Naslov
Individual and country-level variables associated with the medicalization of birth: Multilevel analyses of IMAgiNE EURO data from 15 countries in the WHO European region

Autori
Miani, Céline : Wandschneider, Lisa : Batram-Zantvoort, Stephanie : Covi, Benedetta Elden, Helen : Hersoug Nedberg, Ingvild : Drglin, Zalka : Pumpure, Elizabete : Costa, Raquel : Rozée, Virginie : Otelea, Marina Ruxandra : Drandić, Daniela : Radetic, Jelena : Abderhalden-Zellweger, Alessia : Ćerimagić, Amira : Arendt, Maryse : Mariani, Ilaria : Linden, Karolina : Mihevc Ponikvar, Barbara : Jakovicka, Dara : Dias, Heloisa : Ruzicic, Jovana : de Labrusse, Claire : Valente, Emanuelle Pessa : Zaigham, Mehreen : Bohinec, Anja : Rezeberga, Dace : Barata, Catarina : Pfund, Anouk : Sacks, Emma : Lazzerini, Marzia : the IMAgiNE EURO study group

Kolaboracija
The IMAgiNE EURO Study Group

Izvornik
International journal of gynaecology and obstetrics (0020-7292) 159 (2022), 1; 9-21

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
birth, cesarean, episiotomy, Europe, gender equality, IMAgiNE EURO, medicalization, midwifery, respectful maternity care

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Biotehnologija

POVEZANOST RADA