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Large gaps in the quality of healthcare experienced by Swedish mothers during the COVID-19 pandemic : A cross-sectional study based on WHO standards

Zaigham, Mehreen LU orcid ; Linden, Karolina LU orcid ; Sengpiel, Verena ; Mariani, Ilaria ; Valente, Emanuelle Pessa ; Covi, Benedetta ; Lazzerini, Marzia and Elden, Helen (2022) In Women and Birth 35(6). p.619-627
Abstract

Background and Problem: Existing healthcare systems have been put under immense pressure during the COVID-19 pandemic. Disruptions in essential maternal and newborn services have come from even high-income countries within the World Health Organization (WHO) European Region. Aim: To describe the quality of care during pregnancy and childbirth, as reported by the women themselves, during the COVID-19 pandemic in Sweden, using the WHO ‘Standards for improving quality of maternal and newborn care in health facilities’. Methods: Using an anonymous, online questionnaire, women ≥18 years were invited to participate if they had given birth in Sweden from March 1, 2020 to June 30, 2021. The quality of maternal and newborn care was measured... (More)

Background and Problem: Existing healthcare systems have been put under immense pressure during the COVID-19 pandemic. Disruptions in essential maternal and newborn services have come from even high-income countries within the World Health Organization (WHO) European Region. Aim: To describe the quality of care during pregnancy and childbirth, as reported by the women themselves, during the COVID-19 pandemic in Sweden, using the WHO ‘Standards for improving quality of maternal and newborn care in health facilities’. Methods: Using an anonymous, online questionnaire, women ≥18 years were invited to participate if they had given birth in Sweden from March 1, 2020 to June 30, 2021. The quality of maternal and newborn care was measured using 40 questions across four domains: provision of care, experience of care, availability of human/physical resources, and organisational changes due to COVID-19. Findings: Of the 5003 women included, n = 4528 experienced labour. Of these, 46.7% perceived a poorer quality of maternal and newborn care due to the COVID-19. Fundal pressure was applied in 22.2% of instrumental vaginal births, 36.8% received inadequate breastfeeding support and 6.9% reported some form of abuse. Findings were worse in women undergoing prelabour Caesarean section (CS) (n = 475). Multivariate analysis showed significant associations of the quality of maternal and newborn care to year of birth (P < 0.001), parity (P < 0.001), no pharmacological pain relief (P < 0.001), prelabour CS (P < 0.001), emergency CS (P < 0.001) and overall satisfaction (P < 0.001). Conclusion: Considerable gaps over many key quality measures and deviations from women-centred care were noted. Findings were worse in women with prelabour CS. Actions to promote high-quality, evidence-based and respectful care during childbirth for all mothers are urgently needed.

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author
; ; ; ; ; ; and
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Childbirth, COVID-19, Cross-sectional study, Maternal, Newborn, Quality of care, Respectful maternity care, Sweden, WHO
in
Women and Birth
volume
35
issue
6
pages
619 - 627
publisher
Elsevier
external identifiers
  • scopus:85124197865
  • pmid:35123922
  • pmid:35123922
ISSN
1878-1799
DOI
10.1016/j.wombi.2022.01.007
language
English
LU publication?
yes
id
d2afe2ef-e7ca-43b2-a576-783fd41de4a3
date added to LUP
2022-02-12 08:31:43
date last changed
2024-04-12 05:44:39
@article{d2afe2ef-e7ca-43b2-a576-783fd41de4a3,
  abstract     = {{<p>Background and Problem: Existing healthcare systems have been put under immense pressure during the COVID-19 pandemic. Disruptions in essential maternal and newborn services have come from even high-income countries within the World Health Organization (WHO) European Region. Aim: To describe the quality of care during pregnancy and childbirth, as reported by the women themselves, during the COVID-19 pandemic in Sweden, using the WHO ‘Standards for improving quality of maternal and newborn care in health facilities’. Methods: Using an anonymous, online questionnaire, women ≥18 years were invited to participate if they had given birth in Sweden from March 1, 2020 to June 30, 2021. The quality of maternal and newborn care was measured using 40 questions across four domains: provision of care, experience of care, availability of human/physical resources, and organisational changes due to COVID-19. Findings: Of the 5003 women included, n = 4528 experienced labour. Of these, 46.7% perceived a poorer quality of maternal and newborn care due to the COVID-19. Fundal pressure was applied in 22.2% of instrumental vaginal births, 36.8% received inadequate breastfeeding support and 6.9% reported some form of abuse. Findings were worse in women undergoing prelabour Caesarean section (CS) (n = 475). Multivariate analysis showed significant associations of the quality of maternal and newborn care to year of birth (P &lt; 0.001), parity (P &lt; 0.001), no pharmacological pain relief (P &lt; 0.001), prelabour CS (P &lt; 0.001), emergency CS (P &lt; 0.001) and overall satisfaction (P &lt; 0.001). Conclusion: Considerable gaps over many key quality measures and deviations from women-centred care were noted. Findings were worse in women with prelabour CS. Actions to promote high-quality, evidence-based and respectful care during childbirth for all mothers are urgently needed.</p>}},
  author       = {{Zaigham, Mehreen and Linden, Karolina and Sengpiel, Verena and Mariani, Ilaria and Valente, Emanuelle Pessa and Covi, Benedetta and Lazzerini, Marzia and Elden, Helen}},
  issn         = {{1878-1799}},
  keywords     = {{Childbirth; COVID-19; Cross-sectional study; Maternal; Newborn; Quality of care; Respectful maternity care; Sweden; WHO}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{619--627}},
  publisher    = {{Elsevier}},
  series       = {{Women and Birth}},
  title        = {{Large gaps in the quality of healthcare experienced by Swedish mothers during the COVID-19 pandemic : A cross-sectional study based on WHO standards}},
  url          = {{http://dx.doi.org/10.1016/j.wombi.2022.01.007}},
  doi          = {{10.1016/j.wombi.2022.01.007}},
  volume       = {{35}},
  year         = {{2022}},
}