Autor(es):
Miani, C ; Wandschneider, L ; Batram-Zantvoort, S ; Covi, B ; Elden, H ; Nedberg, IH ; Drglin, Z ; Pumpure, E ; Costa, R ; Rozée, V ; Otelea, M ; Drandić, D ; Radetic, J ; Abderhalden-Zellweger, A ; Ćerimagić, A ; Arendt, M ; Mariani, I ; Linden, K ; Ponikvar, BM ; Jakovicka, D ; Dias, H ; Ruzicic, J ; de Labrusse, C ; Valente, EP ; Zaigham, M ; Bohinec, A ; Rezeberga, D ; Barata, C ; Pfund, A ; Sacks, E ; Lazzerini, M
Data: 2022
Identificador Persistente: https://hdl.handle.net/10216/151622
Origem: Repositório Aberto da Universidade do Porto
Assunto(s): birth; cesarean; episiotomy; Europe; gender equality; IMAgiNE EURO; medicalization; midwifery; respectful maternity care
Descrição
Objective: 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. © 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
