Patient Safety in Maternity Care in Brazil: The Maternity Safety Thermometer as a Tool to Improve the Quality of Care - Revista Brasileira de Ginecologia e Obstetrícia
Over the last few years, the topic of maternity care in Brazil has been at the heart of several debates. One of the main reasons is the overuse of interventions such as high rates of caesarean section, augmentation of labor with uterotonics and amniotomy, uterine fundal pressure during the second stage of labor (Kristeller maneuver), episiotomy and lithotomy position during childbirth, and mother-baby separation. In recent years, disrespect and mistreatment of women in health facilities during labor and childbirth are also frequently reported.
Since the 1980s, many actions have been taken to deal with these problems, especially the high rates of caesarean section, which increases the risk of adverse outcomes in the short-term for both women and newborns, when done without medical indication. Overtreatment, as well as the underuse of effective and safe interventions (such as birth companion, midwifery care, and the clinical use of magnesium sulfate [MgSO4] for eclampsia prevention and treatment) are among the main factors of maternal and neonatal complications that lead to near-miss and death, including hemorrhages, blood transfusion, anesthetic complications, internal organ damage, infections, thromboembolic disorder, neonatal respiratory distress, and other iatrogenic prematurity complications.
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Over the last few years, the topic of maternity care in Brazil has been at the heart of several debates. One of the main reasons is the overuse of interventions such as high rates of caesarean section, augmentation of labor with uterotonics and amniotomy, uterine fundal pressure during the second stage of labor (Kristeller maneuver), episiotomy and lithotomy position during childbirth, and mother-baby separation. In recent years, disrespect and mistreatment of women in health facilities during labor and childbirth are also frequently reported.
Since the 1980s, many actions have been taken to deal with these problems, especially the high rates of caesarean section, which increases the risk of adverse outcomes in the short-term for both women and newborns, when done without medical indication. Overtreatment, as well as the underuse of effective and safe interventions (such as birth companion, midwifery care, and the clinical use of magnesium sulfate [MgSO4] for eclampsia prevention and treatment) are among the main factors of maternal and neonatal complications that lead to near-miss and death, including hemorrhages, blood transfusion, anesthetic complications, internal organ damage, infections, thromboembolic disorder, neonatal respiratory distress, and other iatrogenic prematurity complications.
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