Prenatal care: preparation for childbirth in primary healthcare in the south of Brazil

Gonçalves, Mariana Faria; Teixeira, Érica Mairene Bocate; Silva, Márcia Aparecida dos Santos; Corsi, Nathalia Maciel; Ferrari, Rosângela Aparecida Pimenta; Pelloso, Sandra Marisa; Cardelli, Alexandrina Aparecida Maciel

doi:10.1590/1983-1447.2017.03.2016-0063

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Original Papers • Rev. Gaúcha Enferm. (Online) 38 (3) • 2017 • https://doi.org/10.1590/1983-1447.2017.03.2016-0063 copy

Prenatal care: preparation for childbirth in primary healthcare in the south of Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To evaluate the relationship between prenatal care and delivery guidelines In Primary Health Care.

Methods

This is a cross-sectional study, with 358 puerperal women of a public maternity from the south of Brazil. The data collection was performed from July to October of 2013, with prenatal card data transcription and a structured interview. The data has been analyzed through the use of the Chi-square test (p≤0.05).

Results

The prenatal care had a high coverage (85,5%) and early start by 71,8% of the women, however, 52% of them did not receive orientation for the childbirth. There was a statistical association between receiving orientation for the childbirth and fewer visits (p=0.028), longer interval between the last prenatal visit and the childbirth (p=0.002), and the classification of the prenatal care as intermediate and inadequate (p=0.024).

Conclusions

Despite of the ideal number of visits, the quality of care has been classified as intermediate or inadequate, besides that, precarious access to the orientation for the childbirth during the prenatal care has been evidenced.

Keywords
Prenatal care; Childbirth; Health education; Obstetric nursing

	Orientation for the childbirth
	Yes		No
	n	%	n	%	p value^* * Chi-square test (p <0.05)
Age (in years)
Up to 19	36	20.9	40	21.5
20 to 34	119	69.2	124	66.7	0.817
35 and over	17	9.9	22	11.8
Marital situation
With partner	143	83.1	158	84.9	0.641
Without partner	29	16.9	28	15.1	0.641
Schooling (years of study)
Low (1 to 7 years)	36	20.9	53	28.5
Average (8 to 11 years)	121	70.3	121	65.1	0.087
High (more than 11 years)	15	8.7	12	6.5	0.087
Occupation situation
Paid	74	43.0	73	39.2	0.469
Unpaid	98	57.0	113	60.8	0.469
Family income ^ Minimum wage in 2013 - R$ 678.00.
Up to 1 minimum wage	40	23.3	46	24.7
From 2 to 3 minimum wages	85	49.4	80	43.0	0.656
More than 3 minimum wages	47	27.3	60	32.3	0.656
Parity
Primiparous	70	40.7	71	38.2	0.626
Multiparous	102	59.3	115	61.8	0.626
Previous normal delivery
No	98	57.0	102	54.8	0.684
Yes	74	43.0	84	45.2	0.684
Previous Cesarean section
No	136	79.1	146	78.5	0.894
Yes	36	20.9	40	21.5	0.894

	Orientation for the childbirth
	Yes		No
	n	%	n	%	p value^* * Chi-square test (p<0.05)
No. of prenatal visits ^ n=356 (Two pregnant women did not deliver the prenatal card at the admission to the maternity ward)
6 and over	154	90.6	152	81.7
3 to 5	14	8.2	31	16.7	0.028
0 to 2	2	1.2	3	1.6	0.028
Gestational week at the start of the prenatal care**
Until the 13^th week	129	75.9	128	68.8
14^th to 27^th week	35	20.6	50	26.9	0.175
28^th week and over	6	3.5	8	4.3	0.175
Interval between the last prenatal visit and the childbirth**
Up to 15 days	137	80.6	123	66.1	0.002
16 days or more	33	19.4	63	33.9	0.002
Adequacy of the prenatal care according to Coutinho**
Adequate	53	31.2	38	20.4
Intermediate	77	45.3	92	49.5	0.024
Inadequate	40	23.5	56	30.1	0.024
Guidance on the attachment to the place of birth
Yes	110	64.0	113	60.8	0.533
No	62	36.0	73	39.2
Visited maternity during pregnancy
Yes	30	17.4	24	12.9	0.231
No	142	82.6	162	87.1	0.231

Type of orientation for the childbirth	n	%
Incentive to normal delivery	67	18.7
Signs of onset of labor	61	17.0
Differences between the normal delivery and the cesarean delivery	15	4.2
Beneficial practices for the evolution of labor and pain relief	12	3.4
Inadequate orientation^* * Look for another service, cesarean benefits, go to the maternity at the beginning of the latent phase of labor, do not make scandal to be well treated.	17	4.7
Total	172	48.0

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author: Alexandrina Aparecida Maciel Cardelli E-mail: macielalexandrina@gmail.com