Usage frequency of medical practices based on the evidence in the childbirth attention in hospitals of Medellín, Colombia, 2004-2005

Abstract

BACKGROUND: Most maternal deaths in Medellín in 2003 and 2004 occurred during childbirth or immediately afterwards. In the majority of cases, quality problems in medical attention were detected. Knowledge of the application of some beneficial, ineffective or harmful practices during childbirth attention is a contribution to the evaluation of the attention process of pregnant women.

METHODOLOGY, OBJECTIVE AND SETTING: Descriptive and prospective study to know the usage frequency of some beneficial, ineffective and harmful practices during childbirth attention in three health institutions located in Medellín, Colombia, one of them public and the other two, private. They see patients of the first, second and third levels of complexity.

RESULTS: At the institutions included in the study 30.7% of childbirths were carried out by Caesarean section. In 12% of vaginal childbirth cases, the perineum was shaved. In 31.5% of the situations, partogram was not performed. In 43.1% of cases women were not accompanied by any relative or close friend during childbirth work, and 76.1% of patients had their childbirth in supine position. In 19.3% of cases, an active handling of childbirth did not take place. 71.4% of first-time pregnant women underwent an episiotomy. Prophylactic antibiotics were not applied to 55% of the mothers delivered by Caesarean section.

CONCLUSIONS: Some practices in medical attention of childbirth are still used or avoided despite the current recommendations of the medical literature.