In addition to fielding three questionnaires with hundreds of questions about women’s health conditions during pregnancy and after childbirth – including questions about depression and knowledge about pregnancy – the study used the Live Birth Information System (SINASC) to obtain data about the type of delivery and the gestational age of the babies. The rate of prematurity among babies whose mothers received the intervention was eight percent, as compared to 11 percent — the same rate as the city of Rio de Janeiro — among those who had conventional prenatal care. “Although we did not reach the ideal sample size of 800 women that we had originally planned for, we can say that the intervention generated a tendency to reduce prematurity,” says Lopes. According to the researchers, violence was one of the main factors that hindered recruitment because it limited the operations of family clinics and the movement of pregnant women to them. Another important factor was the discontinuity of municipal health policies. “We attribute the reduced rates of prematurity to greater self-care and reduced stress provided through participation in the group,” say the researchers in charge. “The risks of premature birth, such as high blood pressure, were also more easily identified and controlled.”
Group prenatal care also has advantages for health management: using the same professionals, it is possible to expand access to a much larger number of pregnant women. To implement the program in a family clinic or Basic Health Unit (UBS), it is necessary to train professionals in the method — 20 were trained for this project — and designate, at minimum, a location for the meetings to take place. A team consisting of a nurse and an obstetrician or midwife is required, in addition to scales, blood pressure measurement equipment and snacks.
Although they have not conducted cost-effectiveness analyzes, the researchers estimate that with R$8,000 a month it would be possible to keep this basic structure running for four meetings of two hours per month, or one per week. “The project has attracted the attention of Rio’s municipal health secretary and other managers,” explains Lopes, who held six meetings with them. “Our goal now is to expand it to other cities.”
