TY - JOUR
T1 - Measuring harm-free care in childbirth
T2 - a pilot application of the Maternity Safety Thermometer in Brazil
AU - Alonso, Bruna Dias
AU - Niy, Denise Yoshie
AU - de Azevedo Aguiar, Cláudia
AU - da Fonseca, Eder Lucio
AU - Sandall, Jane
AU - Diniz, Carmen Simone Grilo
N1 - Funding Information:
FAPESP funded the HAMABE research project (Process number 2015/50498-0), and CAPES funded the Bruna Dias Alonso PhD (Finance Code 001).
Publisher Copyright:
© The authors (2022), this article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
PY - 2022
Y1 - 2022
N2 - Introduction: interventions during labour and childbirth are frequently unnecessary and can be harmful to most women and babies in Brazil. In addition, there is a high prevalence of abuse and disrespect situations. Objective: to describe the prevalence of maternal and neonatal harm and harm-free care in a Brazilian maternity setting. Methods: pilot application of the Portuguese version of Maternal Safety Thermometer (MST) by a cross-sectional study in a public setting. Data collection was made at two timepoints. Results: 140 women were included. Over 84% of women had a postpartum sutured wound, resulting from a caesarean section, an episiotomy, or a perineal trauma. Puerperal infection, especially on a caesarean wound, was the most frequent physical harm. Women’s perception of safety, including being left alone in labour, and feeling their safety concerns were not taken seriously, decreased from 80.6% to 43.3% in the second timepoint. Using the MST helped to improve the quality of medical records since critical information about a patient’s health status was not properly recorded, or even absent. Conclusion: MST is a concise tool which includes indicators related to harm-free care measured in a short time range. However, this study suggests that the MST can underestimate harm if it is used alone to assess harm-free care in maternities with excessive levels of intervention, and poor reporting of harms (i.e., blood loss), as in most Brazilian settings.
AB - Introduction: interventions during labour and childbirth are frequently unnecessary and can be harmful to most women and babies in Brazil. In addition, there is a high prevalence of abuse and disrespect situations. Objective: to describe the prevalence of maternal and neonatal harm and harm-free care in a Brazilian maternity setting. Methods: pilot application of the Portuguese version of Maternal Safety Thermometer (MST) by a cross-sectional study in a public setting. Data collection was made at two timepoints. Results: 140 women were included. Over 84% of women had a postpartum sutured wound, resulting from a caesarean section, an episiotomy, or a perineal trauma. Puerperal infection, especially on a caesarean wound, was the most frequent physical harm. Women’s perception of safety, including being left alone in labour, and feeling their safety concerns were not taken seriously, decreased from 80.6% to 43.3% in the second timepoint. Using the MST helped to improve the quality of medical records since critical information about a patient’s health status was not properly recorded, or even absent. Conclusion: MST is a concise tool which includes indicators related to harm-free care measured in a short time range. However, this study suggests that the MST can underestimate harm if it is used alone to assess harm-free care in maternities with excessive levels of intervention, and poor reporting of harms (i.e., blood loss), as in most Brazilian settings.
KW - Childbirth
KW - Health care
KW - Hospitals
KW - Maternity
KW - Outcome assessment
KW - Patient safety
UR - http://www.scopus.com/inward/record.url?scp=85133024032&partnerID=8YFLogxK
U2 - 10.36311/jhgd.v32.13228
DO - 10.36311/jhgd.v32.13228
M3 - Article
AN - SCOPUS:85133024032
SN - 0104-1282
VL - 32
SP - 248
EP - 257
JO - Journal of Human Growth and Development
JF - Journal of Human Growth and Development
IS - 2
ER -