Public versus private: assessing maternity care in the far South of Brazil

Objectives:to compare public and private sector maternity care in the municipality of Rio Grande, in the Brazilian State of Rio Grande do Sul. Methods: a standardized questionnaire was applied to all pregnant women residing in this municipality who had a child in 2007. All aspects, from the beginning of gestation to immediate postpartum were investigated. Statistical analysis took the form of comparison of proportions for these two groups, using the chi-squared test. Results: of the 2584 children born whose mothers resided in the municipality, information was obtained on 2557, representing 98.9% of the total. Of these mothers, 96% received at least one prenatal consultation. Pregnant women attended by the private sector began prenatal care earlier, had a larger number of medical consults, blood tests, pelvic ultrasound examinations, and gynecological examinations of the breasts and cytopathological examinations of the cervix. Pregnant women in the public sector had more urine tests and serum tests for syphilis and were often give iron sulfate supplements. All these differences were statistically significant (p<0.05). Conclusions: pregnant women in the private sector systematically received better prenatal care in terms of consultations and examinations. Their delivery was more often carried out by a physician and they underwent more unnecessary interventions, such as a caesarian section or episiotomy, while they were less likely to receive iron supplements.