Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.
Birth. 2019 Sep;46(3):509-516. doi: 10.1111/birt.12448.
The promotion of a positive birth experience has been a main goal of the World Health Organization's (WHO) recent work on improving maternity care. The purpose of this study was to assess the cesarean rates, the prevalence of birth practices, perinatal outcomes, and maternal satisfaction, in women involved with the respectful maternity care (RMC) support groups in Sao Paulo, Brazil.
This was a cross-sectional study of women with low-risk pregnancies who were assisted by professionals recommended by the RMC groups. An online questionnaire was administered. Variables to assess birth practices were classified as positive, negative, or unspecified according to the WHO guidelines. The Pearson chi-square tests and odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were computed to assess differences between the groups.
Five-hundred and eighty women completed the questionnaire. The cesarean rate was 14.7%, and the operative vaginal birth rate was 9.5%. The VBAC rate was 87.1%, and there was no significant difference in risk for cesarean between women with or without a prior cesarean. Of all women, 83.1% had a midwife's assistance and 75.5% hired a doula; 81.4% gave birth in a nonlithotomic position. The practices of enema, fasting and episiotomy were all under 2%. All 5-minute Apgar scores were ≥7. Most (83.1%) women reported having a positive birth experience.
Woman's engagement with the birth support groups and a transdisciplinary team focused on RMC are key elements to achieve positive perinatal outcomes and high women's satisfaction.
促进积极的分娩体验一直是世界卫生组织（WHO）改善产妇护理工作的主要目标。本研究旨在评估在巴西圣保罗参与尊重产妇护理（RMC）支持小组的妇女的剖宫产率、分娩实践的流行率、围产儿结局和产妇满意度。
这是一项对低风险妊娠妇女的横断面研究，这些妇女由 RMC 小组推荐的专业人员协助。采用在线问卷进行调查。根据世卫组织的指导方针，评估分娩实践的变量被分为积极、消极或未指定。采用 Pearson 卡方检验和比值比（OR）及其 95%置信区间（CI）来评估组间差异。
共有 580 名妇女完成了问卷。剖宫产率为 14.7%，阴道助产率为 9.5%。VBAC 率为 87.1%，有或没有先前剖宫产的妇女之间剖宫产的风险无显著差异。所有妇女中有 83.1%有助产士的协助，75.5%聘请了导乐；81.4%在非截石位分娩。灌肠、禁食和会阴切开术的实践均低于 2%。所有 5 分钟 Apgar 评分均≥7。大多数（83.1%）妇女报告有积极的分娩体验。
妇女参与分娩支持小组和跨学科团队专注于 RMC 是实现积极围产儿结局和高产妇满意度的关键因素。
