Womenʼs assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study

Marina Ruxandra Otelea, Anca Angela Simionescu (Coresponding Author), Ilaria Mariani, the IMAgiNE EURO Study Group, Elizabete Pumpure (Member of the Working Group), Dace Rezeberga (Member of the Working Group), Gita Jansone-Šantare (Member of the Working Group), Dārta Jakovicka (Member of the Working Group), Anna Regīna Knoka (Member of the Working Group), Katrīna Paula Vilcāne (Member of the Working Group)

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
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Abstract

Objective: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth. Methods: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis. Results: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower. Conclusion: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected. ClinicalTrials.gov identifier: NCT04847336.

Original languageEnglish
Pages (from-to)126-136
Number of pages11
JournalInternational Journal of Gynecology and Obstetrics
Volume159
Issue numberSuppl.1
DOIs
Publication statusPublished - Dec 2022

Keywords*

  • breastfeeding
  • cesarean
  • childbirth
  • COVID-19
  • IMAgiNE EURO
  • mode of birth
  • quality of care
  • Romania

Field of Science*

  • 3.2 Clinical medicine
  • 3.3 Health sciences

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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