methods Women giving birth in healthcare facilities in Latvia from March 1, 2020, to October 28, 2021, answered an online questionnaire including 40 WHO standards‐based quality measures. Descriptive and multivariate quantile regression analyses were performed to compare QMNC in 2020 and 2021. Results 2079 women were included in the analysis: 1860 women who went into labor (group 1) and 219 with prelabor cesarean (group 2). Among group 1, 66.4% (n = 99/149) of women received fundal pressure in an instrumental vaginal birth, 43.5% (n = 810) lacked involvement in choices, 17.4% (n = 317) reported suffering abuse, 32.7% (n = 609) reported inadequate breastfeeding support while 5.2% (n = 96) lack of early breastfeeding. A significant reduction in QMNC due to the COVID‐19 pandemic was reported by 29.5% (n = 219) and 25.0% (n = 270) of respondents in 2020 and 2021, respectively (P = 0.045). Multivariate analyses highlighted a significantly lower QMNC index for 2020 compared with 2021 (P < 0.001). Conclusion This first study investigating QMNC in Latvia showed significant gaps in QMNC perceived by respondents, with slightly better results in 2021. Appropriate healthcare strategies to improve health care for women and newborns in Latvia are required. http://clinicaltrials.gov Identifier:NCT04847336.

“…The IMAgiNE EURO surveys show high levels of medicalization throughout Europe, especially cesarean, instrumental births, and application of fundal pressure 1–10 . This is also coupled with lack of informed consent, lack of support for initiation and continuation of breastfeeding, and lack of respect and dignity for birthing women.…”

Section: White Ribbon Alliance (Wra)mentioning

confidence: 99%

“…However, no country, no health system, nor the World Health Organization, to say nothing of our hospitals, was prepared for what 2020–2022 brought us. The articles in this Supplement 1–10 . chronicle the risk of pregnancy during COVID‐19, particularly the vulnerability of women giving birth during a pandemic.…”

Section: Figomentioning

confidence: 99%

Perspectives of professionals and human rights associations on the IMAgiNE EURO study

Conry

Kumar-Hazard²,

Rubashkin³

et al. 2022

The year 2020 will be remembered around the globe as the time when our lives, our health systems, and our worlds turned on end.Warnings about the risks of pandemics, especially the lack of preparedness for a pandemic, had circulated since the emergence of MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). However, no country, no health system, nor the World Health Organization, to say nothing of our hospitals, was prepared for what 2020-2022 brought us. The articles in this Supplement. [1][2][3][4][5][6][7][8][9][10] chronicle the risk of pregnancy during COVID-19, particularly the vulnerability of women giving birth during a pandemic.Globally, we now understand the serious vulnerability and risk of complications women face when they develop COVID-19 during pregnancy, from the risk of stillbirth and placentitis, to the risks of respiratory distress, need for intensive care, and for extracorporeal membrane oxygenation in pregnancy. [11][12][13] We also now appreciate, two years after the pandemic, the importance of vaccination and disinformation. However, the articles in this Supplement take us back to the beginning-when the care for a mother and family came secondary to the fear of COVID-19-and provide a maternal perspective on the quality of care delivered.The articles originate from a multicountry survey on maternal and newborn health service preparedness, quality, and resilience during the pandemic, and they help us to understand the choices made.Choices that sacrificed communication, shared decision-making, and respect. The COVID-19 pandemic has had a profound impact on the health and well-being of populations. Pregnancy places women at