Born in Belo Horizonte: the trajectory of parturient women and their reproductive outcomes

Abstract

Objective: To analyze the trajectory taken by pregnant women for delivery care in Belo Horizonte and its relation with the reproductive outcomes. Method: A cross-sectional study using a database from a study conducted in Belo Horizonte. The studied variables were referent to the trajectory of women seeking delivery care, to their social, demographic and health care characteristics, and to the reproductive outcomes. Odds Ratios were estimated with their 95% confidence intervals to evaluate the factors associated with unfavorable trajectory and outcomes. Results: A total of 1,087 cases were studied, of which 39.3% had an unfavorable trajectory. The chance of having an unfavorable trajectory was higher for women who were not Belo Horizonte residents, with lower education, non-white race/color, and who had undergone prenatal care in public healthcare service. The prevalence of reproductive outcomes was similar regardless of the trajectory status, except for vaginal delivery. Conclusion: An unfavorable trajectory remains high, and shows weaknesses in the health care services network to guarantee timely and qualified access to pregnant women. However, the care received in the health services outweighs the risks of an unfavorable trajectory.

Avaliação da qualidade dos registros de cartões de pré-natal de mulheres urbanas

“…However, the woman has the possibility to seek care elsewhere. Referencing pregnant women in the network avoids the problem of pilgrimage, that is, the need for the pregnant women to have to go through more than one unit, in search of delivery assistance, 16 in addition to guaranteeing the right of access to information and in line with care centered on the person -in this case, the woman. 3 This search for motherhood can lead to unfavorable outcomes for women and fetuses, due to inadequacies in meeting their needs.…”

“…3 This search for motherhood can lead to unfavorable outcomes for women and fetuses, due to inadequacies in meeting their needs. 11,16 In turn, the registration of the Basic Reference Unit -mainly in the antenatal care monitored in the Unified Health System (UHS) -allows referral and counter-referral, and the discharge responsible for continuity of care in the puerperium and the newborn. A hypothesis that would justify the devaluation of the registration of data related to the care network, is that it may not be well agreed between the levels of assistance -especially for pregnant women not residing in Belo Horizonte -, or even that the professionals are unaware of the agreed attention network.…”