1. Regional differences in the quality of maternal and neonatal care during the COVID‐19 pandemic in Portugal: Results from the IMAgiNE EURO study.
- Author
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Costa, Raquel, Barata, Catarina, Dias, Heloísa, Rodrigues, Carina, Santos, Teresa, Mariani, Ilaria, Covi, Benedetta, Valente, Emanuelle Pessa, Lazzerini, Marzia, Ćerimagić, Amira, Drandić, Daniela, Kurbanović, Magdalena, Virginie, Rozée, de La Rochebrochard, Elise, Löfgren, Kristina, Miani, Céline, Batram‐Zantvoort, Stephanie, Wandschneider, Lisa, Morano, Sandra, and Chertok, Ilana
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COVID-19 pandemic , *NEONATOLOGY , *REGIONAL differences , *EURO , *WOMEN'S rights - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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