title: [Characteristics of labor and delivery care in three healthcare models within the Unified National Health System in Belo Horizonte, Minas Gerais State, Brazil].
abstract: This cross-sectional study of 831 low-risk pregnancies compared the management of labor and delivery in a birthing center, a hospital that had previously won the "Galba de Araújo" Award (for excellence in obstetric and neonatal care), and a standard-protocol maternity facility. The rates for use of ocytocin during labor were 27.9%, 59.5%, and 40.1%, while amniotomy was performed in 67.6%, 73.6%, and 82.2% of the women, respectively. Episiotomy rates were lower in the first two facilities, which have adopted patient-centered obstetric practices (7.2% at the birthing center and 14.8% at the award-winning hospital) as compared to 54.9% at the standard maternity facility. The liberal offer of epidural anesthesia at the awarding-winning hospital resulted in a higher anesthesia rate (54.4%) as compared to the standard facility (7.7%). Forceps delivery and neonatal admission rates were higher in the standard hospital, but there were no differences in mean Apgar or cesarean rates. The findings suggest resistance to selective use of interventions in all three models of obstetric care, although favoring the birthing center as a strategy for controlling interventions during labor and childbirth in low-risk pregnancies, with no resulting harm to the mothers or newborns.
authors: Universidade Estadual de Montes Claros, Brasil. sibyllecampos@hotmail.com
authors: Sibylle Emilie
authors: SE
authors: Vogt
authors: Simone Grilo
authors: SG
authors: Diniz
authors: Carlos Mendes
authors: CM
authors: Tavares
authors: Nagela Cristine Pinheiros
authors: NC
authors: Santos
authors: Camilla Alexsandra
authors: CA
authors: Schneck
authors: Bianca
authors: B
authors: Zorzam
authors: Débora de Andrade
authors: Dde A
authors: Vieira
authors: Kátia Silveira da
authors: KS
authors: Silva
authors: Marcos Augusto Bastos
authors: MA
authors: Dias
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods*; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008427:Maternal Health Services / Q000379:methods*; D009313:National Health Programs; D009321:Natural Childbirth / Q000706:statistics & numerical data; D010120:Oxytocics; D010121:Oxytocin; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors; D055815:Young Adult
chemical_list: D010120:Oxytocics; D010121:Oxytocin