Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards
Objectives To examine quality of maternal and newborn care (QMNC) around childbirth in facilities in Belgium during the COVID-19 pandemic and trends over time.Design A cross-sectional observational study.Setting Data of the Improving MAternal Newborn carE in the EURO region study in Belgium.Particip...
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| Format: | Article |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e086937.full |
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| author | Marzia Lazzerini Emanuelle Pessa Valente Enrico Lopriore Mariana Pereira Helen Elden Ilaria Mariani Anna Galle Christoph Zenzmaier Nicos Middleton Antonella Nespoli Dace Rezeberga Mehreen Zaigham Karolina Linden Sandra Morano Raquel Costa Heloísa Dias Rozée Virginie Elizabete Pumpure Dārta Jakovicka Maryse Arendt Barbara Tasch Barbara Baranowska Urszula Tataj-Puzyna Catarina Barata Teresa Santos Zalka Drglin Anja Bohinec Serena Brigidi Lara Martín Castañeda Claire De Labrusse Anouck Pfund Harriet Thorn Joana Oliveira Simona Fumagalli Marina Ruxandra Otelea Helga Berghman Silke D’Hauwers Nele Vaerewijck Arianna Bomben Stefano delle Vedove Martina König-Bachmann Simon Imola Elisabeth D'Costa Ourania Kolokotroni Eleni Hadjigeorgiou Maria Karanikola Ioli Orphanide Eteocleous Lenka Laubrova Zirovnicka Miloslava Kramná Elise de La Rochebrochard Antigoni Sarantaki Kristina Dimitra Metallinou Aikaterini Lykeridou Stefano Delle Vedove Gita Jansone-Šantare Anna Šibalova Elīna Voitehoviča Dārta Krēsliņa Alina Liepinaitienė Andželika Kondrakova Marija Mizgaitienė Simona Juciūtė Thomas Van den Akker Beata Szlendak Paulina Pawlicka Tiago Miguel Pinto Sofia Marques Ana Meireles Maria Arminda Nunes Alejandra Oliden Alessia Abderhalden-Zellweger Susanne Grylka Michael Gemperle Antonia Mueller |
| author_facet | Marzia Lazzerini Emanuelle Pessa Valente Enrico Lopriore Mariana Pereira Helen Elden Ilaria Mariani Anna Galle Christoph Zenzmaier Nicos Middleton Antonella Nespoli Dace Rezeberga Mehreen Zaigham Karolina Linden Sandra Morano Raquel Costa Heloísa Dias Rozée Virginie Elizabete Pumpure Dārta Jakovicka Maryse Arendt Barbara Tasch Barbara Baranowska Urszula Tataj-Puzyna Catarina Barata Teresa Santos Zalka Drglin Anja Bohinec Serena Brigidi Lara Martín Castañeda Claire De Labrusse Anouck Pfund Harriet Thorn Joana Oliveira Simona Fumagalli Marina Ruxandra Otelea Helga Berghman Silke D’Hauwers Nele Vaerewijck Arianna Bomben Stefano delle Vedove Martina König-Bachmann Simon Imola Elisabeth D'Costa Ourania Kolokotroni Eleni Hadjigeorgiou Maria Karanikola Ioli Orphanide Eteocleous Lenka Laubrova Zirovnicka Miloslava Kramná Elise de La Rochebrochard Antigoni Sarantaki Kristina Dimitra Metallinou Aikaterini Lykeridou Stefano Delle Vedove Gita Jansone-Šantare Anna Šibalova Elīna Voitehoviča Dārta Krēsliņa Alina Liepinaitienė Andželika Kondrakova Marija Mizgaitienė Simona Juciūtė Thomas Van den Akker Beata Szlendak Paulina Pawlicka Tiago Miguel Pinto Sofia Marques Ana Meireles Maria Arminda Nunes Alejandra Oliden Alessia Abderhalden-Zellweger Susanne Grylka Michael Gemperle Antonia Mueller |
| collection | DOAJ |
| description | Objectives To examine quality of maternal and newborn care (QMNC) around childbirth in facilities in Belgium during the COVID-19 pandemic and trends over time.Design A cross-sectional observational study.Setting Data of the Improving MAternal Newborn carE in the EURO region study in Belgium.Participants Women giving birth in a Belgian facility from 1 March 2020 to 1 May 2023 responded a validated online questionnaire based on 40 WHO standards-based quality measures organised in four domains: provision of care, experience of care, availability of resources and organisational changes related to COVID‐19.Primary and secondary outcome measures Quantile regression analysis was performed to assess predictors of QMNC; trends over time were tested with the Mann‐Kendall test.Results 897 women were included in the analysis, 67% (n=601) with spontaneous vaginal birth, 13.3% (n=119) with instrumental vaginal birth (IVB) and 19.7% (n=177) with caesarean section. We found overall high QMNC scores (median index scores>75) but also specific gaps in all domains of QMNC. On provision of care, 21.0% (n=166) of women who experienced labour reported inadequate pain relief, 64.7% (n=74) of women with an instrumental birth reported fundal pressure and 72.3% (n=86) reported that forceps or vacuum cup was used without their consent. On experience of care, 31.1% (n=279) reported unclear communication, 32.9% (n=295) reported that they were not involved in choices,11.5% (n=104) stated not being treated with dignity and 8.1% (n=73) experienced abuse. Related to resources, almost half of the women reported an inadequate number of healthcare professionals (46.2%, n=414). Multivariable analyses showed significantly lower QMNC scores for women with an IVB (−20.4 in the 50th percentile with p<0.001 and 95% CI (−25.2 to −15.5)). Over time, there was a significant increase in QMNC Score for ‘experience of care’ and ‘key organisational changes due to COVID-19’ (trend test p< 0.05).Conclusions and relevance Our study showed several gaps in QMNC in Belgium, underlying causes of these gaps should be explored to design appropriate interventions and policies.Trial registration number NCT04847336. |
| format | Article |
| id | doaj-art-d4e61972a5244c45bc6f0f8f3676788b |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d4e61972a5244c45bc6f0f8f3676788b2025-08-20T02:51:18ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-086937Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards Marzia Lazzerini0Emanuelle Pessa Valente1Enrico LoprioreMariana PereiraHelen EldenIlaria Mariani2Anna Galle3Christoph ZenzmaierNicos MiddletonAntonella NespoliDace RezebergaMehreen ZaighamKarolina LindenSandra MoranoRaquel CostaHeloísa DiasRozée VirginieElizabete PumpureDārta JakovickaMaryse ArendtBarbara TaschBarbara BaranowskaUrszula Tataj-PuzynaCatarina BarataTeresa SantosZalka DrglinAnja BohinecSerena BrigidiLara Martín CastañedaClaire De LabrusseAnouck PfundHarriet ThornJoana OliveiraSimona FumagalliMarina Ruxandra OteleaHelga Berghman4Silke D’Hauwers5Nele Vaerewijck6Arianna Bomben7Stefano delle Vedove8Martina König-BachmannSimon ImolaElisabeth D'CostaOurania KolokotroniEleni HadjigeorgiouMaria KaranikolaIoli Orphanide EteocleousLenka Laubrova ZirovnickaMiloslava KramnáElise de La RochebrochardAntigoni Sarantaki KristinaDimitra MetallinouAikaterini LykeridouStefano Delle VedoveGita Jansone-ŠantareAnna ŠibalovaElīna VoitehovičaDārta KrēsliņaAlina LiepinaitienėAndželika KondrakovaMarija MizgaitienėSimona JuciūtėThomas Van den AkkerBeata SzlendakPaulina PawlickaTiago Miguel PintoSofia MarquesAna MeirelesMaria Arminda NunesAlejandra OlidenAlessia Abderhalden-ZellwegerSusanne GrylkaMichael GemperleAntonia MuellerWHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, ItalyWHO Collaborating Center, IRCCS materno infantile Burlo Garofolo, Trieste, ItalyWHO Collaborating Center, IRCCS materno infantile Burlo Garofolo, Trieste, ItalyInternational Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University Faculty of Medicine and Health Sciences, Gent, BelgiumInternational Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University Faculty of Medicine and Health Sciences, Gent, BelgiumUniversity Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University Faculty of Medicine and Health Sciences, Gent, BelgiumInternational Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University Faculty of Medicine and Health Sciences, Gent, BelgiumInstitute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, ItalyInstitute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, ItalyObjectives To examine quality of maternal and newborn care (QMNC) around childbirth in facilities in Belgium during the COVID-19 pandemic and trends over time.Design A cross-sectional observational study.Setting Data of the Improving MAternal Newborn carE in the EURO region study in Belgium.Participants Women giving birth in a Belgian facility from 1 March 2020 to 1 May 2023 responded a validated online questionnaire based on 40 WHO standards-based quality measures organised in four domains: provision of care, experience of care, availability of resources and organisational changes related to COVID‐19.Primary and secondary outcome measures Quantile regression analysis was performed to assess predictors of QMNC; trends over time were tested with the Mann‐Kendall test.Results 897 women were included in the analysis, 67% (n=601) with spontaneous vaginal birth, 13.3% (n=119) with instrumental vaginal birth (IVB) and 19.7% (n=177) with caesarean section. We found overall high QMNC scores (median index scores>75) but also specific gaps in all domains of QMNC. On provision of care, 21.0% (n=166) of women who experienced labour reported inadequate pain relief, 64.7% (n=74) of women with an instrumental birth reported fundal pressure and 72.3% (n=86) reported that forceps or vacuum cup was used without their consent. On experience of care, 31.1% (n=279) reported unclear communication, 32.9% (n=295) reported that they were not involved in choices,11.5% (n=104) stated not being treated with dignity and 8.1% (n=73) experienced abuse. Related to resources, almost half of the women reported an inadequate number of healthcare professionals (46.2%, n=414). Multivariable analyses showed significantly lower QMNC scores for women with an IVB (−20.4 in the 50th percentile with p<0.001 and 95% CI (−25.2 to −15.5)). Over time, there was a significant increase in QMNC Score for ‘experience of care’ and ‘key organisational changes due to COVID-19’ (trend test p< 0.05).Conclusions and relevance Our study showed several gaps in QMNC in Belgium, underlying causes of these gaps should be explored to design appropriate interventions and policies.Trial registration number NCT04847336.https://bmjopen.bmj.com/content/14/12/e086937.full |
| spellingShingle | Marzia Lazzerini Emanuelle Pessa Valente Enrico Lopriore Mariana Pereira Helen Elden Ilaria Mariani Anna Galle Christoph Zenzmaier Nicos Middleton Antonella Nespoli Dace Rezeberga Mehreen Zaigham Karolina Linden Sandra Morano Raquel Costa Heloísa Dias Rozée Virginie Elizabete Pumpure Dārta Jakovicka Maryse Arendt Barbara Tasch Barbara Baranowska Urszula Tataj-Puzyna Catarina Barata Teresa Santos Zalka Drglin Anja Bohinec Serena Brigidi Lara Martín Castañeda Claire De Labrusse Anouck Pfund Harriet Thorn Joana Oliveira Simona Fumagalli Marina Ruxandra Otelea Helga Berghman Silke D’Hauwers Nele Vaerewijck Arianna Bomben Stefano delle Vedove Martina König-Bachmann Simon Imola Elisabeth D'Costa Ourania Kolokotroni Eleni Hadjigeorgiou Maria Karanikola Ioli Orphanide Eteocleous Lenka Laubrova Zirovnicka Miloslava Kramná Elise de La Rochebrochard Antigoni Sarantaki Kristina Dimitra Metallinou Aikaterini Lykeridou Stefano Delle Vedove Gita Jansone-Šantare Anna Šibalova Elīna Voitehoviča Dārta Krēsliņa Alina Liepinaitienė Andželika Kondrakova Marija Mizgaitienė Simona Juciūtė Thomas Van den Akker Beata Szlendak Paulina Pawlicka Tiago Miguel Pinto Sofia Marques Ana Meireles Maria Arminda Nunes Alejandra Oliden Alessia Abderhalden-Zellweger Susanne Grylka Michael Gemperle Antonia Mueller Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards BMJ Open |
| title | Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards |
| title_full | Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards |
| title_fullStr | Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards |
| title_full_unstemmed | Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards |
| title_short | Quality of care at childbirth during the COVID-19 pandemic in Belgium: a cross-sectional study based on WHO standards |
| title_sort | quality of care at childbirth during the covid 19 pandemic in belgium a cross sectional study based on who standards |
| url | https://bmjopen.bmj.com/content/14/12/e086937.full |
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