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. 2022 Dec;159 Suppl 1(Suppl 1):70-84.
doi: 10.1002/ijgo.14456.

Quality of maternal and newborn care in Switzerland during the COVID-19 pandemic: A cross-sectional study based on WHO quality standards

Claire de Labrusse  1 , Alessia Abderhalden-Zellweger  1 , Ilaria Mariani  2 , Anouck Pfund  1 , Michael Gemperle  3 , Susanne Grylka-Baeschlin  3 , Antonia N Mueller  3 , Emanuelle Pessa Valente  2 , Benedetta Covi  2 , Marzia Lazzerini  2 ; IMAgiNE EURO study group
Collaborators, Affiliations

Quality of maternal and newborn care in Switzerland during the COVID-19 pandemic: A cross-sectional study based on WHO quality standards

Claire de Labrusse et al. Int J Gynaecol Obstet. 2022 Dec.

Abstract

Objective: To explore quality of maternal and newborn care (QMNC) in healthcare facilities during the COVID-19 pandemic in Switzerland.

Methods: Women giving birth in Switzerland answered a validated online questionnaire including 40 WHO standards-based quality measures. QMNC score was calculated according to linguistic region and mode of birth. Differences were assessed using logistic regression analysis adjusting for relevant variables.

Results: A total of 1175 women were included in the analysis. Limitations in QMNC during the pandemic were reported by 328 (27.9%) women. Several quality measures, such as deficient communication (18.0%, n = 212), insufficient number of healthcare professionals (19.7%, n = 231), no information on the newborn after cesarean (26.5%, n = 91) or maternal and newborn danger signs (34.1%, n = 401 and 41.4% n = 487, respectively) suggested preventable gaps in QMNC. Quality measures significantly differed by linguistic region and mode of birth. Multivariate analysis established a significantly lower QMNC for women in French- and Italian-speaking regions compared with the German-speaking region. Moreover, in several quality indicators reflecting communication with healthcare providers, women who did not answer the questionnaire in one of the Swiss national languages had significantly worse scores than others. A significant lower QMNC was also found for young and primiparous women and for those who experienced cesarean or instrumental vaginal birth.

Conclusion: Women giving birth in Switzerland during the pandemic reported notable gaps in QMNC. Providers should be attuned to women who are younger, primiparous, and those who had an emergency cesarean or instrumental vaginal birth given the lower QMNC reported by these groups. Women who did not respond in a Swiss national language may need improved communication strategies.

Keywords: COVID-19; IMAgiNE EURO; Switzerland; WHO standards; maternal health; maternity services; mode of birth; quality of care.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Study flow diagram. aWe used 45 key variables (40 key quality measures and five key sociodemographic questions).
FIGURE 2
FIGURE 2
QMNC index by sociodemographic variables. NICU, neonatal intensive care unit; OB‐GYN, obstetrician/gynecologist; QMNC, quality of maternal and newborn care; SCBU, special care baby unit.
FIGURE 3
FIGURE 3
QMNC index by major linguistic region. QMNC, quality of maternal and newborn care.
FIGURE 4
FIGURE 4
QMNC index by mode of birth. ELC, planned or elective cesarean before labor; EMC—L, emergency cesarean during labor; EMC—NL, emergency cesarean before labor; IVB, instrumental vaginal birth; QMNC, quality of maternal and newborn care; SVB, spontaneous vaginal birth.
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