Browsing by Author "Covi, Benedetta"
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- Individual and country‐level variables associated with the medicalization of birth: Multilevel analyses of IMAgiNE EURO data from 15 countries in the WHO European regionPublication . Miani, Céline; Wandschneider, Lisa; Batram‐Zantvoort, Stephanie; Covi, Benedetta; Elden, Helen; Nedberg, Ingvild Hersoug; Drglin, Zalka; Pumpure, Elizabete; Costa, Raquel; Rozée, Virginie; Otelea, Marina Ruxandra; Drandić, Daniela; Radetic, Jelena; Abderhalden‐Zellweger, Alessia; Ćerimagić, Amira; Arendt, Maryse; Mariani, Ilaria; Linden, Karolina; Ponikvar, Barbara Mihevc; Jakovicka, Dārta; Dias, Heloisa; Ruzicic, Jovana; de Labrusse, Claire; Valente, Emanuelle Pessa; Zaigham, Mehreen; Bohinec, Anja; Rezeberga, Dace; Barata, Catarina; Pfund, Anouk; Sacks, Emma; Lazzerini, Marzia; Ćerimagić, Amira; Drandić Roda, Daniela; Kurbanović, Magdalena; Virginie, Rozée; de La Rochebrochard, Elise; Löfgren, Kristina; Miani, Céline; Batram‐Zantvoort, Stephanie; Wandschneider, Lisa; Lazzerini, Marzia; Valente, Emanuelle Pessa; Covi, Benedetta; Mariani, Ilaria; Morano, Sandra; Chertok, Ilana; Hefer, Emek; Artzi‐Medvedik, Rada; Pumpure, Elizabete; Rezeberga, Dace; Jansone‐Šantare, Gita; Jakovicka, Dārta; Knoka, Anna Regīna; Vilcāne, Katrīna Paula; Liepinaitienė, Alina; Kondrakova, Andželika; Mizgaitienė, Marija; Juciūtė, Simona; Arendt, Maryse; Tasch, Barbara; Nedberg, Ingvild Hersoug; Kongslien, Sigrun; Vik, Eline Skirnisdottir; Baranowska, Barbara; Tataj‐Puzyna, Urszula; Węgrzynowska, Maria; Costa, Raquel; Barata, Catarina; Santos, Teresa; Rodrigues, Carina; Dias, Heloísa; Otelea, Marina Ruxandra; Radetić, Jelena; Ružičić, Jovana; Drglin, Zalka; Ponikvar, Barbara Mihevc; Bohinec, Anja; Brigidi, Serena; Castañeda, Lara Martín; Elden, Helen; Sengpiel, Verena; Linden, Karolina; Zaigham, Mehreen; De Labrusse, Claire; Abderhalden, Alessia; Pfund, Anouck; Thorn, Harriet; Grylka, Susanne; Gemperle, Michael; Mueller, AntoniaObjective: To investigate potential associations between individual and country- level factors and medicalization of birth in 15 European countries during the COVID- 19 pandemic. Methods: Online anonymous survey of women who gave birth in 2020– 2021. Multivariable multilevel logistic regression models estimating associations between indicators of medicalization (cesarean, instrumental vaginal birth [IVB], episiotomy, fundal pressure) and proxy variables related to care culture and contextual factors at the individual and country level. Results: Among 27 173 women, 24.4% (n = 6650) had a cesarean and 8.8% (n = 2380) an IVB. Among women with IVB, 41.9% (n = 998) reported receiving fundal pressure. Among women with spontaneous vaginal births, 22.3% (n = 4048) had an episiotomy. Less respectful care, as perceived by the women, was associated with higher levels of medicalization. For example, women who reported having a cesarean, IVB, or episiotomy reported not feeling treated with dignity more frequently than women who did not have those interventions (odds ratio [OR] 1.37; OR 1.61; OR 1.51, respectively; all: P < 0.001). Country- level variables contributed to explaining some of the variance between countries. Conclusion: We recommend a greater emphasis in health policies on promotion of respectful and patient- centered care approaches to birth to enhance women's experiences of care, and the development of a European- level indicator to monitor medicalization of reproductive care.
- Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European RegionPublication . Lazzerini, Marzia; Covi, Benedetta; Mariani, Ilaria; Drglin, Zalka; Arendt, Maryse; Nedberg, Ingvild Hersoug; Elden, Helen; Costa, Raquel; Drandić, Daniela; Radetić, Jelena; Otelea, Marina Ruxandra; Miani, Céline; Brigidi, Serena; Rozée, Virginie; Ponikvar, Barbara Mihevc; Tasch, Barbara; Kongslien, Sigrun; Linden, Karolina; Barata, Catarina; Kurbanović, Magdalena; Ružičić, Jovana; Batram-Zantvoort, Stephanie; Castañeda, Lara Martín; Rochebrochard, Elise de La; Bohinec, Anja; Vik, Eline Skirnisdottir; Zaigham, Mehreen; Santos, Teresa; Wandschneider, Lisa; Viver, Ana Canales; Ćerimagić, Amira; Sacks, Emma; Valente, Emanuelle PessaThe COVID‑19 pandemic has increased the existing challenges of all health systems, and the quality of maternal and newborn care (QMNC) worldwide has been particularly affected.1,2 During the pandemic, even among high income countries of the World Health Organisation (WHO) European Region, multiple studies, including a systematic review1,3, 4, 5 have documented a deterioration in key indicators, such as: reduced utilisation of maternal and newborn health services, increased number of stillbirths, increased medicalization of care (more caesarean sections and induction of labours), reduced family involvement, low support and uptake of breastfeeding, and amplified maternal anxiety and stress.
- Quality of maternal and newborn care around the time of childbirth for migrant versus nonmigrant women during the COVID ‐19 pandemic: Results of the IMAgiNE EURO study in 11 countries of the WHO European regionPublication . Costa, Raquel; Rodrigues, Carina; Dias, Heloísa; Covi, Benedetta; Mariani, Ilaria; Valente, Emanuelle Pessa; Zaigham, Mehreen; Vik, Eline Skirnisdottir; Grylka‐Baeschlin, Susanne; Arendt, Maryse; Santos, Teresa; Wandschneider, Lisa; Drglin, Zalka; Drandić, Daniela; Radetic, Jelena; Rozée, Virginie; Elden, Helen; Mueller, Antonia N.; Barata, Catarina; Miani, Céline; Bohinec, Anja; Ruzicic, Jovana; de La Rochebrochard, Elise; Linden, Karolina; Geremia, Sara; de Labrusse, Claire; Batram‐Zantvoort, Stephanie; Ponikvar, Barbara Mihevc; Sacks, Emma; Lazzerini, MarziaTo describe the perception of quality of maternal and newborn care (QMNC) around the time of childbirth among migrant and nonmigrant women in Europe. Methods Women who gave birth at a health facility in 11 countries of the WHO European Region from March 2020 to July 2021 were invited to answer an online questionnaire including demographics and childbirth experience. Data were analyzed and compared for 1781 migrant and 20 653 nonmigrant women. Results Migrant women who experienced labor perceived slightly more difficulties in attending routine antenatal visits (41.2% vs 39.4%; P = 0.001), more barriers in accessing facilities (32.9% vs 29.9%; P = 0.001), lack of timely care (14.7% vs 13.0%; P = 0.025), inadequate room comfort and equipment (9.2% vs 8.5%; P = 0.004), inadequate number of women per room (9.4% vs 8.6%; P = 0.039), being prevented from staying with their baby as they wished (7.8% vs 6.9%; P = 0.011), or suffering abuse (14.5% vs 12.7%; P = 0.022) compared with nonmigrant women. For women who had a prelabor cesarean, migrant women were more likely not to receive pain relief after birth (16.8% vs.13.5%; P = 0.039) and less likely to provide informal payment (1.8% vs 4.4%; P = 0.005) compared with nonmigrant women. Overall, the QMNC index was not significantly different for migrant compared with nonmigrant women. Conclusion Gaps in overall QMNC were reported by both migrant and nonmigrant women, with improvements to healthcare necessary for all.
- Regional differences in the quality of maternal and neonatal care during the COVID ‐19 pandemic in Portugal: Results from the IMAgiNE EURO studyPublication . Costa, Raquel; Barata, Catarina; Dias, Heloísa; Rodrigues, Carina; Santos, Teresa; Mariani, Ilaria; Valente, Emanuelle Pessa; Lazzerini, Marzia; Covi, BenedettaObjective: 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.