Comparative Analysis of Childbirth Associated Factors in Quality of Maternal Care in Healthcare Facilities in Italy, Latvia, Lithuania and Poland

Objectives
Evaluating maternal care quality and adhering to WHO standards, such as optimal Cesarean rates, appropriate episiotomy use, pain relief, and avoiding outdated practices like Kristeller maneuver, prevents complications and improves maternal outcomes. This study compares delivery practices, informed consent, and pain management across Latvia, Lithuania, Poland, and Italy to enhance maternity care.

Materials and Methods
Women aged 18+ who gave birth in healthcare facilities in Italy, Latvia, Lithuania, and Poland between January 2022 and December 2023 participated via validated questionnaire, assessing maternal and newborn care as part of the IMAgiNE EURO study. Comparative analysis was conducted.

Results
A total of 21,221 responses were analyzed (18,190-Italy, 889- Latvia, 850-Lithuania, and 1,292- Poland). Vaginal delivery rates ranged from 57.7% to 79.3% depending on the country. Freedom of position was reported by 63.1% in Italy and 24.2% in Lithuania. Episiotomy rates varied, with 16.6% in Latvia and 48.0% in Lithuania. Kristeller maneuver use in vaginal deliveries ranged from 14.0% to 25.6%. Informed consent for instrumental delivery was reported by 30.0% in Lithuania and 48.7% in Poland. Cesarean section (CS) rates varied. Pain relief during emergency CS was provided in 78.7% in Italy and 94.7% in Lithuania, while for planned CS, it was 81.2% in Italy and 95.2% in Lithuania. Mothers were informed about their newborns after surgery in 36.8% in Lithuania and 74.9% in Poland.

Conclusions
Discrepancies in childbirth and delivery practices in neighboring countries and Italy highlight the need for improvements in patient-centered maternity care, emphasizing the importance of informed consent, access to pain relief, and promoting childbirth without unnecessary interventions.