Eligibility and discontinuation of prenatal care in a freestanding birth center: a cross-sectional study.
Franciely Schermak, Maria Luiza Gonzalez Riesco
PMID 41036934WHAT IT FOUND
At a São Paulo birth center, most registered women were ineligible, and most eligible women stopped prenatal care before delivery.
Prior cesarean, gestational diabetes, gestational hypertensive syndrome, lower education and income were common.
Key findings
01Of 9,954 women analyzed, 5,619 (56.4%) were ineligible for Casa Angela prenatal care; among 4,335 eligible women, 2,727 (62.9%) had prenatal care discontinued.
02The main recorded reason for non-eligibility was previous cesarean delivery (37.6%), followed by gestational diabetes (11.0%) and gestational hypertensive syndrome (9.8%); the main recorded reason for discontinuation was gestational hypertensive syndrome (15.6%).
03Odds-ratio analyses showed that brown or black women, women with lower education or income, and women not living with a partner had lower odds of eligibility and higher odds of discontinuation; the study design cannot show cause.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design can show associations but cannot prove that a factor caused ineligibility or discontinuation. Reasons were recorded for only 1,363 (24.3%) ineligible women and 1,466 (53.8%) women whose care was discontinued, so many reasons are missing. Data came from secondary records, and information loss may have biased the results.
Declared interests
Funded by CAPES (funding code 001). The supplied text reports no conflicts of interest.
The easy way to misread this
Do not read the 62.9% discontinuation rate as proof that most women who register cannot give birth at a birth center. It applies to 4,335 eligible women, and reasons were recorded for only 1,466 of 2,727; the cross-sectional design cannot show cause.