Caesarean section and neonatal outcomes in private hospitals in Brazil: comparative study of two different perinatal models of care

Abstract

This study aims at comparing caesarean section rates and neonatal outcomes of two perinatal models of care provided in private hospitals in Brazil. Birth in Brazil data, a national hospital based cohort conducted in the years 2011/2012 was used. We analysed 1,664 postpartum women and their offspring attended at 13 hospitals lo cated in the South-east region of Brazil, divid ed into a "typical” – standard care model and "atypical" – Baby-Friendly hospital with col laborative practices between nurse-midwives and obstetricians on duty to attend deliveries in an alternative labour ward. The Robson’s classi fication system was used to compare caesarean sections, which was lower in the atypical hospi tal (47.8% vs. 90.8%, p < 0.001). Full term birth, early skin-to-skin contact, breastfeeding in the first hour, rooming-in care, and discharge in ex clusive breastfeeding were more frequent in the atypical hospital. Neonatal adverse outcome did not differ significantly between hospitals. The atypical hospital’s intervention should be fur ther evaluated since it might reduce caesarean section prevalence and increase good practices in neonatal care.