[Obstetric care during childbirth in Rio de Janeiro: hospital practices and user access].
The purpose of this paper is to identify and describe Rio de Janeiro maternity hospital profiles and the route between the mother's place of residence and the hospital. Data sources were: the State Live Birth Information System (1995) and the National Survey on Medical Care (1992). Two groups of maternity hospitals were identified using multivariate cluster analysis. Group A had an extremely high cesarean rate (81%), with mothers and neonates presenting good health conditions. Cesarean rates were lower in Group B, although still high (32%), and other variables reflected worse neonatal conditions. Cesarean rate was the indicator which best discriminated between the groups, followed by proportion of adolescent mothers and mothers with a high school education. The uneven spatial distribution of maternity hospitals, which were concentrated in the richest area of the city, was a factor in the long routes used by women to reach medical care for childbirth.
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Gerência de Programas de Saúde da Criança, Coordenação de Programas de Atendimento Integral à Saúde, Superintendência de Saúde Coletiva, Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, 21040-210, Brasil.
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D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001723:Birth Rate; D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D016000:Cluster Analysis; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D011247:Pregnancy; D012959:Socioeconomic Factors