The Association Between Women's Perception of Birth During the Pandemic, Companion of Choice and Support From Health Professionals: A Cross-Sectional Study in 20 Countries in the WHO European Region.
Batram-Zantvoort, Stephanie;
Miani, Céline;
Mariani, Ilaria;
Valente, Emanuelle Pessa;
Zaigham, Mehreen;
Nedberg, Ingvild Hersoug;
Kurbanović, Magdalena;
Pumpure, Elizabete;
Bohinec, Anja;
Sarantaki, Antigone;
+38 more...Baranowska, Barbara;
Abderhalden-Zellweger, Alessia;
de La Rochebrochard, Elise;
Costa, Raquel;
Otelea, Marina Ruxandra;
Liepinaitienė, Alina;
Radetic, Jelena;
Ćerimagić, Amira;
Arendt, Maryse;
König-Bachmann, Martina;
Vedove, Stefano Delle;
Linden, Karolina;
Kongslien, Sigrun;
Drandić, Daniela;
Kreslina, Darta;
Drglin, Zalka;
Metallinou, Dimitra;
Tataj-Puzyna, Urszula;
Gemperle, Michael;
Rozée, Virginie;
Dias, Heloísa;
Mizgaitienė, Marija;
Ruzicic, Jovana;
Simon, Imola;
Fumagalli, Simona;
Elden, Helen;
Vik, Eline Skirnisdottir;
Ponikvar, Barbara Mihevc;
Lykeridou, Aikaterini;
Szlendak, Beata;
de Labrusse, Claire;
Pinto, Tiago Miguel;
Jazdauskienė, Simona;
Zenzmaier, Christoph;
Chertok, Ilana;
Sacks, Emma;
Lazzerini, Marzia;
IMAgiNE EURO Study group;
(2025)
The Association Between Women's Perception of Birth During the Pandemic, Companion of Choice and Support From Health Professionals: A Cross-Sectional Study in 20 Countries in the WHO European Region.
Birth (Berkeley, Calif.).
ISSN 0730-7659
DOI: https://doi.org/10.1111/birt.12915
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BACKGROUND: Mitigation measures implemented in response to the COVID-19 pandemic led to significant changes in maternity care across Europe, including restrictions on companions during labor and birth. This cross-sectional study explores the association between the presence of a companion of choice and a positive perception of the birth experience. Additionally, it explores the association between health professionals' attention, assistance, and availability during labor and birth and a positive perception of birth. METHODS: We utilized a structured, validated online questionnaire, available in 25 languages, to assess the quality of maternal care during the COVID-19 pandemic from women's perspectives. We conducted logistic regression to explore associations between variables related to the presence of a companion of choice, health professionals' attention, assistance, and availability, and positive perceptions of birth, when controlled for confounders, including birth mode and medical interventions. RESULTS: Responses from 48,039 women across 20 countries in the WHO European Region were included. Always having a companion of choice during birth (aOR: 2.11) and always receiving adequate care from health professionals (assistance aOR: 2.12, attention aOR: 36.64, availability aOR: 2.12) were associated with positive birth perception. Instrumental births (aOR: 0.76), episiotomies (aOR: 0.74), fundal pressure (aOR: 0.52), and cesarean births (planned aOR: 0.80, unplanned prelabor aOR: 0.60, unplanned in-labor aOR: 0.52) were associated with less positive birth perceptions. DISCUSSION: This study highlights the critical role of having a chosen companion and receiving adequate attention, assistance, and availability from health professionals in promoting positive birth perceptions, even in times of crisis such as the COVID-19 pandemic. Ensuring the presence of a companion of choice and comprehensive professional support is crucial for delivering high-quality, respectful maternity care.
