Fatores associados à preferência pela operação cesariana entre puérperas de instituição pública e privada

Objetivo: Estudar os fatores relacionados a preferencia pelo parto cesareo entre puerperas de clinica publica e privada da cidade de Tubarao, SC. Metodo: Estudo transversal com 169 puerperas, de clinica publica e privada da cidade de Tubarao (SC), no periodo de agosto a outubro de 2007. Aplicou-se questionario semi-estruturado pelos pesquisadores e perguntou-se a puerpera questoes especificas sobre preferencia pelo tipo de parto.Resultados: Encontrou-se uma prevalencia de 61,3% de cesareas na clinica publica e de 100% na instituicaoprivada. As variaveis significativamente associadas a cesarea foram: servico privado, idade materna superior a 30 anos, estado marital (casada ou em uniao estavel), escolaridade da mae, maior renda do casal, dilatacao cervical na admissao inferior a 3 centimetros,patologias associadas, cesarea previa e horario diurno do parto. A preferencia pela cesarea foi maior na clinica privada e entre as puerperas de clinica publica que realizaram parto vaginal na ultima gestacao. 93% das mulheres da clinica privada e 71,4% das de clinica publicadisseram preferir o parto cesareo devido ao “medo da dor do parto normal”. Conclusao: Tanto as puerperas que realizaram parto cesareo em clinica privada, quanto as que tiveramparto normal em instituicao publica preferiram a cesarea como opcao para uma proxima gestacao. Esta mesmapreferencia foi vista entre as puerperas com presenca de cesarea previa. A principal justificativa encontradapara a preferencia pelo parto cesareo em ambas as instituicoes foi o medo da dor do parto normal. Objective: Studying the factors related to the preference for c-section among puerperas from public and private medical clinics in Tubarao city, SC.Methods: Transversal study with 169 puerperas from public and private medical clinics in Tubarao city, SC, between August and October, 2007. Semi-structured forms were filled in by the investigators and specific question was asked about the puerperas on preference regarding the mode of delivery. Results: It was found a prevalence of 61,3% of csectionsat public medical clinic and a 100% of preva-lence at private medical clinic. The meaningful variables associated to the c-section were: private service, maternal age over 30, marital status married or living in together, better mother´s scholarity, higher couple´s income, less than 3 centimeters of dilation in the admission, associatedpathologies, previous c-sections and daytime delivery. The preference for c-section was bigger in the private medical clinic (84,1%) and among the puerperas from the public clinic that had a natural delivery (70,7%). 93% of the women from private clinical and 71,4% from public clinical said that preferred c-section because of “fear of the pain of the vaginal delivery". Conclusion: Either the women from private clinicalthat had a c-section delivery and that from public clinical that had a vaginal delivery preferred c-section like optionfor a next gestation. The same preference was seen between the women recently confined with presence of a prior c-section. The main justification found for the preference by the c-section in both institutions was the fear of the pain of the vaginal delivery.