Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study
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 hospi...
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| Veröffentlicht in: | Ciência & saude coletiva 2022, Vol.27 (7), p.2741-2752 |
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| creator | Zaiden, Laura 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 |
| description | 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 |
| doi_str_mv | 10.1590/1413-81232022277.20632021 |
| format | Article |
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Resumo Modelos colaborativos (MC) com foco no cuidado intraparto compartilhado entre parteiras e obstetras têm sido propostos como uma estratégia para reduzir essas taxas. Nosso objetivo foi comparar o uso de práticas baseadas em evidências, intervenções obstétricas e taxas de cesarianas em dois ambientes: uma maternidade que aplica um MC de atendimento (MRJ) e dados de um conjunto de maternidades incluídas na pesquisa Nascer no Brasil (NB) que não adotam um MC. Os dados foram extraídos de prontuários médicos e documentos administrativos no MRJ e de prontuários e entrevistas presenciais em NB. As diferenças foram comparadas pelo teste do qui-quadrado, com nível de significância estabelecido em p<0,05. MRJ apresentou maior frequência de acompanhante no parto, assistência ao parto por enfermeiras obstétricas, métodos não farmacológicos de alívio da dor, ingestão de alimentos durante o trabalho de parto e menor uso de ocitocina, analgesia e amniotomia. Mais mulheres também tiveram o parto assistido por enfermeira obstétrica e em posição vertical, bem como menor uso de episiotomias e vácuo-extrator/fórceps. A taxa de cesariana foi menor no MRJ. O cuidado compartilhado entre enfermeiras e obstetras pode ser uma estratégia eficaz para melhorar a qualidade do cuidado intraparto.</description><identifier>ISSN: 1413-8123</identifier><identifier>ISSN: 1678-4561</identifier><identifier>EISSN: 1678-4561</identifier><identifier>DOI: 10.1590/1413-81232022277.20632021</identifier><language>eng</language><publisher>ABRASCO - Associação Brasileira de Saúde Coletiva</publisher><subject>Health Policy & Services</subject><ispartof>Ciência & saude coletiva, 2022, Vol.27 (7), p.2741-2752</ispartof><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-cbf9b348d00087eb016f9e7c4bda65370da42fe641aec455cee51885e198bad3</citedby><cites>FETCH-LOGICAL-c384t-cbf9b348d00087eb016f9e7c4bda65370da42fe641aec455cee51885e198bad3</cites><orcidid>0000-0001-5074-708X ; 0000-0001-9157-2271 ; 0000-0002-3047-515X ; 0000-0003-1243-2110 ; 0000-0002-0236-2043 ; 0000-0002-4231-0205 ; 0000-0001-5908-1763 ; 0000-0002-7016-2879</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,4009,27902,27903,27904</link.rule.ids></links><search><creatorcontrib>Zaiden, Laura</creatorcontrib><creatorcontrib>Nakamura-Pereira, Marcos</creatorcontrib><creatorcontrib>Gomes, Maria Auxiliadora Mendes</creatorcontrib><creatorcontrib>Esteves-Pereira, Ana Paula</creatorcontrib><creatorcontrib>Matos, Caio Pereira de</creatorcontrib><creatorcontrib>Barros, Lucas de Araujo</creatorcontrib><creatorcontrib>Takemoto, Maíra Libertad Soligo</creatorcontrib><creatorcontrib>Leal, Maria do Carmo</creatorcontrib><title>Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study</title><title>Ciência & saude coletiva</title><addtitle>Ciênc. saúde coletiva</addtitle><description>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.
Resumo Modelos colaborativos (MC) com foco no cuidado intraparto compartilhado entre parteiras e obstetras têm sido propostos como uma estratégia para reduzir essas taxas. Nosso objetivo foi comparar o uso de práticas baseadas em evidências, intervenções obstétricas e taxas de cesarianas em dois ambientes: uma maternidade que aplica um MC de atendimento (MRJ) e dados de um conjunto de maternidades incluídas na pesquisa Nascer no Brasil (NB) que não adotam um MC. Os dados foram extraídos de prontuários médicos e documentos administrativos no MRJ e de prontuários e entrevistas presenciais em NB. As diferenças foram comparadas pelo teste do qui-quadrado, com nível de significância estabelecido em p<0,05. MRJ apresentou maior frequência de acompanhante no parto, assistência ao parto por enfermeiras obstétricas, métodos não farmacológicos de alívio da dor, ingestão de alimentos durante o trabalho de parto e menor uso de ocitocina, analgesia e amniotomia. Mais mulheres também tiveram o parto assistido por enfermeira obstétrica e em posição vertical, bem como menor uso de episiotomias e vácuo-extrator/fórceps. A taxa de cesariana foi menor no MRJ. O cuidado compartilhado entre enfermeiras e obstetras pode ser uma estratégia eficaz para melhorar a qualidade do cuidado intraparto.</description><subject>Health Policy & Services</subject><issn>1413-8123</issn><issn>1678-4561</issn><issn>1678-4561</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpVUctuwyAQRFUrNU37D-6tF6eAscG9VVFfUqQcmjsCvFaIbJMCTpW_L26aQ08sO7OzMIPQPcELUtb4kTBS5ILQgmJKKecLiqupJhdoRiouclZW5DLVZ941uglhhzHlBaMzNK51iBC9NZkdIvgDDNG6IaRbprJepdZg4zHburC3UXXZt43bhBjXdUo7r6I9QNa7BrrMtZlRHp5-4X6v_kCnQ9JVk2yaD3FsjrfoqlVdgLu_c442ry-b5Xu-Wr99LJ9XuSkEi7nRba0LJhqMseCgManaGrhhulFVWXDcKEZbqBhRYFhZGoCSCFECqYVWTTFHi5NsMBY6J3du9OkNQX5OdsizbUmdJz9Sa44eTgN7775GCFH2NhhIXx3AjUHSitdVLUpME7U-UY13IXho5d7bXvmjJFhO0ch_O1I08hxN8QPrfIHe</recordid><startdate>2022</startdate><enddate>2022</enddate><creator>Zaiden, Laura</creator><creator>Nakamura-Pereira, Marcos</creator><creator>Gomes, Maria Auxiliadora Mendes</creator><creator>Esteves-Pereira, Ana Paula</creator><creator>Matos, Caio Pereira de</creator><creator>Barros, Lucas de Araujo</creator><creator>Takemoto, Maíra Libertad Soligo</creator><creator>Leal, Maria do Carmo</creator><general>ABRASCO - Associação Brasileira de Saúde Coletiva</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>GPN</scope><orcidid>https://orcid.org/0000-0001-5074-708X</orcidid><orcidid>https://orcid.org/0000-0001-9157-2271</orcidid><orcidid>https://orcid.org/0000-0002-3047-515X</orcidid><orcidid>https://orcid.org/0000-0003-1243-2110</orcidid><orcidid>https://orcid.org/0000-0002-0236-2043</orcidid><orcidid>https://orcid.org/0000-0002-4231-0205</orcidid><orcidid>https://orcid.org/0000-0001-5908-1763</orcidid><orcidid>https://orcid.org/0000-0002-7016-2879</orcidid></search><sort><creationdate>2022</creationdate><title>Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study</title><author>Zaiden, Laura ; 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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-cbf9b348d00087eb016f9e7c4bda65370da42fe641aec455cee51885e198bad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Health Policy & Services</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zaiden, Laura</creatorcontrib><creatorcontrib>Nakamura-Pereira, Marcos</creatorcontrib><creatorcontrib>Gomes, Maria Auxiliadora Mendes</creatorcontrib><creatorcontrib>Esteves-Pereira, Ana Paula</creatorcontrib><creatorcontrib>Matos, Caio Pereira de</creatorcontrib><creatorcontrib>Barros, Lucas de Araujo</creatorcontrib><creatorcontrib>Takemoto, Maíra Libertad Soligo</creatorcontrib><creatorcontrib>Leal, Maria do Carmo</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><jtitle>Ciência & saude coletiva</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zaiden, Laura</au><au>Nakamura-Pereira, Marcos</au><au>Gomes, Maria Auxiliadora Mendes</au><au>Esteves-Pereira, Ana Paula</au><au>Matos, Caio Pereira de</au><au>Barros, Lucas de Araujo</au><au>Takemoto, Maíra Libertad Soligo</au><au>Leal, Maria do Carmo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study</atitle><jtitle>Ciência & saude coletiva</jtitle><addtitle>Ciênc. saúde coletiva</addtitle><date>2022</date><risdate>2022</risdate><volume>27</volume><issue>7</issue><spage>2741</spage><epage>2752</epage><pages>2741-2752</pages><issn>1413-8123</issn><issn>1678-4561</issn><eissn>1678-4561</eissn><abstract>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.
Resumo Modelos colaborativos (MC) com foco no cuidado intraparto compartilhado entre parteiras e obstetras têm sido propostos como uma estratégia para reduzir essas taxas. Nosso objetivo foi comparar o uso de práticas baseadas em evidências, intervenções obstétricas e taxas de cesarianas em dois ambientes: uma maternidade que aplica um MC de atendimento (MRJ) e dados de um conjunto de maternidades incluídas na pesquisa Nascer no Brasil (NB) que não adotam um MC. Os dados foram extraídos de prontuários médicos e documentos administrativos no MRJ e de prontuários e entrevistas presenciais em NB. As diferenças foram comparadas pelo teste do qui-quadrado, com nível de significância estabelecido em p<0,05. MRJ apresentou maior frequência de acompanhante no parto, assistência ao parto por enfermeiras obstétricas, métodos não farmacológicos de alívio da dor, ingestão de alimentos durante o trabalho de parto e menor uso de ocitocina, analgesia e amniotomia. Mais mulheres também tiveram o parto assistido por enfermeira obstétrica e em posição vertical, bem como menor uso de episiotomias e vácuo-extrator/fórceps. A taxa de cesariana foi menor no MRJ. O cuidado compartilhado entre enfermeiras e obstetras pode ser uma estratégia eficaz para melhorar a qualidade do cuidado intraparto.</abstract><pub>ABRASCO - Associação Brasileira de Saúde Coletiva</pub><doi>10.1590/1413-81232022277.20632021</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-5074-708X</orcidid><orcidid>https://orcid.org/0000-0001-9157-2271</orcidid><orcidid>https://orcid.org/0000-0002-3047-515X</orcidid><orcidid>https://orcid.org/0000-0003-1243-2110</orcidid><orcidid>https://orcid.org/0000-0002-0236-2043</orcidid><orcidid>https://orcid.org/0000-0002-4231-0205</orcidid><orcidid>https://orcid.org/0000-0001-5908-1763</orcidid><orcidid>https://orcid.org/0000-0002-7016-2879</orcidid><oa>free_for_read</oa></addata></record> |
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| title | Obstetric interventions in a maternity hospital with a collaborative model of care: a comparative observational study |
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