Factors associated with the route of birth delivery in a city in the Northeast region in the State of Rio Grande do Sul, Brazil

Silvane Rasador,Claides Abegg

doi:10.1590/1806-93042019000400004

Abstract

Abstract Objectives: to investigate factors associated with the route of birth delivery in a hospital extending public and private healthcare services, in the Northeast region in the State of Rio Grande do Sul. Methods: a cross-sectional study with 676 postpartum women, conducted from January to May 2017. The data were collected from the hospital records and women were interviewed shortly after childbirth in the maternity. Data analysis was performed by associating the Pearson’s chi-square and the Poisson regression tests with robust variance. Results: the prevalence of cesarean sections was 58.7%, that is, 41.7% in public health-care and 83.9% in private healthcare. The main reason for having a cesarean section was having had a previous one (PR=5.69; CI95%=3.64 - 8.90; p<0.001), followed by having source of childbirth financing (PR=1.54; CI95%=1.27 - 1.87; p<0.001), having source of prenatal care financing (PR=1.48; CI95%=1.22 - 1.79; p<0.001), the childbirth and prenatal care professional (PR=1.46; CI95%=1.28 - 1.66; p<0.001) and the prenatal care professional (PR=1.43; CI95%=1.07 - 1.90; p=0.016). Conclusions: the high cesarean section rates identified in this study were mainly associated with previous cesarean section. The findings suggest a change in the current childbirth care model in the city, characterized as highly medicalized, focused on the physician and on hospital care.

Highlights

As far as the nineteenth century, pregnant women care was performed by midwives, women who learned in practice of childbirth, which occurred in a home environment.[1]
When evaluating the type of childbirth in accordance with the prenatal financing, we found a cesarean section prevalence of 48% in women who performed their prenatal using the private healthcare service, when compared to those who performed at the public healthcare service (PR=1.48; CI95%=1.22-1.79; p
We identified high cesarean section rates which were associated with previous cesarean section, childbirth and private financing for prenatal care; the same professional who performed both the prenatal care and childbirth; performed prenatal care only

Summary

Introduction

As far as the nineteenth century, pregnant women care was performed by midwives, women who learned in practice of childbirth, which occurred in a home environment.[1] As of the twentieth century, childbirth became a medical event and it started to take place inside a hospital environment.[2] The institutionalization of childbirth and specially the fact that the childbirth is seen as a medical event added to a reduction of vaginal birth and increased cesarean section.[3]. There are still lack of evidences to prove the benefits of cesarean sections in women and babies who do not need this surgery.[5]

Objectives

Methods

Results

Conclusion