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Use of intrapartum evidence-based practices in childbirth after participating in the Senses of Birth intervention among Brazilian women

Citation

M M Fernandes, Luisa et al. (2021), Use of intrapartum evidence-based practices in childbirth after participating in the Senses of Birth intervention among Brazilian women, Dryad, Dataset, https://doi.org/10.5061/dryad.r7sqv9sb8

Abstract

Brazil has a cesarean rate of 56% and low use of Intrapartum Evidence-based Practices (IEBP) of 3.4%, reflecting a medically centered and highly interventionist maternal health care model. The Senses of Birth (SoB) is a health education intervention created to promote normal birth, use of EBP, and reduce unnecessary c-sections. This study aimed to understand the use of intrapartum EBP by Brazilian women who participated in the SoB intervention. 555 women answered the questionnaire between 2015 and 2016. Bivariate analysis and ANOVA test were used to identify if social-demographic factors, childbirth information, and perceived knowledge were associated with the use of EBP. A qualitative analysis was performed to explore women's experiences. Research participants used the following EBP: birth plan (55.2%), companionship during childbirth (81.6%), midwife care (54.2%), freedom of mobility during labor (57.7%), choice of position during delivery (57.2%), and non-pharmacological pain relief methods (74.2%). Doula support was low (26.9%). Being a black woman was associated with not using a birth plan or having doula support. Women who gave birth in private hospitals were more likely not to use the EBP. Barriers to the use of EBP identified by women were an absence of individualized care, non-respect for their choices or provision of EBP by health care providers, inadequate structure and ambiance in hospitals to use EBP, and rigid protocols not centered on women’s needs. The SoB intervention was identified as a potential facilitator. Women who used EBP described a sense of control over their bodies and self-efficacy to advocate for their chosen practices. Women saw the strategies to overcome barriers as a path to become their childbirth protagonist. Health education is essential to increase the use of EBP; however, it should be implemented combined with changes in the maternal care system, promoting woman-centered and evidence-based models.

Methods

See Methods section in the manuscript.

Eligible participants were identified at the Senses of Birth Intervention entrance when answering positive for the current pregnancy question and invited to join the study by one of the trained interviewers. All pregnant women over 18 years old who visit the intervention between March 2015 and March 2016 were invited to answer the post-intervention survey, forming a convenience sample of 1,287 women [32]. The group of respondent pregnant women was invited to join the online follow-up survey. Five hundred and fifty-five (555) women answered the follow-up post-partum survey between June 2015 and April 2016, with a response rate of 43.1%, in three different states and five different cities of Brazil (Belo Horizonte/MG; Rio de Janeiro/RJ and Niterói/RJ; Ceilândia/DF and Brasília/DF)

Usage Notes

The original survey and data collection was conducted in Portuguese, since the study target Brazilian women. To improve access to the data, the data labels and data dictionary (readme file) were translated into English by the authors. The variables presented here are the minimum dataset needed to reproduce the quantitative analysis done in the referred manuscript.

Funding

Ministry of Health

Bill and Melinda Gates Foundation

Pan American Health Organization