0001/2021 - Apoio contínuo na assistência ao parto para redução das cirurgias cesarianas: síntese de evidências para políticas Continuous support during childbirth to reduce cesarean sections: evidence brief for policy
As taxas mundiais de cirurgia cesariana têm crescido há 30 anos, correspondendo a mais de 56% dos nascimentos no Brasil. Considerando os agravos ocasionados por cesáreas eletivas na saúde materna e infantil, esta revisão buscou apresentar uma estratégia para a redução destas taxas. Para realizar a síntese das melhores evidências, adotou-se a metodologia SUPPORT. Foram incluídas revisões sistemáticas publicadas em inglês, português ou espanhol sobre intervenções não clínicas. As buscas resultaram em quatro estudos, que em metanálise associaram o apoio contínuo à redução de 25 a 51% nas taxas de cesárea. Igualmente, o apoio contínuo reduziu a duração e as intervenções clínicas desnecessárias durante o trabalho de parto e a probabilidade de bebê com baixo escore de Apgar aos cinco minutos. Além disso, proporcionou melhoria na amamentação e na recuperação da mulher, aumento da satisfação com o processo de nascimento, e maiores chances de parto vaginal espontâneo. O apoio contínuo foi benéfico para gestante e recém-nascido. A intervenção garante respeito, segurança e qualidade durante o parto, bem como reduz custos hospitalares. Portanto, é uma estratégia efetiva que deve ser adotada nos serviços de saúde para ampliar o acesso das mulheres aos seus direitos.
Palavras-chave:
Cesárea; Parto Normal; Política Informada por Evidências; Formulação de Políticas; Revisão
Abstract:
Cesarean section rates have increased globally in the last 30 years, representing more than 56% of total births in Brazil. Considering the impacts of elective cesarean sections in maternal and child health, this review aimed to present an option to reduce these rates. We used the SUPPORT tools to summarize the best evidence. Systematic reviews published in English, Portuguese, or Spanish, which focused on non-clinical interventions were included. Continuous support during labor and birth was described in four systematic reviews as an option to reduce cesarean rates (down to -51%). It also decreased unnecessary clinical interventions during labor, the duration of labor, and the likelihood of delivering a baby with a low Apgar score at 5 minutes. Moreover, continuous support improved breastfeeding, postpartum recovery of women during the puerperium period, and increased women’s satisfaction with the birth experience and the possibility of spontaneous vaginal deliveries. The intervention was beneficial for women and newborns. Continuous support fosters respect, safety, and quality during birth, besides reducing hospítal costs. Therefore, it is an effective strategy that should be adopted in hospitals and other health services to improve women’s access to their rights.
Continuous support during childbirth to reduce cesarean sections: evidence brief for policy
Resumo (abstract):
Cesarean section rates have increased globally in the last 30 years, representing more than 56% of total births in Brazil. Considering the impacts of elective cesarean sections in maternal and child health, this review aimed to present an option to reduce these rates. We used the SUPPORT tools to summarize the best evidence. Systematic reviews published in English, Portuguese, or Spanish, which focused on non-clinical interventions were included. Continuous support during labor and birth was described in four systematic reviews as an option to reduce cesarean rates (down to -51%). It also decreased unnecessary clinical interventions during labor, the duration of labor, and the likelihood of delivering a baby with a low Apgar score at 5 minutes. Moreover, continuous support improved breastfeeding, postpartum recovery of women during the puerperium period, and increased women’s satisfaction with the birth experience and the possibility of spontaneous vaginal deliveries. The intervention was beneficial for women and newborns. Continuous support fosters respect, safety, and quality during birth, besides reducing hospítal costs. Therefore, it is an effective strategy that should be adopted in hospitals and other health services to improve women’s access to their rights.
Oliveira, C.F, Bortoli, M.C, Setti, C., Luquine Júnior, C.D., Toma, T.S. Apoio contínuo na assistência ao parto para redução das cirurgias cesarianas: síntese de evidências para políticas. Cien Saude Colet [periódico na internet] (2021/Jan). [Citado em 10/11/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/apoio-continuo-na-assistencia-ao-parto-para-reducao-das-cirurgias-cesarianas-sintese-de-evidencias-para-politicas/17900?id=17900
