Analysis of care provided to the mother and the newborn at the time of delivery in public and private maternities in the state of Espírito Santo – Brazil

Abstract

Objective: To analyze the care offered to mothers and newborns at the time of birth in maternity hospitals in Espírito Santo, according to the type of service provided, evaluated through indicators based on recommendations for good care practices recommended by the WHO and the Rede Cegonha program. Methods: This was a cross-sectional study nested within a multicenter hospital birth cohort. Interviews were carried out in the maternity ward, at 7 and 27 days. The evaluation of care was based on the recommendations of the labor and birth component, with the outcome being the type of service provided: public or private. For analysis, a hierarchical model and Poisson regression with robust variance adjustment were used. Results: Public maternity hospitals showed a higher prevalence regarding gestational risk classification (PR: 3.33; 95% CI: 2.99; 3.70); pre-delivery examination (PR: 2.38; 95% CI: 1.60; 3.53); use of oxytocin (PR: 1.23; 95% CI: 1.11; 1.29) and vaginal delivery (PR: 1.15; 95% CI: 1.09; 1.21); and lower prevalence regarding the presence of a companion (PR: 0.83; 95% CI: 0.77; 0.89); skin-to-skin contact in the delivery room (PR: 0.92; 95% CI: 0.86; 0.98); pediatrician in the delivery room (PR: 0.81; 95% CI: 0.70; 0.93); rooming-in (PR: 0.92; 95% CI: 0.86; 0.98) and guidance on breastfeeding (PR: 0.90; 95% CI: 0.84; 0.96). Conclusion: Both public and private maternity hospitals still need to adjust to ensure the implementation of good practices as defined by the WHO and SUS that ensure qualified assistance for the mother-child binomial.