Monitoring and evaluation indicators of Freestanding Birth Centers: results of the study Births in Brazilian Birthing Centers

Abstract

This study aimed to analyze the monitoring and evaluation indicators of Freestanding Birth Centers (FBC) in Brazil. This cross-sectional study was aligned with the survey Birth in Brazil II. All eight FBC that attended more than 100 births in 2019 were included in this study. Data referred to 2020 or 2021 and were collected from interviews with service managers and a structured instrument made available online. Variables correspond to all 12 monitoring and evaluation indicators provided for in the ordinance by the Brazilian Ministry of Health for the accreditation of FBC. Results showed that the service attended 3,097 births in a year. Nurses/midwives attended 96.9% of these births and 98.7% of them included a companion of the woman’s choice. Amniotomy was performed in 15.7% of labors; oxytocin and episiotomy were used in 7% and performed in 0.4% of them, respectively; 60.2% of births occurred in the vertical position; and the perineum remained intact in 32.2% of them. As for the newborns, 0.6% had five-minute Apgar scores < 7 and 97.6% had skin-to-skin contact with their mothers. The intrapartum, postnatal, and neonatal transfers rates totaled 17.3%, 2.6%, and 4.3%, respectively. The indicators of the FBC show that this model of care offers mothers and babies safe, respectful, human-centered care that is based on the best scientific evidence.