Approach to Extremely Severe Maternal Morbidity by Analyzing the Model of The Three Delays

Abstract

Introduction: The three-delay model can address the explanatory analysis of maternal deaths, and the same approach can be applied to extremely severe maternal morbidity.
Objective: To identify the social determinants of extremely severe maternal morbidity from the perspective of the survivors.
Methods: A qualitative study was carried out. The sampling was intentional and the field work was carried out from 2019 to 2020. The sample included four women who survived an extremely severe maternal morbidity event. Interviews with patients and relatives were carried out under the concept of verbal autopsy to access the reports transmitted by the women themselves who overcame the complication presented.
Results: Three subcategories were identified based on the delays in the care provided: first delay 1) Downplaying alarm symptoms and 2) Misgivings about medical care on the weekend; second delay 1) Underestimation by primary care of the available infrastructure; third delay 1) Misinterpretation of alarm symptoms and return home; 2) Coordination of consultations, use of diagnostic means and follow-up, and 3) Lack of professional surveillance during hospitalization.
Conclusions: The use of the model of the three delays in the analysis of extremely serious maternal morbidity contributes to the identification of the associated social determinants to improve the results in this matter.