Access to care during labor and delivery and safety to maternal health

Abstract

<jats:p> Objective: to analyze the time of access to care during labor and delivery and the safety of maternal health. Method: cross-sectional analytical study, carried out in five maternity hospitals, four of which are of habitual and intermediate risk and one of high risk. For data collection, data from the maternal medical record and interviews with the puerperal woman were used. In the data analysis, the Chi-square test (p≤0.05) was performed to search for possible associations between the independent variables - model three delays and dependents [Adverse maternal outcomes], [Knowledge about labor/delivery] and [Service satisfaction]. Results: statistical significance was observed between the adverse maternal outcome and the delay in looking for a health service (p = 0.005) and the delay in transport to the maternity hospital (p = 0.050), while the outcome knowledge about labor/delivery showed statistical association with delay in looking for a health service (p = 0.048). There was no statistically significant difference between the three delays model and satisfaction with the care. Conclusion: the women’s knowledge about labor and delivery and the time of access to obstetric care negatively interferes with the maternal outcome at delivery, which directly impacts maternal health safety.</jats:p>

Women’s perception of labor and birth care: obstacles to humanization

“…Although the results show that its applicability has a shorter duration in the second period of childbirth, there was an important increase in the risk of severe perineal lacerations, uterine rupture, dyspareunia and urinary incontinence six months after childbirth, in addition to neonatal complications such as shoulder dystocia, increased risk of a fifth minute Apgar score below seven, in addition to fetal sequelae such as hypoperfusion and cerebral palsy (21) . We need to expand discussions in the field of health work, focusing on job qualification, based on scientific evidence, expanding the reconfiguration of care during childbirth and childbirth described by health policies, especially humanization (1)(2)(3)9,14) , inducing the childbirth care model transition in Brazil.…”

“…Childbirth safety is currently one of the milestones of current obstetric care and one of the emerging topics in the international health scenario, beyond women's expectations, a care that affects their health without harm and with better outcomes in the care provided at work of childbirth and birth (1) . It becomes necessary, in addition to timely access to health services (1) , a practice based on scientific evidence and without the use of outdated behaviors that are still employed in the context of care, being contradicted by guidelines and recommendations of international entities and the World Health Organization (WHO), which contributes to a transformation of obstetric care as a redefinition of behaviors adopted by health professionals (2)(3) .…”

“…However, it is still necessary to implement changes in line with these important initiatives, as obstetric care presents some obstacles to the use of these practices, such as the lack of: professional training, institutional policy; maternity hospital infrastructure, knowledge of women and caregivers about their reproductive rights; attitude of reframing by professionals, in view of their performance and the care model. Moreover, there is an asymmetric relationship between health professionals and women, causing a crisis of confidence (1,(6)(7)(10)(11)(12) .…”

Pengaruh Sosial Ekonomi terhadap Pemilihan Pelayanan Kesehatan Maternal

“…Kemungkinan aksesibilitas sebagai hambatan utama lain yang muncul, termasuk masalah seperti jarak ke fasilitas kesehatan, sistem rujukan yang buruk, dan pengeluaran yang mungkin muncul harus dipertimbangkan. Penelitian sebelumnya menunjukkan bahwa kedekatan dengan fasilitas kesehatan merupakan faktor utama bagi ibu hamil dalam memilih layanan persalinan [15], [16]. Masalah seperti kurangnya pilihan transportasi dan infrastruktur transportasi yang buruk dapat mengakibatkan peningkatan biaya kunjungan perawatan kesehatan.…”

A percepção do cuidado centrado na mulher por enfermeiras obstétricas num centro de parto normal

“…Considerando o contexto da assistência, marcado por uma deficiência na estrutura dos serviços maternos e por obstáculos no acesso às redes de atenção, a assistência obstétrica se apresenta prejudicial à saúde perinatal, somado à epidemia de cesariana e às intervenções desnecessárias. Esses fatos se apresentam negativamente para as mulheres no país e são fatores impeditivos para garantir a efetividade das metas internacionais trazidas nos Objetivos do Desenvolvimento Sustentável (ODS) 2030, os quais buscam uma melhor qualidade e a demonstração de redução de indicadores da saúde materna, em especial quanto às condutas obstétricas e à mortalidade materna 6 .…”