title: [Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil].
abstract: OBJECTIVE
  To evaluate the quality of birth care based on the World Health Organization guidelines.
  
  
  METHODS
  A case-control study was carried out in a public and a private maternity hospitals contracted by the Brazilian Health System in the city of Rio de Janeiro, Brazil, from October 1998 to March 1999. The sample comprised 461 women in the public maternity hospital (230 vaginal deliveries and 231 Cesarean sections) and 448 women in the private one (224 vaginal deliveries and 224 Cesarean sections). Data was collected through interviews with puerperal women and review of medical records. A summarization score of quality of delivery care was constructed.
  
  
  RESULTS
  There was low frequency of practices that should be encouraged, such as having an accompanying person (1% in the private hospital for both vaginal delivery and C-sections), freedom of movements throughout labor (9.6% of C-sections in the public hospital and 9.9% of vaginal deliveries in the private hospital) and breastfeeding in the delivery room (6.9% of C-sections in the public hospital and 8.0% of C-sections in the private hospital). There was a high frequency of known harmful practices such as enema administration (38.4%); routine pubic shaving; routine intravenous infusion (88.8%); routine use of oxytocin (64.4%), strict bed rest throughout labor (90.1%) and routine supine position in labor (98.7%) in vaginal deliveries. The best summarizing scores were seen in the public maternity hospital.
  
  
  CONCLUSIONS
  The two maternity hospitals have a high frequency of interventions during birth care. In spite of providing care to higher risk pregnant women, the public maternity hospital has a less interventionist profile than the private one. Procedures carried out on a routine basis should be pondered based on evidence of their benefits.
authors.affiliation: Faculdade de Medicina, Universidade do Sul de Santa Catarina, Tubarão, SC, Brasil. eleonora.dorsi@terra.com.br
authors.forename: Eleonora
authors.initials: E
authors.lastname: d'Orsi
authors.forename: Dóra
authors.initials: D
authors.lastname: Chor
authors.forename: Karen
authors.initials: K
authors.lastname: Giffin
authors.forename: Antonia
authors.initials: A
authors.lastname: Angulo-Tuesta
authors.forename: Gisele Peixoto
authors.initials: GP
authors.lastname: Barbosa
authors.forename: Andrea de Souza
authors.initials: Ade S
authors.lastname: Gama
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Reis
authors.forename: Zulmira
authors.initials: Z
authors.lastname: Hartz
mesh_terms: D001938:Brazil; D016022:Case-Control Studies; D002585:Cesarean Section; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D003696:Delivery Rooms; D036861:Delivery, Obstetric / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006771:Hospitals, Maternity / Q000592:standards* / Q000706:statistics & numerical data; D016304:Hospitals, Private / Q000592:standards* / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008429:Maternal Welfare; D009775:Obstetrics and Gynecology Department, Hospital / Q000592:standards / Q000706:statistics & numerical data; D011247:Pregnancy; D018566:Pregnancy, High-Risk