Teenage pregnancy is frequently risky both to the health of the mother and the baby, and it is very important to assess physical and mental health of the teenager-woman, since cases of pregnancy in women under 20 years of age are usually not planned and often result in search of abortion or child abandonment. According to estimates of WHO – World Health Organization, approximately one third of the women seeking hospital care due to complications of abortions are teenagers, what increases the risk of maternal mortality in this age group.
The proportion of teenage pregnancies in the State is one of the lowest in Brazil. In 2015, according to DATASUS–Departamento de Informática do Sistema Único de Saúde (Informatics Department of the Unified Health System), the proportion of live births to mothers under 20 years of age was 14.54%, whereas the average of Brazil was 18.15%. Among the Federation Units, RS was in 25th place, surpassed only by Santa Catarina, São Paulo and the Federal District with 14.29% and 13.82% and 12.31% respectively, which have the lowest percentages of Brazil. In 2016, the indicator reached 14%, according to the SES RS, confirmed the downwards tendency observed since 2000.
Another significant aspect concerning maternal and neonatal health is the proportion of cesarean deliveries¹. In Brazil, rates are extremely high in all regions, well above the recommended by WHO, that by 1985 defended cesarean delivery rates between 5% and 15%, a position reiterated in more recent studies. According to the ANS (National Agency of Supplementary Health)², cesarean section, when indicated unnecessarily, carries risks to the health of the mother and the baby: it increases the chances of respiratory problems in the newborn by 120 times and triples the risk of death of the parturient during the procedure and due to puerperal infection. About 25% of neonatal deaths and 16% of infant deaths in Brazil are associated with prematurity³ triggered by planned cesarean sections.
In Brazil, in 2015, the percentage of cesarean deliveries was 55.5%, whereas in Rio Grande do Sul, the seventh in the ranking among the Federation Units, it reached 61%, well above the Brazilian rate. Its proportion showed increasing growth over the period 2000-2014, having reached 63% in the State in 2014. The decrease of two percentage points of 2015 in relation to the previous year was observed in several other states of the country and also in the national average. According to the Ministério da Saúde (Ministry of Health), the reduction in the number of cesarean deliveries is a consequence of measures such as the implementation of public policies such as the stork network and investments in normal birth centers; the qualification of high-risk maternity hospitals; the greater presence of obstetric nurses during childbirth and the ANS's performance with health plan operators.
¹ Cesarean deliveries are surgical procedures idealized and performed envisaging the relief of maternal and fetal conditions, when there is risk for the mother, the fetus or both during labor or, under some specific conditions, in its proximity.
² The ANS - National Agency for Supplementary Health published resolution to stimulate ormal birth in supplemental health on 01/07/2015.
³ Prematurity is defined by WHO as being born before 37 weeks of gestation.