Delivery and postpartum care in Rio Branco in the northern state of Acre, Brazil: a population based survey
DOI:
https://doi.org/10.7322/jhgd.118010Keywords:
natural childbirth, cesarean section, postpartum periodAbstract
Introduction: Pregnancy can be associated with health risks for both the mother and infant, and specialised care during the pregnancy, delivery and puerperium periods can help reduce complications for the mother-infant binomial.
Objective: To assess the demographic, social and reproductive aspects of delivery and the postpartum period in Rio Branco, Acre, Brazil.
Methods: A population-based cross-sectional survey was conducted via an interview with 552 mothers with children aged 0 to 5 years between 2007 and 2008. Cluster sampling of the population was performed in two stages (census sectors and domiciles).
Results: The majority of the 552 mothers were multiparous (79.6%). Around 70% of pregnancies occurred in teenage mothers. The proportion of caesarean section deliveries was 38.4% in mothers from urban zones and 28.5% in those from rural areas, and was higher in mothers who attended private clinics, who self-reported as being Caucasian, and who had a higher educational level. With regard to puerperal complications, mothers who underwent caesarean section had a higher prevalence of hypertension (71.1%) with an adjusted prevalence ratio of 3.90 (95% CI [2.00, 7.61]).
Conclusions: The results revealed a high rate of teenage pregnancy, and arterial hypertension was the leading complication during the postpartum period experienced by women who had undergone caesarean section. These findings merit further attention, and should be used to improve the care provided to Rio Branco.
References
Lawn JE, Cousens S, Zupan K; Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: When? Where? Why? Lancet. 2005;365(9462):891-900. DOI:
http://dx.doi.org/10.1016/S0140-6736(05)71048-5
World Health Organization (WHO). Health and the milennium development goals. Geneva: World Health Organization, 2005.
Brasil. Centro Brasileiro de Análise e Planejamento. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher: PNDS 2006. Dimensões do processo reprodutivo e da saúde da criança. Brasília: Ministério da Saúde, 2009.
Leal MC, Pereira APE, Domingues RMSM, Theme Filha MM, Dias MAB, Nakamura-Pereira M, et al. Intervenções obstétricas durante o trabalho de parto e parto em mulheres brasileiras de risco habitual. Cad Saúde Pública. 2014;30(suppl 1):S17-32. DOI: http://dx.doi.org/10.1590/0102-311X00151513
Roberts CL, Tracy S, Peat B. Rates of obstetric intervention among private and public patients in Australia: population based descriptive study. BMJ. 2000;321(7254):137-41. DOI: https://dx.doi.org/10.1136/bmj.321.7254.137
Cecatti JG. Saúde da mulher: Enfoque da evidência científica para a prevenção da morbidade e mortalidade materna. Rev Bras Saude Mater Infant. 2005;5(1):9-11.
World Health Organization (WHO). Mannaging complications in pregnancy and childbirth: a guide for midwives and doctors. Geneva: WHO/ UNFPA/ UNICEF/ World Bank, 2000.
Viggiano MB, Viggiano MGC, Souza E, Camano L. Necessidades de cuidados intensivos em maternidade pública terciária. Rev Bras Ginecol Obstet. 2004; 26(4):317-23. DOI: http://dx.doi.org/10.1590/S0100-72032004000400009
Starrs A. The safe motherhood action agenda: priorities for the next decade. Proceedings. Washington, DC: World Bank, 1997.
World Health Organization. Appropriate technology for birth. Lancet. 1985; 2(84532):436-67. DOI: https://doi.org/10.1016/S0140-6736(85)92750-3
Bofante TM, Silveira GC, Sakae TM, Sommacal LF, Fedrizzi EN. Fatores associados à preferência pela operação cesariana entre puérperas de instituição pública e privada. Arq Catarin Med. 2009;38(1):26-32.
Domingues RMSM, Dias MAB, Nakamura-Pereira M, Torres JA, d'Orsi E, Pereira APE, et al. Processo de decisão pelo tipo de parto no Brasil: da preferência inicial das mulheres à via de parto final. Cad Saude Publica. 2014; 30(suppl1): S101-16. DOI: http://dx.doi.org/10.1590/0102-311X00105113
Félix GMA, Gomes APR, França PS. Depressão no ciclo gravídico-puerperal. Comun Ciencias Saude. 2008;19(1):51-60.
Holmes, DS. Psicologia dos transtornos mentais. 2ed. Porto Alegre: Artmed; 2001.
Queiroz MVO, Jorges MSB, Marques JF, Cavalcante AM, Moreira KAP. Indicadores de qualidade da assistência ao nascimento baseado na satisfação de puérperas. Texto Contexto Enferm. 2007;16(3):479-87. DOI: http://dx.doi.org/10.1590/S0104-07072007000300014
Potter JE, Berquo E, Perpetuo IH, Leal OF, Hopkins K, Souza MR, et al. Unwanted caesarean sections among public and private patients in Brazil: prospective study. BMJ. 2001;323(7322):1155-8. DOI: https://dx.doi.org/10.1136/bmj.323.7322.1155
Gama SGN, Viellas EF, Schilithz AOC, Theme Filha MM, Carvalho ML, Gomes KRO, et al. Fatores associados à cesariana entre primíparas adolescentes no Brasil, 2011-2012. Cad Saude Publica. 2014; 30(suppl 1): S117-27. DOI: http://dx.doi.org/10.1590/0102-311X00145513
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