Objectives: to analyze the adequacy of care for normal childbirth in the Hospital Universitario Severo Ochoa (HUSO), a Level
2 hospital in the Community of Madrid according to the recommendations in the Care Strategy for Normal Childbirth (CSNC), and to detect its strengths and areas to be improved.
Method: a descriptive cross-sectional study. Through consecutive sampling, the study included 346 childbirths in women with 37 to 42 weeks of pregnancy. Eighteen (18) indicators stated in the CSNC were measured, assessing care during delivery. A bivariate analysis was conducted, applying Pearson’s Chi Square Test. The Pareto Diagram was used to establish the priority of areas to be improved.
Results: “Area for improvement”: amniotomy (44.8%), use of oxytocin in spontaneous labour (42.6%), inductions (42.2%), partogram completed (55.5%), lithotomy position during expulsion (54.3%), Kristeller maneuver (15.7%), episiotomy in normal delivery (41.6%), active management of the third stage of labour (3.8%) and skin-to-skin (66.5%). “Strengths”: epidural anesthesia (73.4%), third and fourth degree tears with and without episiotomy (1.4%; 0%), and instrumental delivery (12.3%). There was evidence of association between inductions, use of oxytocin and emergency Caesarean sections (p< 0.004), the use of epidural anesthesia and instrumental deliveries (p< 0.007), and the Kristeller maneuver and 3rd and 4th degree tears (p< 0.000).
Conclusions: given these results, a plan for improvement should include strategies to reduce the number of amniotomies and the use of oxytocin, through the review of admission criteria for delivery in process and the number of induced childbirths. Working on these points as a priority would reduce the interventions during childbirth care, and could result in improved obstetric outcomes.