AMBAR: A midwifery-led training program to improve obstetric and neonatal practices among low-risk births in Mexico.
Birth
; 50(1): 151-160, 2023 03.
Article
em En
| MEDLINE
| ID: mdl-36529703
ABSTRACT
BACKGROUND:
Birth care in Mexican health institutions is highly medicalized and of poor quality because of the prevalence of outdated and dangerous practices. AMBAR-a training program for health care providers on the use of evidence-based midwifery practices-was implemented during 2016-2018 and evaluated to assess the impact of training on key practices.METHODS:
For this mixed-methods study, we evaluated the effects of a training program implemented in three public hospital networks in Mexico. Qualitative data were collected and integrated into the program before evaluating the effects of the intervention on 10 birth practices, 5 beneficial and 5 potentially harmful. Quantitative data on birth practices and covariates were collected at six time points (baseline and 5 follow-ups) in a final sample of 330 direct observations. Effect estimates were obtained by longitudinal logistic and Poisson regression models, adjusted for confounding variables.RESULTS:
AMBAR had a significant effect on 4 of the 10 birth practices that were evaluated. Beneficial practices, such as skin-to-skin contact (P = 0.003) and delayed cord clamping (P = 0.039), increased significantly. Harmful when overused birth practices, such as vaginal examinations (P = 0.001), and cesarean birth (P < 0.001) decreased significantly.CONCLUSIONS:
Midwifery-based training programs for health care providers can have an impact on the quality of care of birthing people and newborns, increasing the use of evidence-based practices and decreasing frequently overused practices.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tocologia
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Female
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Humans
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Newborn
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Pregnancy
País como assunto:
Mexico
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article