Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Dec;159 Suppl 1(Suppl 1):126-136.
doi: 10.1002/ijgo.14482.

Women's assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study

Marina Ruxandra Otelea  1 , Anca Angela Simionescu  2   3 , Ilaria Mariani  4 , Emanuelle Pessa Valente  4 , Michaela Iuliana Nanu  5 , Ioana Nanu  5 , Claudia Mariana Handra  1 , Benedetta Covi  4 , Marzia Lazzerini  4 ; IMAgiNE EURO Study Group
Collaborators, Affiliations
Observational Study

Women's assessment of the quality of hospital-based perinatal care by mode of birth in Romania during the COVID-19 pandemic: Results from the IMAgiNE EURO study

Marina Ruxandra Otelea et al. Int J Gynaecol Obstet. 2022 Dec.

Abstract

Objective: To assess women's perceptions of the quality of maternal and newborn care (QMNC) received in hospitals in Romania during the COVID-19 pandemic by mode of birth.

Methods: A validated anonymous online questionnaire based on WHO quality measures. Subgroup analysis of spontaneous vaginal birth (SVB), emergency cesarean, and elective cesarean and multivariate analyses were performed, and QMNC indexes were calculated. Maternal age, educational level, year of birth, mother born in Romania, parity, type of hospital, and type of professionals assisting the birth were used for multivariate analysis.

Results: A total of 620 women completed the survey. Overall, several quality measures suggested gaps in QMNC in Romania, with the lowest QMNC indexes reported for provision of care and availability of resources. Women who had either elective or emergency cesarean compared with those who had SVB more frequently lacked early breastfeeding (OR 2.04 and 2.13, respectively), skin-to-skin contact (OR 1.73 and 1.75, respectively), rooming-in (OR 2.07 and 1.96, respectively), and exclusive breastfeeding at discharge (OR 2.27 and 1.64, respectively). Compared with elective cesarean, emergency cesarean had higher odds of ineffective communication by healthcare providers (OR 1.65), lack of involvement in choices (OR 1.58), insufficient emotional support (OR 2.07), and no privacy (OR 2.06). Compared with other modes of birth, a trend for lower QMNC indexes for emergency cesarean was observed for all domains, while for elective cesarean the QMNC index for provision of care was significantly lower.

Conclusion: Quality indicators of perinatal care remain behind targets in Romania, with births by cesarean the most affected.

Gov identifier: NCT04847336.

Keywords: COVID-19; IMAgiNE EURO; Romania; breastfeeding; cesarean; childbirth; mode of birth; quality of care.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Study flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bratila E, Vladareanu S, The Ministry of Health . Metodologia privind naşterea la gravidele cu infecţie suspicionată/confirmată cu SARS‐CoV‐2/Covid19, preluarea, îngrijirea şi asistenţa medicală a nou născutului (Romanian) [Methodology regarding childbirth in pregnant women with suspected/confirmed SARS‐CoV‐2/Covid19 infection, taking over, care and medical assistance of the newborn]. Ministry of Health, 2020. Accessed May 15, 2022. http://www.ms.ro/wp‐content/uploads/2020/04/Metodologia‐privindnasterea‐...
    1. Suciu N, Nanu M, Stativa E, Novak C, Mihăilescu G. Study on the reproductive health in Romania. 2016. Accessed August 1, 2021. https://www.insmc.ro/wp‐content/uploads/2021/01/STUDIU_IOMC_final_23.09....
    1. Simionescu AA, Marin E. Caesarean birth in Romania: safe motherhood between ethical, medical and statistical arguments. Maedica (Bucur). 2017;12:5‐12. - PMC - PubMed
    1. Simionescu AA, Horobet A, Marin E, Belascu L. Who indicates Caesarean section in Romania? A cross‐sectional survey in tertiary level maternity on childbirth patients and doctors' profiles. Obstetrica Ginecologia. 2021;69:62.
    1. Rydahl E, Declercq E, Juhl M, Maimburg RD. Cesarean section on a rise ‐ Does advanced maternal age explain the increase? A population register‐based study. PLoS One. 2019;14:e0210655. - PMC - PubMed

Publication types

Associated data