The Association Between Women's Perception of Birth During the Pandemic, Companion of Choice and Support From Health Professionals: A Cross-Sectional Study in 20 Countries in the WHO European Region.
Stephanie Batram-Zantvoort, Céline Miani, Ilaria Mariani, Emanuelle Pessa Valente, Mehreen Zaigham, Ingvild Hersoug Nedberg, Magdalena Kurbanović, Elizabete Pumpure, Anja Bohinec, Antigone Sarantaki, Barbara Baranowska, Alessia Abderhalden-Zellweger, Elise de La Rochebrochard, Raquel Costa, Marina Ruxandra Otelea, Alina Liepinaitienė, Jelena Radetic, Amira Ćerimagić, Maryse Arendt, Martina König-Bachmann, Stefano Delle Vedove, Karolina Linden, Sigrun Kongslien, Daniela Drandić, Darta Kreslina, Zalka Drglin, Dimitra Metallinou, Urszula Tataj-Puzyna, Michael Gemperle, Virginie Rozée, Heloísa Dias, Marija Mizgaitienė, Jovana Ruzicic, Imola Simon, Simona Fumagalli, Helen Elden, Eline Skirnisdottir Vik, Barbara Mihevc Ponikvar, Aikaterini Lykeridou, Beata Szlendak, Claire de Labrusse, Tiago Miguel Pinto, Simona Jazdauskienė, Christoph Zenzmaier, Ilana Chertok, Emma Sacks, Marzia Lazzerini
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Abstract
Background: Mitigation measures implemented in response to the COVID-19 pandemic led to significant changes in maternity care across Europe, including restrictions on companions during labor and birth. This cross-sectional study explores the association between the presence of a companion of choice and a positive perception of the birth experience. Additionally, it explores the association between health professionals' attention, assistance, and availability during labor and birth and a positive perception of birth.
Methods: We utilized a structured, validated online questionnaire, available in 25 languages, to assess the quality of maternal care during the COVID-19 pandemic from women's perspectives. We conducted logistic regression to explore associations between variables related to the presence of a companion of choice, health professionals' attention, assistance, and availability, and positive perceptions of birth, when controlled for confounders, including birth mode and medical interventions.
Results: Responses from 48,039 women across 20 countries in the WHO European Region were included. Always having a companion of choice during birth (aOR: 2.11) and always receiving adequate care from health professionals (assistance aOR: 2.12, attention aOR: 36.64, availability aOR: 2.12) were associated with positive birth perception. Instrumental births (aOR: 0.76), episiotomies (aOR: 0.74), fundal pressure (aOR: 0.52), and cesarean births (planned aOR: 0.80, unplanned prelabor aOR: 0.60, unplanned in-labor aOR: 0.52) were associated with less positive birth perceptions.
Discussion: This study highlights the critical role of having a chosen companion and receiving adequate attention, assistance, and availability from health professionals in promoting positive birth perceptions, even in times of crisis such as the COVID-19 pandemic. Ensuring the presence of a companion of choice and comprehensive professional support is crucial for delivering high-quality, respectful maternity care.
期刊介绍：
Birth: Issues in Perinatal Care is a multidisciplinary, refereed journal devoted to issues and practices in the care of childbearing women, infants, and families. It is written by and for professionals in maternal and neonatal health, nurses, midwives, physicians, public health workers, doulas, social scientists, childbirth educators, lactation counselors, epidemiologists, and other health caregivers and policymakers in perinatal care.
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