Assistência ao parto em São Leopoldo (RS): um estudo de base populacional

Abstract

O objetivo foi descrever as condições estruturais de assistência ao parto, estabelecer o percentual de cesarianas, as características de atenção ao parto e verificar a associação do tipo e presença de pediatra no parto com variáveis socioeconômicas. Foi realizado um estudo transversal de base populacional, incluindo 840 mulheres de 20 a 49 anos residentes na zona urbana de São Leopoldo (RS). Entre as 840 mulheres entrevistadas na pesquisa, 36 (4,3%) tiveram filho nos doze meses anteriores à realização da pesquisa. O percentual de mulheres que tiveram parto cesáreo foi de 52,8%. Quanto à realização do parto, 97,2% foram feitos por médico e 72,2% das mulheres referiram a presença de pediatra no momento do parto. O financiamento do parto ocorreu em 68,6% dos casos pelo SUS, 20% foram financiados pelos planos privados de saúde e 11,4% foram pagos de forma particular. O parto cesáreo foi menos frequente entre as mulheres de nível socioeconômico mais baixo (RP 0,42; IC95% 0,20-0,86). Verificou-se que 30,4% das mulheres que receberam cuidados pelo SUS não manifestaram presença de pediatra no momento do parto. Foram encontradas evidências mostrando a associação de tipo de parto e variáveis que expressam classe econômica, sendo possível afirmar que a remuneração interfere no tipo de parto.The study was carried out to describe the deliveries structural conditions, characteristics of assistance to the deliveries, to establish the percentage of cesarean section, and to verify the association between the presence of the pediatrician and the type of childbirth with socioeconomic variables. A cross-sectional population-based study was carried out including 840 women from 20 to 49 years old resident in São Leopoldo, Rio Grande do Sul State. Among them, 36 (4.3%) had children within 12 months prior the research. The percentage of women who had caesarian delivery was 52.8%. Regarding the obstetric delivery, 97.2% had been assisted by a doctor and 72.2% of the women had reported the presence of pediatrician at the time of the labor. In 68.6% of the cases the delivery process was financed by the SUS, 20% were by private health care plans and 11.4% were privately paid. The caesarean delivery was less frequent among the women belonging to lower socioeconomic levels (prevalence rate 0.42; CI95% 0.20-0.86). It was verified that 30.4% of the women who had received maternal care by SUS did not report the presence of pediatrician in the labor. It was evidenced the association of the type of delivery and some variables related to economic class, making it possible to state that financial compensation intervenes with the type of obstetrical delivery.