IMAgiNE EURO study groupMiani, CélineWandschneider, LisaPumpure, ElizabeteJakovicka, DārtaRezeberga, Dace2023-01-092023-01-092022-12IMAgiNE EURO study group, Miani, C, Wandschneider, L, Pumpure, E, Jakovicka, D & Rezeberga, D 2022, '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', International Journal of Gynecology and Obstetrics, vol. 159 , no. Suppl. 1, pp. 9-21. https://doi.org/10.1002/ijgo.144590020-7292https://dspace.rsu.lv/jspui/handle/123456789/10010© 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.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.131727009enginfo:eu-repo/semantics/openAccessFemaleHumansPregnancyCOVID-19/epidemiologyMedicalizationMultilevel AnalysisPandemicsWorld Health Organization3.3 Health sciences3.2 Clinical medicine1.1. Scientific article indexed in Web of Science and/or Scopus database/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article10.1002/ijgo.14459https://www-webofscience-com.db.rsu.lv/wos/woscc/full-record/WOS:000905238400002