P95 – Large gaps in the quality of healthcare experienced by Swedish mothers during the COVID-19 pandemic: a cross-sectional study based on WHO standards

8. Samhällseffekter

Mehreen Zaigham1, Karolina Linden2, Verena Sengpiel3, Ilaria Mariani4, Emanuelle Pessa Valente4, Benedetta Covi4, Marzia Lazzerini4, Helen Elden2

1 Obstetrics and Gynaecology, Department of Obstetrics and Gynecology, Institution of Clinical Sciences Lund, Lund University, Sweden
2 Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
3 Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg
4 Institute for Maternal and Child Health – IRCCS “Burlo Garofolo” – WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy

Bakgrund: Disruptions in essential maternal and newborn services have come from even high-income countries within the World Health Organization (WHO) European Region during the COVID-19 pandemic. The aim of the study was to report the quality of care during pregnancy and childbirth, as reported by the women themselves, during the pandemic in Sweden using WHO Standards.

Metod: Women ≥18 years were invited to participate in anonymous, online questionnaire if they had given birth in Sweden from March 1, 2020 to June 30, 2021. The quality of maternal and newborn care (QMNC) was measured using 40 questions across four domains: provision of care, experience of care, availability of human/physical resources, and organizational changes due to COVID-19.

Resultat: Of the 5003 women included in the study, (n=4528) underwent labour.Of these, 46.7% perceived a reduction in QMNC due to the COVID-19 pandemic,29.9% experienced difficulties in accessing routine antenatal care and 62.5% reported that health workers were not always using protective personal equipment.Fundal pressure was applied in 22.2% of instrumental vaginal births and 6.9% reported some form of abuse.Findings were worse in women undergoing prelabor Cesarean section (CS) (n=475).Multivariate analysis showed significantly worse QMNC Index to year of birth (P<0.001), parity (P<0.001), elective/emergency CS (P<0.001), and overall satisfaction (P<0.001).

Slutsats: Women giving birth in Sweden reported considerable gaps over many key QMNC measures including the use of outdated practices and deviations from patient-centred care.Findings were worse in women with prelabour CS. Actions to promote high-quality, evidence-based and respectful care during childbirth for all mothers are urgently needed.