Experiences of childbirth care in Lithuania and Romania: Insights from the European Babies Born Better survey.

BACKGROUND: Data on experience and satisfaction of users are essential for improvement of health care, especially in the field of childbirth. The aim of this study was to compare childbirth care experiences in Lithuania and Romania. METHODS: Data derived from the EU Babies Born Better online survey were analyzed. Parturients from Lithuania (N = 373) and Romania (N = 359) who had given birth within the last 5 years were included. Participants were asked to (1) describe the best things in childbirth care and (2) suggest changes in the care received at their birthplace. Qualitative data were analyzed using a previously developed deductive coding framework. RESULTS: In agreement with previous findings from Austria, positive experiences mainly addressed care experienced at an individual level (in particular healthcare practitioners' competence and personality traits) and suggested changes mainly addressed services at birthplace (issues related to infrastructure, information and counseling, and empowerment). Responses not initially included in the coding framework addressed aspects such as informal payment (in both countries), desire for home birth (particularly in Lithuania), or mistreatment of parturients (particularly in Romania). CONCLUSIONS: We conclude that similar trends in childbirth care exist in Lithuania and Romania with regard to parturients' personal experiences and psychosocial needs and that addressing the needs of parturients is important for improving service provision.

Scalability of a singing-based intervention for postpartum depression in Denmark and Romania: protocol for a single-arm feasibility study.

INTRODUCTION: Postpartum depression (PPD) affects around one in seven women globally, with these women in need of non-pharmaceutical treatment strategies. There is a long history of the benefits of singing for maternal mental health, and promising research exists showing the clinical effectiveness of group singing. Group singing interventions are being scaled up to support new mothers in the United Kingdom, but we do not know if such an intervention may benefit women in different cultural contexts. This protocol focuses on exploring the feasibility of implementation and perceived impact of a 10-week group singing intervention for new mothers in Romania and Denmark eliciting signs of PPD. METHODS AND ANALYSIS: Data will be collected from up to 48 women with a score ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) participating in a 10-week group singing intervention in Denmark or Romania, as well as a range of project stakeholders. The singing classes will take place in person and be facilitated by professional singing leaders. Feasibility of implementation will be analysed through qualitative data (eg, focus groups, interviews) and quantitative data (eg, the Feasibility of Intervention Measure). Perceived impact will be explored via surveys that include mental health measures (EPDS, Multidimensional Scale of Perceived Social Support, WHO Five Well-Being Index) from singing intervention participants (at weeks 1, 6, 10) and focus groups. Descriptive statistics, repeated measures analysis of variance and analysis of covariance will be used to analyse quantitative data. Framework method and thematic analysis will be used to analyse qualitative data. ETHICS AND DISSEMINATION: The national ethics committees in Romania (IRB-PH Protocol #2021-211217-012) and Denmark (case number 1-10-72-274-21) have approved the study, as has the Ethics Review Committee at the World Health Organization (ERC.0003714). All participants will be required to provide informed consent. Results will be disseminated by reports published by the WHO Regional Office for Europe, peer-reviewed publications and at conferences.

A Cross-Section Study of Relationship Characteristics and Smoking Cessation During Pregnancy in a Sample of Romanian Pregnant Women.

INTRODUCTION: Partner support and relationship characteristics may be important factors in effective couple-based pregnancy smoking cessation programs. Research is needed to investigate the links between couple relationship characteristics and maternal smoking cessation to inform the development of such interventions. METHODS: This paper relies on cross-section data collected during the formative phase in the development of an ongoing couple-focused pregnancy tobacco cessation trial. Data (n = 143 pregnant women) were collected from two large public and one private obstetrics and gynecology clinics located in Cluj-Napoca, Romania. Multiple logistic regression was used to identify correlates of smoking cessation during pregnancy. RESULTS: Higher education was a significant correlate of smoking cessation during pregnancy. Women with a college degree or more had higher odds to quit smoking during pregnancy in comparison to their counterparts who graduated high school or less (OR 14.3, 95% CI 2.75-74.28). In addition, women with increased positive partner interactions related to their smoking cessation efforts correlated with higher odds of quitting smoking during pregnancy (OR 1.48, 95% CI 1.15-1.91). DISCUSSION: While pregnancy tobacco cessation interventions with partner support do exist, most were not successful and did not focus on couple-related concepts such as partner interactions, dyadic coping, and dyadic efficacy. The findings of the study are important because they bring new insights regarding the potential role of relationship characteristics to inform future cessation programs focused on pregnant smokers and their life partners.