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

Abstract

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.

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

“…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 …”

“…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.…”

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

“…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.…”

“…When women are not provided with respectful care during childbirth this impacts on the rest of their care journey—they may not feel or be supported to initiate or continue breastfeeding, or to bond through skin‐to‐skin contact or rooming‐in with their baby. Lack of informed consent for interventions, 5–7 such as fundal pressure or instrumental birth, is a violation of the right to bodily autonomy and erodes public trust in the healthcare system. The integrity of the person is a basic right in the Charter of Fundamental Rights of the European Union 11 .…”

“…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.…”