Abstract
Abstract Objectives: to evaluate prenatal care provided to low-risk pregnant women users of the Sistema Único de Saúde (SUS) (Public Health System) in the city of Joinville, SC. Methods: this is a cross-sectional observational study carried out from March 2018 to February 2019, through interview and analysis of the Pregnant Card of puerperal over 18 years old, from Joinville, who underwent prenatal care at SUS, excluding recent given up puerperal. Prenatal care was evaluated according to the recommended criteria by the Prenatal and Birth Humanization Program. Results: 683 mothers were interviewed. The criteria with the highest levels of adequacy were accessibility (99.6%), early initiation on prenatal care (92.7%) and 6 or more consultations (87.1%) and the criteria with the lowest rates of adequacy were the set of guidelines (17.7%) and the third and first trimester exams (42.5% and 63.5% respectively). Conclusion: it is concluded that the prenatal care provided by SUS in the city of Joinville, despite the almost universal accessibility, the early onset and the prevalence of puerperal women with more than 6 consultations, showed a sharp decline in the analysis of the recommended indicators.
Highlights
Prenatal care (PNC) is one of the pillars of maternal and child healthcare, whose relevance in reducing morbidity and mortality in this population is already established[1-3]
According to the World Health Organization (WHO), it is estimated that, in 2015, 303 thousand women died from preventable causes related to pregnancy, 2.7 million babies died in the neonatal period and 2.6 million fetuses were stillborn.[7]
Interviews were applied to all puerperal women who had the inclusion criteria for this study: age 18 years or more, carried out low-risk PN care entirely in the public health in the city of Joinville, have at hand the Pregnant Card, speak and understand Brazilian Portuguese language and accept to voluntarily participate in the study, by reading and agreeing to the Termo de Compromisso Livre e Esclarecido (TCLE) (Informed Consent form), being told about the free will to leave the research at any time
Summary
Prenatal care (PNC) is one of the pillars of maternal and child healthcare, whose relevance in reducing morbidity and mortality in this population is already established[1-3]. Studies conducted in 2015 and 2012 in the city of Joinville, analyzed respectively 4,206 puerperal medical records and 921 babies admitted to a Neonatal Unit, concluded that pregnant women who had 6 or fewer PNC consultations had more complications during pregnancy and the fetuses had low birth weight, higher risk of prematurity and neonatal death.[4,5]. Corroborating this result, other studies carried out in 2011 and 2013 in the cities of São Paulo and Teresina, which analyzed 2,404 pregnant women and 208 puerperal women, respectively, clearly emphasized the relationship between PN care and the newborn's well-being.[1,6]. Regarding neonatal mortality rate between 2000 and 2015, there was a decrease from 16.7% to 9.4%.8,9
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