Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study

• Autor(a) principal: Zaiden,Laura
• Data de Publicação: 2022
• Outros Autores: Nakamura-Pereira,Marcos, Gomes,Maria Auxiliadora Mendes, Esteves-Pereira,Ana Paula, Matos,Caio Pereira de, Barros,Lucas de Araujo, Takemoto,Maíra Libertad Soligo, Leal,Maria do Carmo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Ciência & Saúde Coletiva (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232022000702741
• topic: Maternal and child health; Caesarean section; Delivery; Outcome and process assessment (Health Care)

Abstract Collaborative models (CM) focused on intrapartum care shared between both midwives and obstetricians have been proposed as a strategy to reduce these rates. Our aim was to compare use of evidence-based practices, obstetric interventions and c-section rates in two settings: a maternity hospital that applies a CM of care (MRJ) and data from a pool of maternity hospitals included in the Birth in Brazil Survey (NB) that do not adopt a CM. Data was abstracted from medical and administrative records in MRJ and from medical records and face-to-face interviews in NB. Differences were compared using chi-square test, with significance level set at p<0.05. MRJ showed a higher frequency of labour companionship, labour care provided by nurse midwives, non-pharmacological pain relief methods, food intake during labour, and less use of oxytocin, analgesia and amniotomy. More women also had second stage assisted by a nurse midwife and in a vertical position, as well as lower use of episiotomies and vacuum-extractor/forceps. The c-section rate was lower at MRJ. Shared care between midwives and obstetricians can be an effective strategy to improve quality of intrapartum care.