Prenatal care and childbirth assistance in Amazonian women before and after the Pacific Highway Construction (2003–2011): a cross-sectional study

Abstract

BackgroundAttention to prenatal care and child delivery is important for the health of women and children, but in the Amazon these indicators tend to be historically unfavorable, in part by geographical and political isolation. In 2003 both Brazilian and Peru governments have finished paving an international road connecting remotes areas in the Brazilian Amazon to the Pacific coast in Peru.MethodsThe situation of prenatal care and child delivery with mothers of children under 5 years old living in the urban area of Assis Brasil, Acre was assessed in two cross-sectional studies performed in 2003 and 2011, corresponding to the period before and after the Pacific highway construction.ResultsIn 2003, most mothers were of black/Afro-American ethnicity, or “pardos” (the offspring of a Caucasian with a African descendant) (77.69 %), had more than 4 years of schooling (73.40 %) and had a mean age of 22.18 years. In 2011, the number of as a migration of indigenous women increased from 0 to 14.40 % of the respondents, because of migration from communities along the rivers to urban areas, with no other significant changes in maternal characteristics. No significant improvement in childbirth assistance was noticed between 1997 and 2011; only the percentage of in-hospital vaginal deliveries performed by doctors increased from 17.89 to 66.26 % (p <0.001) during this period. Access to prenatal care was associated with white ethnicity in 2003, and higher socioeconomic level and white ethnicity in 2011, while the higher number of prenatal visits was associated with higher maternal education and higher socioeconomic levels in 2011. Vaginal child delivery at a hospital facility was associated with maternal age in 2003, and year of birth, being of white ethnicity and higher level of education in 2011.ConclusionsThe indicators of prenatal care and child delivery were below the national average, showing that geographical isolation still affects women’s health care in the Amazon, despite the construction of the highway and governmental health protocols adopted during this period.

Critical linkages between land use change and human health in the Amazon region: A scoping review

“…Eight out of 14 papers described negative relationships between LUC and health [ 25 – 32 ], one depicted positive [ 33 ], and five demonstrated neutral/mix correlations [ 13 , 34 – 37 ]. The most common health issue was lung health [ 13 , 29 , 33 , 34 , 36 ], followed by mosquito-borne illnesses [ 13 , 31 ] and rabies [ 26 , 37 ].…”

“…Road building is considered a particularly damaging form of LUC in tropical forests [ 38 ] and was the most commonly addressed in the analyzed articles [ 13 , 26 , 27 , 30 , 32 ]. Andrade et al (2016) found that the presence of highways was related to a higher risk of contracting bovine and human rabies in the state of Pará, Brazil [ 26 ].…”

“…There also continued to be a low number of institutionalized births (compared to the national average), suggesting the continued use of in-house childbirth. [ 32 ].…”

Parto E Nascimento Na Fronteira Franco-Brasileira: Percepções De Enfermeiros

“…Nesse sentido, as colaboradoras explicitaram que é rotineira a chegada de parturientes na unidade hospitalar com ausência de pré-natal ou número de consultas insuficientes, conforme recomendado pela Rede Cegonha (19) . Este fato converge com o verificado em alguns inquéritos de saúde, em que a Região Norte do Brasil apresentou os piores escores do Programa de Melhoria do Acesso e da Qualidade pré-natal (20)(21)(22) . A pesquisa Nascer no Brasil também verificou que a atenção inadequada ao pré-natal, assim como as mulheres que residiam na Região Norte e as que ficaram sem acompanhantes durante a internação, apresentaram elevada taxa de mortalidade neonatal (21) .…”

Análise da adesão ao pré-natal em um censo de gestantes adolescentes do leste de Minas Gerais / Analysis of prenatal adhesion in a census of pregnant adolescents in east Minas Gerais

“…9 Em razão disso, é ideal que a mãe inicie o mais precocemente possível o acompanhamento pré-natal e que sejam realizadas a monitorização de aspectos físicos e laboratoriais, ações de educação em saúde pré-natal e intraparto, com encorajamento para que o parto seja via vaginal e para o aleitamento materno exclusivo até o sexto mês de vida do bebê. 10,11 Além disso, destaca-se que o Ministério da Saúde (MS) (2013) 12 recomenda um número mínimo de seis consultas pré-natal (CPN), com registro das informações da paciente no momento da consulta e de todos os procedimentos preconizados na caderneta da gestante.…”