Práticas de assistência à saúde no pré-natal, parto e nascimento nas maternidades da Rede Cegonha/Alyne: uma revisão de escopo

Abstract

Despite the various health policies and programs that have sought to improve the model of care for pregnancy, labor and childbirth in Brazil, pregnancy, childbirth and birth continue to be challenging experiences for many women and babies. Social and regional inequalities, as well as factors of gender, race and ethnicity, continue to impact the quality of care provided, which makes it necessary to expand knowledge about health care for pregnant women, postpartum women and newborns in the country. Thus, this scoping review mapped publications on healthcare practices in prenatal care and childbirth and birth in maternity hospitals linked to RC/Alyne. The bibliographic search was carried out in databases such as PubMed, Scopus, SciELO and Lilacs considering studies published between 2011 and 2024 that addressed practices in the context of RC/Alyne. The bibliographic search was carried out in databases such as PubMed, Scopus, SciELO and Lilacs considering studies published between 2011 and 2024 that addressed practices in the context of RC/Alyne. Thus, 20 studies on healthcare practices in Prenatal and Delivery and Birth in the Network's maternity hospitals were included. The studies analyzed allowed us to verify that, regarding access to Prenatal and Place of Birth, the supply of the service is much lower than the demand, and that early Prenatal Reception presents weaknesses in identifying pregnant women and performing essential exams. Regarding Care Practices in Delivery and Birth, the studies revealed that the number of cesarean sections continues to increase, which indicates that the Incentive for Normal Vaginal Birth does not occur properly. Regarding the Presence of a Companion, studies have shown that some maternity hospitals impose restrictions, constituting institutional violence. Furthermore, the use of non-pharmacological methods for pain relief is a practice that is still not widely used in Brazilian maternity hospitals. Regarding the Encouragement of Skin-to-Skin Contact, studies have pointed to the need for strategies to encourage this practice, since it does not yet reach all births and presents inequities between white and brown/black women. Regarding the Encouragement of Breastfeeding in the 1st hour of life, studies have pointed to dichotomous weaknesses in the implementation of the practice in RC/Alyne, especially in the North and nNortheast regions. Therefore, the results of the review allow us to infer that there is a need to improve the design of public policies to correct socioeconomic, sociodemographic and ethnicracial inequities in the Network, which can be reduced with the implementation of protocols directed at practices incorporated by RC/Alyne and the provision of training for professionals working in maternal and child care.