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.
; Miani, C; Mariani, I; Valente, EP; Zaigham, M; Nedberg, IH; Kurbanović, M; Pumpure, E; Bohinec, A; Sarantaki, A; +38 more...Baranowska, B; Abderhalden-Zellweger, A; de La Rochebrochard, E; Costa, R; Otelea, MR; Liepinaitienė, A; Radetic, J; Ćerimagić, A; Arendt, M; König-Bachmann, M; Vedove, SD; Linden, K; Kongslien, S; Drandić, D; Kreslina, D; Drglin, Z; Metallinou, D; Tataj-Puzyna, U; Gemperle, M; Rozée, V; Dias, H; Mizgaitienė, M; Ruzicic, J; Simon, I; Fumagalli, S; Elden, H; Vik, ES; Ponikvar, BM; Lykeridou, A; Szlendak, B; de Labrusse, C; Pinto, TM; Jazdauskienė, S; Zenzmaier, C; Chertok, I; Sacks, E; Lazzerini, M; IMAgiNE EURO Study group and
(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: 10.1111/birt.12915
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.
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