Nearly all participants reported having experienced at least one category of disrespect and abuse during childbirth care, which was associated with type of delivery, being referred, and geographic region.

Introducción y objetivos: En el Perú, un país en vías de desarrollo, las cifras de partos domiciliarios en zonas rurales incrementan las tasas de mortalidad materna y neonatal, por tal razón el objetivo del trabajo fue: Determinar la prevalencia y características de los partos domiciliarios en la provincia de Ocongate, zona rural del departamento de Cusco en la sierra del Perú, 2015-2016. Materiales y Métodos: Se realizó un estudio observacional, de diseño de casos y controles, donde se incluyó 46 casos, de mujeres con parto domiciliario y 100 controles con partos institucionales registrados en los años 2015 y 2016, se exploraron resultados descriptivos de características sociodemográficas y Gineco-Obstétricas. Realizando análisis bivariado con la prueba estadística del chi cuadrado, calculando los Odds Ratio e intervalos de confianza al 95% (IC95%) con Regresión Logística Múltiple. Resultados: De 558 partos registrados 49 (8,7%) fueron partos domiciliarios, donde la edad promedio fue de 25,3 ± 6,4 años; en el análisis multivariado encontró que: no tener ningún control prenatal [OR=12,2; IC95% 4,6-64,9]; tener antecedente de parto domiciliario [OR=4,5; IC95% 1,01-20,5]; vivir a una distancia > de 90 minutos [OR=3,2; IC95% 1,08-10,2]; y tener una captación tardía de a gestante, ser factores de riesgo para tener un parto domiciliario. Conclusiones: En la mayoría de mujeres que tuvieron partos domiciliarios influyó negativamente la captación tardía de la gestante, un mayor tiempo de viaje al centro de salud, antecedente de parto domiciliario, y no tener ningún control prenatal, siendo necesario diseñar estrategias para disminuir los partos domiciliarios en zonas rurales del Perú.

Background A high number of vaginal examinations (VEs) may lead to a higher risk of infections, as well as discomfort/dissatisfaction with intrapartum care. Objective To determine the frequency of potential excess of vaginal examinations (PEVE) during the management of labor and identify its associated factors, in Peruvian hospitals. Methods Secondary analysis of the data collected in the DisrespEct and abuse during ChIlDbirth in pEru (DECIDE) study, held between April and May 2016. In this study, women hospitalized in Peruvian hospitals right after giving birth were surveyed by trained personnel. PEVE, the main outcome, was considered as five or more vaginal examinations (VEs) performed during the management of labor. Poisson regression models with robust variance were performed to calculate crude and adjusted prevalence ratios (cPR and aPR) as well as their 95% confidence intervals (95% CI). Results One thousand four hundred twenty registries of 13 hospitals from 8 Peruvian cities were evaluated. The number of women studied at each hospital ranged between 100 and 129. The median age was 26 years (interquartile rank: 22–31). The median number of VEs was 3 (interquartile rank: 2–5). The proportion of women who underwent PEVE was 33.9%, this ranged from 0.9 to 69.9% at the studied hospitals. The frequency of PEVE was higher in women who attended > 2 obstetric psychoprophylaxis sessions, compared to those who attended ≤ 2 sessions (aPR: 1.78 95% CI: 1.01–3.12); and among women who gave birth between 18:00 h and 23:59 h, compared to those who did it between 7:00 and 17:59 h (aPR: 1.28 95% CI: 1.04–1.57). Conclusion Around one in three women underwent a PEVE, although this frequency varied widely across the evaluated hospitals. Women with more psychoprophylaxis sessions, and who gave birth between 18:00 h and 23:59 h, had a higher PEVE frequency. Future studies should assess in depth the causes and consequences of this high frequency.

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