Objective:
To investigate the quality of maternal and newborn care (QMNC) during facility childbirth in Greece from women's perspectives.

Material and Methods:
Women giving birth in Greek facilities from March 2020 answered a validated online WHO standards-based questionnaire as part of the multicountry “Improving MAternal Newborn carE In the EURO Region (IMAgiNE EURO)” study. Data were collected from July 2022 to March 2023 regarding women experiences when giving birth from 1th March 2020. Descriptive analyses were performed and the Cochran-Armitage test was used for time trend comparisons.

Results:
A total of 2277 women giving birth in maternity hospitals in Greece during the study period were included. More than a half (54.5% n=1242) reported having a cesarean, 65.2% (n=133/204 women who experienced an instrumental vaginal birth) were not asked for consent prior to instrumental vaginal birth and 67.7% (n=504/745 women who experienced a vaginal birth) could not choose their birth position. Most women evaluated as positive their experience when giving birth (n=1924, 84.5%), although specific gaps were observed: 19.3% (n=440) of women reported not being treated with dignity, 9.9% (n=225) experienced abuse of which 57.8% (n=130) reported an emotional abuse (women could report multiple types of abuse) and 48.6% (n=1106) declared that healthcare professionals were not able to use effective communication methods to decrease the stress related to COVID-19 pandemic. Finally, 55.2% (n=1255) exclusively breastfed at discharge (without significant differences over trimester time periods, p=0.194).

Conclusions:
Even though maternal reports indicate a generally high satisfaction among women giving birth in Greece, improvements are still needed. There is an urgent need to implement national initiatives to reduce caesarean, increase exclusive breastfeeding rates and promote maternal autonomy and evidence-based, patient-centered respectful care for all mothers and newborns.