Perspectives of professionals and human rights associations on the IMAgiNE EURO study

The year 2020 will be remembered around the globe as the time when our lives, our health systems, and our worlds turned on end. Warnings about the risks of pandemics, especially the lack of preparedness for a pandemic, had circulated since the emergence of MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome). However, no country, no health system, nor the World Health Organization, to say nothing of our hospitals, was prepared for what 2020– 2022 brought us. The articles in this Supplement.1– 10 chronicle the risk of pregnancy during COVID19, particularly the vulnerability of women giving birth during a pandemic. Globally, we now understand the serious vulnerability and risk of complications women face when they develop COVID19 during pregnancy, from the risk of stillbirth and placentitis, to the risks of respiratory distress, need for intensive care, and for extracorporeal membrane oxygenation in pregnancy.11– 13 We also now appreciate, two years after the pandemic, the importance of vaccination and disinformation. However, the articles in this Supplement take us back to the beginning— when the care for a mother and family came secondary to the fear of COVID19— and provide a maternal perspective on the quality of care delivered. The articles originate from a multicountry survey on maternal and newborn health service preparedness, quality, and resilience during the pandemic, and they help us to understand the choices made. Choices that sacrificed communication, shared decisionmaking, and respect. The COVID19 pandemic has had a profound impact on the health and wellbeing of populations. Pregnancy places women at increased risk for anxiety and depression, and the ramifications of COVID19 are felt at home and at work, and with financial loss. For women admitted for hospital care, the lack of control and the loss of autonomy, as expressed in these articles, highlight that we must do better. When we speak of disaster preparedness, the needs of women and families must be prioritized and that can only happen with awareness and attention to history. Plus, a conscious decision by those coordinating health systems that we will learn from the past and prepare for the future, with respect at all levels for families, for providers, and for colleagues. FIGO's work through our Divisions and Committees— made up of more than 250 international healthcare experts, including 180 OBGYNs— is designed to support such efforts through collaboration, helping to ensure safe and respectful care across the lifespan for all women and girls (Figure 1). An important message from this research is that such collaboration and respect must be central themes across all health care. We know that integrating information from surveys like IMAgiNE EURO can contribute to quality of care and foster team building.