Regional differences in the quality of maternal and neonatal care during the COVID‐19 pandemic in Portugal: Results from the IMAgiNE EURO study. Issue 1 (18th December 2022)

• Record Type: Journal Article
• Authors: Costa, Raquel; Barata, Catarina; Dias, Heloísa; Rodrigues, Carina; Santos, Teresa; Mariani, Ilaria; Covi, Benedetta; Valente, Emanuelle Pessa; Lazzerini, Marzia
• Other Names: Ćerimagić Amira investigator.; Drandić Daniela investigator.; Kurbanović Magdalena investigator.; Virginie Rozée investigator.; de La Rochebrochard Elise investigator.; Löfgren Kristina investigator.; Miani Céline investigator.; Batram‐Zantvoort Stephanie investigator.; Wandschneider Lisa investigator.; Lazzerini Marzia investigator.; Valente Emanuelle Pessa investigator.; Covi Benedetta investigator.; Mariani Ilaria investigator.; Morano Sandra investigator.; Chertok Ilana investigator.; Hefer Emek investigator.; Artzi‐Medvedik Rada investigator.; Pumpure Elizabete investigator.; Rezeberga Dace investigator.; Jansone‐Šantare Gita investigator.; Jakovicka Dārta investigator.; Knoka Anna Regīna investigator.; Vilcāne Katrīna Paula investigator.; Liepinaitienė Alina investigator.; Kondrakova Andželika investigator.; Mizgaitienė Marija investigator.; Juciūtė Simona investigator.; Arendt Maryse investigator.; Tasch Barbara investigator.; Nedberg Ingvild Hersoug investigator.; Kongslien Sigrun investigator.; Vik Eline Skirnisdottir investigator.; Baranowska Barbara investigator.; Tataj‐Puzyna Urszula investigator.; Węgrzynowska Maria investigator.; Costa Raquel investigator.; Barata Catarina investigator.; Santos Teresa investigator.; Rodrigues Carina investigator.; Dias Heloísa investigator.; Otelea Marina Ruxandra investigator.; Radetić Jelena investigator.; Ružičić Jovana investigator.; Drglin Zalka investigator.; Ponikvar Barbara Mihevc investigator.; Bohinec Anja investigator.; Brigidi Serena investigator.; Castañeda Lara Martín investigator.; Elden Helen investigator.; Sengpiel Verena investigator.; Linden Karolina investigator.; Zaigham Mehreen investigator.; De Labrusse Claire investigator.; Abderhalden Alessia investigator.; Pfund Anouck investigator.; Thorn Harriet investigator.; Grylka Susanne investigator.; Gemperle Michael investigator.; Mueller Antonia investigator.; Conway Francesca guestEditor.; Costa Raquel guestEditor.; Otelea Marina R. guestEditor.; Sacks Emma guestEditor.;
• Is Part Of: International journal of gynaecology and obstetrics. Volume 159:Issue 1(2022)supplement 1
• Page Start: 137
• Page End: 153
• Publication Date: 2022-12-18
• Subjects: childbirth -- COVID‐19 -- IMAgiNE EURO -- maternal care -- newborn care -- Portugal -- quality of care -- respectful maternity care; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.14507
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To compare women's perspectives on the quality of maternal and newborn care (QMNC) around the time of childbirth across Nomenclature of Territorial Units for Statistics 2 (NUTS‐II) regions in Portugal during the COVID‐19 pandemic. Methods: Women participating in the cross‐sectional IMAgiNE EURO study who gave birth in Portugal from March 1, 2020, to October 28, 2021, completed a structured questionnaire with 40 key WHO standards‐based quality measures. Four domains of QMNC were assessed: (1) provision of care; (2) experience of care; (3) availability of human and physical resources; and (4) reorganizational changes due to the COVID‐19 pandemic. Frequencies for each quality measure within each QMNC domain were computed overall and by region. Results: Out of 1845 participants, one‐third (33.7%) had a cesarean. Examples of high‐quality care included: low frequencies of lack of early breastfeeding and rooming‐in (8.0% and 7.7%, respectively) and informal payment (0.7%); adequate staff professionalism (94.6%); adequate room comfort and equipment (95.2%). However, substandard practices with large heterogeneity across regions were also reported. Among women who experienced labor, the percentage of instrumental vaginal births ranged from 22.3% in the Algarve to 33.5% in Center; among these, fundal pressure ranged from 34.8% in Lisbon to 66.7% in Center. Episiotomy was performed in 39.3% of noninstrumental vaginal births with variations between 31.8% in the North to 59.8% in Center. One in four women reported inadequate breastfeeding support (26.1%, ranging from 19.4% in Algarve to 31.5% in Lisbon). One in five reported no exclusive breastfeeding at discharge (22.1%; 19.5% in Lisbon to 28.2% in Algarve). Conclusion: Urgent actions are needed to harmonize QMNC and reduce inequities across regions in Portugal. Synopsis: Large inequities in the quality of maternal and newborn care in Portugal highlight the importance of promoting women's rights and respectful patient‐centered care.