Coexistence and prevalence of obstetric interventions: an analysis based on the grade of membership

• Published in: BMC pregnancy and childbirth 2021-09, Vol.21 (1), p.1-618, Article 618
• Main Authors: de Souza, Karina Cristina Rouwe, da Silva, Thales Philipe Rodrigues, Damasceno, Ana Kelve de Castro, Manzo, Bruna Figueiredo, Souza, Kleyde Ventura de, Filipe, Maria Margarida Leitão, Matozinhos, Fernanda Penido
• Format: Article
• Language: English
• Subjects: Birth; Childbirth & labor; Data collection; Health care networks; Humanized Delivery; Institutionalization; Labor; Medical ethics; Medical procedures; Medical records; Obstetric Nursing; Obstetrics; Parturition; Patients rights; Sociodemographics; Variables; Womens health
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-021-04092-x

Background Obstetric interventions performed during delivery do not reflect improvements in obstetric care. Several practices routinely performed during childbirth, without any scientific evidence or basis - such as Kristeller maneuver, routine episiotomy, and movement or feeding restriction - reflect a disrespectful assistance reality that, unfortunately, remains in place in Brazil. The aims of the current study are to assess the coexistence and prevalence of obstetric interventions in maternity hospitals in Belo Horizonte City, based on the Grade of Membership (GoM) method, as well as to investigate sociodemographic and obstetric factors associated with coexistence profiles generated by it. Methods Observational study, based on a cross-sectional design, carried out with data deriving from the study “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento” (Born in Belo Horizonte: Survey on Childbirth and Birth). The herein investigated interventions comprised practices that are clearly useful and should be encouraged; practices that are clearly harmful or ineffective and should be eliminated; and practices that are inappropriately used, in contrast to the ones recommended by the World Health Organization. The analyzed interventions comprised: providing food to parturient women, allowing them to have freedom to move, use of partogram, adopting non-pharmacological methods for pain relief, enema, perineal shaving, lying patients down for delivery, Kristeller maneuver, amniotomy, oxytocin infusion, analgesia and episiotomy. The current study has used GoM to identify the coexistence of the adopted obstetric interventions. Variables such as age, schooling, skin color, primigravida, place-of–delivery financing, number of prenatal consultations, gestational age at delivery, presence of obstetric nurse at delivery time, paid work and presence of companion during delivery were taken into consideration at the time to build patients’ profile. Results Results have highlighted two antagonistic obstetric profiles, namely: profile 1 comprised parturient women who were offered diet, freedom to move, use of partogram, using non-pharmacological methods for pain relief, giving birth in lying position, patients who were not subjected to Kristeller maneuver, episiotomy or amniotomy, women did not receive oxytocin infusion, and analgesia using. Profile 2, in its turn, comprised parturient women who were not offered diet, who were not allowed to have freedom to move, as