Childbirth care in Brazil: a critical situation has not yet been overcome. 1999-2013

Abstract

Objectives: to analyze the evolution of childbirth care in Brazil, between 1999-2013. Methods: a time-series ecological study, using data from Ministry of Health, Brazilian Institute of Geography and Statistics, and Interagency Network of Information for Health. 18 indicators were analyzed related to childbirth and mortality. Results: there was a reduction in rates of fertility, natality and the total number of births, with increased cesarean surgeries. Growth of prenatal consultation, intensive care beds and reduction of beds in obstetrics sector. The significant growth of caesarean deliveries, prenatal consultation coverage and concentration of births in hospitals occurred simultaneously with the growth: of preventable child deaths by adequate attention, management causes and appropriate delivery, prematurity; low weight; Down's syndrome; and the persistence of maternal deaths due to direct obstetric causes. Conclusions: persists hegemonic technocratic model of childbirth care without considering the observed changes in the profile of mothers and births, with slow reduction of perinatal and neonatal deaths and maintenance of high maternal mortality demonstrating that the critical situation of delivery care model in Brazil has not, yet, been overcome.

Evitabilidade Do Óbito Infantil E Fetal: Interlocução Entre Comitê E Atenção Primária À Saúde

“…Em relação ao pré-natal, outro estudo demonstra que, apesar do aumento do número de consultas no pré-natal e da cobertura, a assistência prestada não apresenta qualidade satisfatória, o que acaba por comprometer a prevenção, diagnóstico e tratamento das mães e bebês (16) .…”

Evaluation of the Maternal Health Indicators: An Ecological Study from 2000 to 2014

“…According to Silva et al [16], this increase presupposes the extension of the pregnant access to the prenatal assistance. …”

“…On Viellas et al [24] research, 73.1% of the pregnants underwent through six or more prenatal queries. On the Silva et al [16] study, there was an annual average increase superior to 28 thousand supported pregnant with more than seven queries, on public or private network.…”

“…Likewise, according to the study of Silva et al [16], which analyzed the data from 1999 to 2013 in Brazil, there were a decline on the normal childbirth and an increasing of 63.68% on the cesarean occurrences.…”

A qualidade do atendimento ao parto na rede pública hospitalar em uma capital brasileira: a satisfação das gestantes

“…Estudos demonstram que o acesso aos serviços obstétricos não é igualitário 6,7 , há iniquidade na distribuição de unidades e leitos 8 , inadequações de estrutura das maternidades 9,10 , persistência no desenvolvimento das práticas obstétricas não recomendáveis, tais como uso de ocitocina, episiotomia, manobra de Kristeller, entre outras 4,5,11,12 , além do aumento constante das taxas de cesarianas, da prematuridade e do baixo peso ao nascer caracterizando a fragilidade dos cuidados prestados 13,14,15 .…”