Abstract
Objective:to analyze the time of access to care during labor and delivery and the safety of maternal health.Method:cross-sectional analytical study, carried out in five maternity hospitals, four of which are of habitual and intermediate risk and one of high risk. For data collection, data from the maternal medical record and interviews with the puerperal woman were used. In the data analysis, the Chi-square test (p≤0.05) was performed to search for possible associations between the independent variables - model three delays and dependents [Adverse maternal outcomes], [Knowledge about labor/delivery] and [Service satisfaction].Results:statistical significance was observed between the adverse maternal outcome and the delay in looking for a health service (p = 0.005) and the delay in transport to the maternity hospital (p = 0.050), while the outcome knowledge about labor/delivery showed statistical association with delay in looking for a health service (p = 0.048). There was no statistically significant difference between the three delays model and satisfaction with the care.Conclusion:the women’s knowledge about labor and delivery and the time of access to obstetric care negatively interferes with the maternal outcome at delivery, which directly impacts maternal health safety.
Highlights
IntroductionSafety and obstetric quality are emerging and important topics in the current health scenario, in addition to the pressure and expectations of patients and families for positive results, health service managers are concerned with harmless care and better care outcomes being provided to the population[1].In this context, an important factor for the safety and quality of maternal care is the timely access to obstetric services, because the delay in receiving obstetric care is significantly associated with the severity of adverse maternal outcomes[2].The authors developed a model called “three delays” to assess access to obstetric care, broken down into three components or phases: [1] delay in the decision to look for the health service; [2] delay in identifying and reaching the appropriate health service; and [3] delay in receiving adequate care at the appropriate time
Conclusion: the women’s knowledge about labor and delivery and the time of access to obstetric care negatively interferes with the maternal outcome at delivery, which directly impacts maternal health safety
This study identified that a significant portion of women received guidance on which maternity hospital to seek and the availability of mobile service in an emergency, less than a third of them were transported to the obstetric service by ambulance, as two thirds had access to the maternity hospital on their own, which may have contributed to the increase in the decision time to look for the health service and the transportation time to the maternity hospital
Summary
Safety and obstetric quality are emerging and important topics in the current health scenario, in addition to the pressure and expectations of patients and families for positive results, health service managers are concerned with harmless care and better care outcomes being provided to the population[1].In this context, an important factor for the safety and quality of maternal care is the timely access to obstetric services, because the delay in receiving obstetric care is significantly associated with the severity of adverse maternal outcomes[2].The authors developed a model called “three delays” to assess access to obstetric care, broken down into three components or phases: [1] delay in the decision to look for the health service; [2] delay in identifying and reaching the appropriate health service; and [3] delay in receiving adequate care at the appropriate time. Safety and obstetric quality are emerging and important topics in the current health scenario, in addition to the pressure and expectations of patients and families for positive results, health service managers are concerned with harmless care and better care outcomes being provided to the population[1]. In this context, an important factor for the safety and quality of maternal care is the timely access to obstetric services, because the delay in receiving obstetric care is significantly associated with the severity of adverse maternal outcomes[2]. When there is any obstetric complication during labor and delivery, the importance of recognizing danger signs, the quick search for care and the provision of adequate care in a timely manner are fundamental to safety maternal health
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