TABLE 2.
| Overall (n = 493) No. (%) | Women born in Luxembourg (n = 314) No. (%) | Women not born in Luxembourg (n = 170) No. (%) | P value | |
|---|---|---|---|---|
| Provision of care | ||||
| 1. No pain relief during labor (SVB, IVB, EC before labor) | 44/423 (10.4) | 27/272 (9.9) | 16/142 (11.3) | 0.789 |
| 2. Mode of birth | ||||
| 2a. SVB | 300 (60.9) | 183 (58.3) | 111 (65.3) | 0.131 |
| 2b. IVB | 70 (14.2) | 46 (14.6) | 22 (12.9) | 0.606 |
| 2c. EC after labor | 53 (10.8) | 43 (13.7) | 9 (5.3) | 0.004 |
| 2d. EC before labor | 18 (3.7) | 10 (3.2) | 8 (4.7) | 0.399 |
| 2e. Elective cesarean | 52 (10.5) | 32 (10.2) | 20 (11.8) | 0.594 |
| 3a. Episiotomy (in SVB) | 45/300 (15.0) | 28/183 (15.3) | 13/111 (11.7) | 0.389 |
| 3b. Fundal pressure (in IVB) | 21/70 (30.0) | 15/46 (32.6) | 5/22 (22.7) | 0.403 |
| 3c. No pain relief after cesarean | 14/123 (11.4) | 8/85 (9.4) | 6/37 (16.2) | 0.278 |
| 4. No skin‐to‐skin contact | 3 (0.6) | 3 (1.0) | 0 (0.0) | 0.672 |
| 5. No early breastfeeding | 26 (5.3) | 21 (6.7) | 4 (2.4) | 0.043 |
| 6. Inadequate breastfeeding support | 80 (16.2) | 53 (16.9) | 26 (15.3) | 0.748 |
| 7. No rooming‐in | 29 (5.9) | 20 (6.4) | 9 (5.3) | 0.783 |
| 8. Not allowed to stay with the baby as wished | 1 (0.2) | 0 (0.0) | 1 (0.6) | 0.351 |
| 9. No exclusive breastfeeding at discharge | 133 (27.0) | 92 (29.3) | 38 (22.4) | 0.124 |
| 10. No immediate attention when needed | 101 (20.5) | 68 (21.7) | 30 (17.6) | 0.353 |
| Experience of care | ||||
| 1a. No freedom of movements during labor | 60/423 (14.2) | 41/272 (15.1) | 19/142 (13.4) | 0.639 |
| 1b. No consent requested for vaginal examination before prelabor cesarean | 13/70 (18.6) | 7/42 (16.7) | 6/28 (21.4) | 0.616 |
| 2a. No choice of birth position (in SVB) | 118/300 (39.3) | 69/183 (37.7) | 47/111 (42.3) | 0.430 |
| 2b. No consent requested (for IVB) | 30/70 (42.9) | 17/46 (37.0) | 13/22 (59.1) | 0.085 |
| 2c. No information on newborn (after cesarean) | 25/123 (20.3) | 13/85 (15.3) | 12/37 (32.4) | 0.031 |
| 3. No clear/effective communication from HCP | 81 (16.4) | 50 (15.9) | 28 (16.5) | 0.979 |
| 4. No involvement in choices | 107 (21.7) | 68 (21.7) | 37 (21.8) | 1.000 |
| 5. Companionship not allowed | 104 (21.1) | 74 (23.6) | 27 (15.9) | 0.062 |
| 6. Not treated with dignity | 66 (13.4) | 49 (15.6) | 16 (9.4) | 0.077 |
| 7. No emotional support | 97 (19.7) | 65 (20.7) | 30 (17.6) | 0.492 |
| 8. No privacy | 50 (10.1) | 36 (11.5) | 13 (7.6) | 0.241 |
| 9. Abuse (physical/verbal/emotional) | 45 (9.1) | 27 (8.6) | 17 (10.0) | 0.729 |
| 10. Informal payment | 41 (8.3) | 33 (10.5) | 6 (3.5) | 0.012 |
| Availability of physical and human resources | ||||
| 1a. No timely care by HCPs at facility arrival | 54 (11.0) | 41 (13.1) | 10 (5.9) | 0.021 |
| 2. No information on maternal danger signs | 145 (29.4) | 92 (29.3) | 51 (30.0) | 0.955 |
| 3. No information on newborn danger signs | 203 (41.2) | 130 (41.4) | 70 (41.2) | 1.000 |
| 4. Inadequate room comfort and equipment | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1.000 |
| 5. Inadequate number of women per rooms | 21 (4.3) | 19 (6.1) | 1 (0.6) | 0.003 |
| 6. Inadequate room cleaning | 6 (1.2) | 5 (1.6) | 1 (0.6) | 0.670 |
| 7. Inadequate bathroom | 8 (1.6) | 5 (1.6) | 1 (0.6) | 0.786 |
| 8. Inadequate partner visiting hours | 112 (22.7) | 77 (24.5) | 31 (18.2) | 0.141 |
| 9. Inadequate number of HCPs | 42 (8.5) | 24 (7.6) | 16 (9.4) | 0.616 |
| 10. Inadequate HCP professionalism | 8 (1.6) | 5 (1.6) | 2 (1.2) | 1.000 |
| Reorganizational changes due to COVID‐19 | ||||
| 1. Difficulties in attending routine antenatal visits | 178 (36.1) | 117 (37.3) | 57 (33.5) | 0.473 |
| 2. Any barriers in accessing the facility | 151 (30.6) | 106 (33.8) | 42 (24.7) | 0.050 |
| 3. Inadequate info graphics | 8 (1.6) | 5 (1.6) | 2 (1.2) | 1.000 |
| 4. Inadequate ward reorganization | 82 (16.6) | 55 (17.5) | 25 (14.7) | 0.505 |
| 5. Inadequate room reorganization | 92 (18.7) | 60 (19.1) | 28 (16.5) | 0.552 |
| 6. Lacking one functioning accessible hand‐washing station | 26 (5.3) | 19 (6.1) | 6 (3.5) | 0.326 |
| 7. HCP not always using PPE | 27 (5.5) | 21 (6.7) | 5 (2.9) | 0.093 |
| 8. Insufficient HCP number | 101 (20.5) | 72 (22.9) | 27 (15.9) | 0.086 |
| 9. Communication inadequate to contain COVID‐19‐related stress | 124 (25.2) | 77 (24.5) | 44 (25.9) | 0.826 |
| 10. Reduction in QMNC due to COVID‐19 | 194 (39.4) | 139 (44.3) | 49 (28.8) | 0.001 |
Abbreviations: EC, emergency cesarean; HCP, healthcare professional; IVB, instrumental vaginal birth; PPE, personal protective equipment; QMNC, quality of maternal and newborn care; SVB, spontaneous vaginal birth.
a
All the indicators in the domains of provision of care, experience of care, and resources are directly based on WHO standards.
b
Indicators with a specified denominator identified (e.g. 3a, 3b) were tailored to take into account different mode of birth (i.e. spontaneous vaginal, instrumental vaginal, and cesarean). These were calculated on subsamples (e.g. 3a was calculated on spontaneous vaginal births; 3b was calculated on instrumental vaginal births).
c
Indicator 6 in the domain of reorganizational changes due to COVID‐19 was defined as: at least one functioning and accessible hand‐washing station (near or inside the room where the mother was hospitalized) supplied with water and soap or with disinfectant alcohol solution.