Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Secretaria de Estado da Justiça e Cidadania do Distrito Federal, Governo do Distrito Federal. Brasília DF Brasil.
Cien Saude Colet. 2021 Mar;26(3):847-858. doi: 10.1590/1413-81232021263.12492020. Epub 2020 Jul 29.
Based on the Rede Cegonha guidelines that propose the strengthening of women's sexual and reproductive rights, we sought to present a brief overview of issues related to reproductive planning and to analyze obstetric practices in childbirth care for adolescents and women of advanced age in maternity hospitals linked to Rede Cegonha. Data were extracted from an assessment conducted in 2017, based on information from the interview with puerperal women and from the hospital record. For age extremes, the high proportion of unplanned pregnancies and low use of contraception means problems in accessing family planning programs. Adolescents are more exposed to the presence of a companion and less to the use of analgesia in labor. Advanced maternal age were more likely to use analgesia in labor and to give birth in the lithotomy position, being less exposed to amniotomy. Although Rede Cegonha is an excellent strategy for improving assistance to childbirth, attention is still needed to the use of potentially unnecessary or not recommended interventions, with greater incentive to good obstetric practices.
基于 Rede Cegonha 指南提出的加强妇女性权利和生殖权利的建议，我们旨在简要概述与生殖计划相关的问题，并分析与 Rede Cegonha 相关的妇产科医院中青少年和高龄产妇分娩护理中的产科实践。数据是从 2017 年进行的评估中提取的，基于对产妇的访谈信息和医院记录。对于年龄极端的情况，无计划妊娠的比例较高，避孕措施使用率较低，这意味着在获得计划生育方案方面存在问题。青少年更容易有伴侣陪伴，而在分娩时使用镇痛剂的情况较少。高龄产妇在分娩时更有可能使用镇痛剂，并采取截石位分娩，而更少进行羊膜切开术。尽管 Rede Cegonha 是改善分娩护理的绝佳策略，但仍需要关注潜在的不必要或不推荐的干预措施的使用，鼓励采取更好的产科实践。
