Access to care during labor and delivery and safety to maternal health.
Juliana Vicente de Oliveira Franchi, Sandra Marisa Pelloso, Rosângela Aparecida Pimenta Ferrari and 1 others
PMID 32520244WHAT IT FOUND
Women who waited more than nine hours after labor symptoms to seek care developed adverse maternal outcomes in 63% of cases.
Transport over 30 minutes was also linked. Waiting time for medical care was not.
Key findings
01Adverse maternal outcomes developed in 46.8% (n=220) of postpartum women, with intrapartum complications and third/fourth degree lacerations most common.
02Women who waited more than nine hours after labor symptoms to seek care developed adverse outcomes in 63% of cases, and women whose transport took more than 30 minutes developed adverse outcomes in 61.7% of cases; both associations were significant.
03Time to decide to seek care was associated with knowledge about labor and delivery, while access time was not associated with satisfaction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The authors said the study was cross-sectional and reflected a specific local reality, so the results cannot be generalized to all Brazilian women. The study measured associations after delivery, so it cannot show that delays caused adverse maternal outcomes. It included only women from urban areas in five hospitals in one region.
Declared interests
The paper states that it was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Grant # 407508/2016-3, and was extracted from a master's thesis.
The easy way to misread this
Do not conclude that longer delays caused adverse maternal outcomes or that giving women more information will reduce them. This was a cross-sectional study of postpartum women; it reports associations between reported time to seek care or transport and adverse outcomes, not a tested intervention or causal effect.