{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T10:35:08Z","timestamp":1769164508747,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T00:00:00Z","timestamp":1570060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High rates of unnecessary cesareans and interventions in vaginal births contribute to stagnant maternal and neonatal mortality rates in Brazil. We used the Maternity Safety Thermometer (MST) to assess the prevalence of harm during maternity care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This secondary analysis of the \u201cBirth in Brazil\u201d survey included a representative sample of 10\u00a0155 women who gave birth in public and private hospitals in southeastern Brazil. The main outcomes were perineal and abdominal trauma, maternal infection and hemorrhage, newborn vitality, and women's perception of safety. We calculated the odds ratios (OR) for the number of MST harms (dependent variable).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 81.6% of the women with vaginal births had sutures for perineal trauma (87.7% of these due to episiotomies). Poor perception of safety was reported by 83.1% of women, and 69.5% of all infants not admitted to the NICU were separated from their mother after birth. The overall rate of cesarean birth was 52.6%, and 7.5% of term infants were admitted to the NICU. In public settings, having an intrapartum cesarean significantly increased the chances of one (OR 2.21; 95% CI 1.20\u20104.07), or two or more (4.08 [2.27\u20107.32]) harms. In private settings, cesarean deliveries without labor were also associated with higher chances of one (4.26 [2.65\u20106.85]), or two or more (4.60 [2.35\u20109.02]) harms. Only 2% of the women had harm\u2010free care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In southeastern Brazil, there is a high prevalence of preventable harm during maternity care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12454","type":"journal-article","created":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T12:24:53Z","timestamp":1570105493000},"page":"583-591","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Using the Maternity Safety Thermometer to estimate harm\u2010free care in Southeast Brazil: A hospital\u2010based cohort"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8530-8925","authenticated-orcid":false,"given":"Heloisa de Oliveira","family":"Salgado","sequence":"first","affiliation":[{"name":"Department of Social Medicine School of Medicine University of S\u00e3o Paulo Ribeir\u00e3o Preto Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3159-4708","authenticated-orcid":false,"given":"Marcel Reis","family":"Queiroz","sequence":"additional","affiliation":[{"name":"Health Board III (Medicine) University Nove de Julho S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-8585","authenticated-orcid":false,"given":"Hellen Geremias","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Carlos Chagas Institute Oswaldo Cruz Foundation Curitiba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5590-108X","authenticated-orcid":false,"given":"Carla Betina","family":"Andreucci","sequence":"additional","affiliation":[{"name":"Department of Medicine - Center for Biological and Health Sciences Federal University of Sao Carlos S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0069-2532","authenticated-orcid":false,"given":"Carmen Simone Grilo","family":"Diniz","sequence":"additional","affiliation":[{"name":"Department of Health Life Cycles and Society School of Public Health University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60138-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32407-3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-021538"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-72032013001200001"},{"key":"e_1_2_7_6_1","unstructured":"WHO.Trends in maternal mortality: 1990 to 2015.Geneva:WHO;2015."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)92750-3"},{"key":"e_1_2_7_8_1","volume-title":"Nascer no Brasil: inqu\u00e9rito nacional sobre parto e nascimento","author":"Fiocruz","year":"2014"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1590\/0102-311X00151513"},{"issue":"2","key":"e_1_2_7_10_1","first-page":"313","article-title":"G\u00eanero, sa\u00fade materna e o paradoxo perinatal","volume":"19","author":"Diniz C","year":"2009","journal-title":"Rev Bras Crescimento Desevolvimento Hum"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(12)40657-7"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2010.08.003"},{"key":"e_1_2_7_13_1","unstructured":"NHS.Maternity Safety Thermometer.2015.https:\/\/www.safetythermometer.nhs.uk\/index.php?option=com_content&view=article&xml:id=93&Itemxml:id=633. 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