BACKGROUND:
Improving maternal care requires alignment with WHO standards, including optimal use of cesarean section (CS), appropriate episiotomy practices, informed consent, pain relief, and the avoidance of outdated or harmful procedures such as the fundal pressure.

OBJECTIVES:
This study aimed to compare key indicators of childbirth care and maternal experiences in Italy, Latvia, Lithuania, and Poland, to inform improvements in quality of care.

METHODS:
Women aged 18 and older who gave birth in healthcare facilities between January 2022 and December 2024 filled in a validated, multilingual questionnaire as part of the IMAgiNE GLOBAL study. Comparative analysis was conducted across countries, focusing on mode of delivery, consent practices, use of interventions, and pain management.

RESULTS:
Data from 21,221 women were analysed (Italy: 18,190; Latvia: 889; Lithuania: 850; Poland: 1,292). Vaginal birth rates ranged from 57.7% (Polland) to 79.3% (Lithuania). Freedom to choose birthing position was highest in Italy (63.1%) and lowest in Lithuania (24.2%). Episiotomy rates varied from 16.6% in Latvia to 48.0% in Lithuania. The fundal pressure was reported by 14.0% to 25.6% of women having vaginal births. Informed consent for instrumental delivery lacked in most women, ranging from 30.0% in Lithuania to 48.7% in Poland. Pain relief during emergency CS was reported by 78.7% in Italy and 94.7% in Lithuania. For planned CS, the figures were 81.2% and 95.2% respectively. After Ss, 74.9% of mothers in Poland reported receiving information about their newborn, compared to only 36.8% in Lithuania.

CONCLUSIONS:
Wide variations in childbirth practices across countries highlight the need to strengthen respectful, evidence-based, and patient-centered care in maternity services.

KEY MESSAGE:
Promoting informed consent, reducing unnecessary interventions such as fundal pressure, and ensuring access to pain relief are critical to advancing maternal care quality across Europe. Poster session 4 (Group B)