Abstract
ABSTRACTOBJECTIVETo analyze if the presence of a companion favors the use of best practices in the delivery care in the South region of Brazil.METHODSThis is a cross-sectional analysis of the longitudinal study Nascer no Brasil. We analyzed data from 2,070 women from the South region of Brazil who went into labor. The data were collected between February and August 2011, by interviews and medical records. We performed a bivariate and multivariate analysis, calculating the crude and adjusted prevalence ratios using Poisson regression with robust variance estimation. The level of significance adopted was 5%.RESULTSMost women had a companion during labor (51.7%), but few remained during delivery (39.4%) or cesarean section (34.8%). Less than half of the women had access to several recommended practices, while non-recommended practices continue to be performed. In the model adjusted for age, education level, source of payment for the delivery, parity, and score of the Brazilian Association of Market Research Institutes, the presence of a companion was statistically associated with a greater supply of liquids and food (aPR = 1.34), dietary prescription (aPR = 1.34), use of non-pharmacological methods for pain relief (aPR = 1.37), amniotomy (aPR = 1.10), epidural or spinal analgesia (aPR = 1.84), adoption of non-lithotomy position in the delivery (aPR = 1.77), stay in the same room during labor, delivery, and postpartum (aPR = 1.62), skin-to-skin contact in the delivery (aPR = 1.81) and cesarean section (PR = 2.43), as well as reduced use of the Kristeller maneuver (aPR = 0.67), trichotomy (aPR = 0.59), and enema (aPR = 0.49).CONCLUSIONSIn the South region of Brazil, most women do not have access to the best practices in addition to undergoing several unnecessary interventions. The presence of a companion is associated with several beneficial practices and the reduction in some interventions, although other interventions are not impacted.
Highlights
SC, Brasil IV Universidade Federal de Santa Catarina
Foram analisados dados de 2.070 mulheres da região Sul que entraram em trabalho de parto
Conflito de Interesses: Os autores declaram não haver conflito de interesses
Summary
ABIPEME: Classificação econômica preconizada pela Associação Brasileira de Empresas de Pesquisa; MNF: método não-farmacológico; PPP: pré-parto, parto e pós-parto. A presença do acompanhante durante o trabalho de parto associou-se à redução no uso de tricotomia (RPa = 0,59; IC95% 0,53–0,65) e de enema (RPa = 0,49; IC95% 0,43–0,56). A Tabela 3 apresenta as prevalências e razões de prevalências brutas e ajustadas das práticas obstétricas realizadas durante o parto, de acordo com a presença do acompanhante no momento do parto/nascimento. No momento do nascimento do bebê, a presença do acompanhante permaneceu significativamente associada à adoção pela mulher de posições diferentes da litotômica (RP = 1,77; IC95% 1,16–2,72), à permanência na sala PPP (RP = 1,62; IC95% 1,31–2,00) e ao contato pele a pele entre a mãe e o bebê logo após o nascimento, tanto no parto (RP 1 ,81; IC95% 1,64–1,99) quanto na cesariana (RP = 2,43; IC95% 1,22–4,85). Durante o trabalho de parto, de acordo com a presença do acompanhante.
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