Open Journal of Obstetrics and Gynecology, 2013, 3, 35-40 OJOG Published Online November 2013 (
Partner profile of pregnant women who have obstetric
prenatal high risk in a university hospital south of Brazil
Gisele Perin Guimarães1,2, Jussara Gue Martini3,4,5
1Clinical Nurse Neonatology Service of the Regional Hospital of St. Joseph, São José, Brazil
2Internment Facility Screening Obstetrical and Gynecological Hospital of the Federal University of Santa Catarina, Florianópolis,
3Department of Nu r sing and the Graduate Program in Nursing at UFSC, Florianópolis, Brazil
4Graduate Program in Respiratory Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
5Center for Health Research, Researcher Group Research in Nursing and Health Education and IEG, Florianópolis, Brazil
Received 23 September 2013; revised 20 October 2013; accepted 27 October 2013
Copyright © 2013 Gisele Perin Guimarães, Jussara Gue Martini. This is an open access article distributed under the Creative Com-
mons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work
is properly cited.
This study aimed to relate the social and obstetric
risk factors presented by pregnant women who un-
derwent high risk prenatal in a southern Brazil hos-
pital unit. This is a quantitative research. The data
collection was conducted from January to September
2012, where 12 high-risk pregnancies and nine com-
panions with diversified social and obstetric condi-
tions were seen. The analysis was by simple statistics.
Pregnant women social profile results indicated that
predominant age group was 31 to 40 years old; all
had some degree of education; 84% Catholic; 75% of
pregnant women were accompanied by someone of
their choice during high risk prenatal care; and 50%
of the choices were for her spouse; half of these preg-
nant women have a professional occupation. Obstet-
rics findings demonstrated that the majority of women
were not planning on the pregnancy, only 17% started
prenatal care in the first trimester, 42% had already
presented risk in previous pregnancy, 58% of women
were classified as high risk due to fetal abnormalities.
Given these findings, it is clear that high-risk preg-
nancy as a period involving several factors, including
social and obstetric that, when connected, can com-
promise the process of gestating for both the mother
and the fetus.
Keywords: Pregnancy; Prenatal Care; High Risk;
Pregnancy is considered as a physiological event in a
couple’s life, with a period of evolution, mostly un-
eventful, surrounded by sensations that generate pleasure
and expectation s in the months that follow until the end-
ing weeks of gestation. However, this period considered
physiologic in women’s lives, it is often modified as a
result of certain conditions, which triggers specific char-
acteristics that may evolve unfavorably, representing
both maternal and fetal risks, with the possibility to ad-
mission at a hospital.
Women who experience a pregnancy outside the nor-
mal range and that are perceived in a health-disease
process are called “high risk pregnancies” [1].
The maternal and fetal risks are not only related to ob-
stetric factors of the current pregnancy, but also external
factors that aggregate unfavorable situations to a favor-
able evolution of the pregnancy, those directly related to
social conditi on s, an d hi st o ry of previous pregnancies.
Another factor that must be taken into consideration is
the high number of pregnant teens in our midst, and that
has been associated with an increased frequency of ad-
verse obstetric outcomes such as low birth weight, pre-
mature delivery, maternal death and perinatal mortality,
preeclampsia and cesarean birth, among others. Not that
these are classified as high risk, but the possibility of be-
coming in the course of pregnancy is higher when com-
pared wit h pregnant women of ot he r a ge groups [2].
Therefore, this article aims to understand the social
and obstetric profile of pregnant women who underwent
prenatal high risk in a hospital in southern Brazil.
The importance of identifying the social and obstetric
profile of pregnant women helps promote a deeper un-
derstanding of the family contexts advantages and diffi-
culties and its relationship, as well as, the risk that rated
G. P. Guimarães, J. G. Martini / Open Journal of Obstetrics and Gynecology 3 (2013) 35-40
the mother as high risk. Through this social and obstetric
information the relationship between subject and re-
searcher get s closer.
It is a quantitative research carried out in public training
hospital in southern Brazil, where the study subjects, 12
high-risk pregnancies and nine companions, were un-
dergoing prenatal care. Data collection began after the
subjects were aware of the objectives, intentions and
modes of participation, and agreed to participate in the
It was not determined a minimum number of partici-
pants. The only stipu lation was related to a timeframe of
six months, which determined that the period to accept
new mothers would be from January through June 2012,
being this, the exclusion criterion. After ending these
months, prenatal care resumed for those who were al-
ready in the process of health education, lasting until
September when all had finished the reflective processes.
Thus, the sample size (n = 12) was set intentionally
selecting the elements that compose the inclusion and
exclusion criteria, i.e. be high risk pregnancies and inter-
est in participating in th e study.
When performing Nursing Consultation (NC), it was
necessary to have a better understanding of the social and
obstetric’ s situation of every high risk pregnant woman
accompanied by their companions during their prenatal
care. This process proportionated us a better visualization
of the main factors related in such special moment of the
At the first stage of the NC, which was carried out in-
dividually with the high-risk pregnant women and their
companions, is the time when initial dialog ue was estab-
lished in search of validation of the social and obstetric
data obtained from their medical records.
Social data collected was: age, education, religion,
profession/occupation, marital status and companion of
choice. Whereas the obstetric approached parity, for ex-
ample, the number of pregnancies experienced, whether
or not that’s a planned pregnancy, risk classification,
diagnosis and if there was the need for hospitalizatio n in
the current pregnancy.
After being extracted information from medical re-
cords, the registry of this data was entered in a field diary
and later transferred to an Excel spreadsheet, for simpli-
fied tabulation. Data analysis was done using on simple
statistics method, enabling a reduction in terms of the
sample, representatively without loss characteristics.
Ethical principles established by Resolution 196/96 of
the National Health Coun cil [3] and the principles of the
Code of Professional Ethics to standardize the investiga-
tive activities were respected. Project was submitted to
UFSC’s (Universidad Federal de Santa Catarina) Ethics
Committee on Human Research, with assent under No.
2257/11, Certificate of Appreciation for Ethics Presenta-
tion No. 448412.
Social and obstetric conditions were varied, thus to better
understand the findings of this study, data will be pre-
sented separately. First will be social findings and later
obstetric events.
Age range of women who experienced high-risk preg-
nancy (n = 12) ranged between 13 and 40 years (n = 5,
42%), of age with predominance (Ta b l e 1) for pregnant
women between 31 and 40 years old. These assertions is
Table 1. Social profile of pregnant women who received pre-
natal care in high-risk HU/UFSC-2012.
Profile n %
13 - 19 years 3 25
20 - 30 years 4 33
31 - 40 years 5 42
Total 12 100
High school graduate 06 50
Incomplete secondary education06 50
Total 12 100
Catholic 10 84
Spiritualist 01 8
No religion 01 8
Total 12 100
Partner 06 50
Other 03 25
Unaccompanied 03 25
Total 12 100
Marital status
Stable Unio n 07 58
Maiden 04 34
Separate 01 8
Total 12 100
Unemployed 06 50
With occupancy 06 50
Total 12 100
Copyright © 2013 SciRes. OPEN ACCESS
G. P. Guimarães, J. G. Martini / Open Journal of Obstetrics and Gynecology 3 (2013) 35-40 37
in line with results presented by the Min istry of Health [4]
highlighting Southern Brazil as the largest proportion of
births alive in this age group, whereas the Northern re-
gion presents the highest rates of high-risk pregnancies
in teens.
The lower age group of women who underwent high
risk prenatal in this study was adolescents (n = 3, 25%).
Age range considered for teenagers in this study was 13
through 19 years old. This is taking into account the
minimum age advocated by Law 8069 of July 13, 1990,
which is provided for in the Child and Ad olescent Statute.
Teen is a person who is between the age of twelve and
eighteen years of age. World Health Organization (WHO)
adopts the rage between 15 and 19 years [5] for teens.
It was observed that the pregnant women in this study
were all literate (n = 12, 100%), varying only in the level
of education, being 50% high school graduate, and 50%
incomplete secondary education. The fact that these
women had a certain degree of education that provided
not only practical, visual and life knowledge, but also
written words and knowledge exchange during the proc-
ess of reflection-action-reflection. Some even had read
about the risk they were experiencing, and sought for
information in the virtual universe of the internet or
through people who reported their personal experiences
of pregnancy on their blogs, a space on the internet or-
ganized in reverse chronological order, focusing on a
particular theme, which can be written by a variable
number of people who share their personal experiences
and can post pictures, text, etc.
However, despite early adoption by the pregnant
women of electronic media search for knowledge related
to their situation, many readings came distorted, gener-
ating higher anxiety levels in them and their companions
and increasing emotional instability, requiring constant
back and forth to bring them to th eir reality and closer to
the context in which they were living .
Religion, predominating Catholicism (84%), was some-
thing strongly emphasized by the pregnant women,
which in conjunction with prenatal care provided com-
fort, motivation and strength to continue the journey of
risky pregnancy. Having faith was the base to keeping
them strong and to facing obstacles, besides the strong
presence of their companion, which provided greater
security in times of difficulty, o f expectations and also of
The choice of companions by the pregnant women
during prenatal care was varied. M ost women 50% (n = 6)
were accompanied by their partners. Other choices of
companions were the mother and sister-in-law/God-
mother. It stood up the fact that some women 25% did
not have a companion, having to face the difficulties of
the high-risk pregnancy without any support, whether
from family, friends or someone who they could share
their feelings with and encourage a dialogic relationship
during the prenatal care assistance meetings.
An important fact that should be noted is the marital
status of the 12 pregnant women being followed. Most
women had a companion through a domestic union (sta-
ble union—Brazilian regulation) 58% (n = 7), allowing
for the sharing of moments experienced during the preg-
nancy. This study had a significant number of unmar-
ried pregnant women, a total of 34% (n = 4).
The constitution of the family income is exercised
with balance by the companion, considering that 50% of
pregnant women did not any realize profit-making ac-
tivities, devoting most of their time to domestic activities.
On the other hand, the other 50% of women from this
study had a professional occupation, such as: cleaning
ladies; maid; beautician; seamstress, bartender and op-
erator. Beside these activities, they still took care of their
home by performing domestic activities and, some, also
adopted the role of br eadwinner, denoting multiple work-
ing shifts.
The results presented so far allowed for a view of the
pregnant women’s social profile, focus of this study;
however, this is not enough to glimpse, in a global scale,
the high-risk pregnancy. For that, we present the obstet-
ric profile, trying to correlate the social and obstetric fac-
tors that pregnant women underwent during the high-risk
prenatal care which allows us to do broader and more
appropriate critical analysis.
Obstetric findings reflect the women’s profile since the
first moment, being that most of these women said they
had not planned for the pregnancy. Only some had
planned with their companions when to get pregnant.
The fact majority had not planned for the pregnancy may
justify the beginning of their prenatal care assistance
only in the second or third trimester of the pregnancy.
With respect to the parity of the women (Table 2),
there was a certain proximity between first pregnancy,
those who a generating their first child and second preg-
nancy. In greater number (n = 5, 42%) it was the group
of women that had had three or more pregnancies, which
are classified as multigravida.
Previous history of the studied pregnant women shows
that the minority of these women had risk situations in
some of their previous pregnancies, corresponding to
17%. Most women received low-risk prenatal care at
their local Basic Health Units—BHU, in contrast with
the current pregnancy where they were classified as
high-risk pregnancies and requiring to perform prenatal
at hospital of reference for such assistance.
After these pregnant women were considered of high-
risk and being monitored by the specialized prenatal care,
it was observed that the majority o f these high risk preg-
nant women 92% (n = 11) displayed a serene and un-
eventful pregnancy, with no need for hospitalization for
Copyright © 2013 SciRes. OPEN ACCESS
G. P. Guimarães, J. G. Martini / Open Journal of Obstetrics and Gynecology 3 (2013) 35-40
Table 2. Profile of women who underwent obstetric prenatal
care for high-risk HU/UFSC-2012.
n %
Home assistance prenatal
1˚ trimester 02 17
2˚ trimester 06 50
3˚ trimester 04 33
Total 12 100
First pregnancy 03 25
Second pregnancy 04 33
Three or more pregnancies 05 42
Total 12 100
Risk situation in previous pregnancy
Yes 02 17
No 07 58
Not applicable (first pregnancy) 03 25
Total 12 100
Hospitalization this pregnancy
Yes 01 8
No 11 92
Total 12 100
reasons related to the pregnancy. However, it is note-
worthy that three pregnant women were first pregnancy
and not considered in relation to the experience of pre-
vious pregnancies.
Women studied, in addition to being classified as high
risk within the prenatal care assistance, were also di-
rected based on the risk type (Table 3). This could be
maternal risk, fetal risk and maternal-fetal risk. When
relating the type of risk, we’ve realized that most of the
women 58% were performing prenatal risk due to fetal
risk, and a smaller propor tion (n = 5, 42%) was related to
maternal-fetal risk. None of the studied women presented
maternal risk exclusively.
Such risk ratings were determined from the clinical
diagnoses (Table 4) collected during prenatal care, which
guided the approach and dialogic processes during all
interactions, favoring the overco ming of needs presented
by each of the women and their companions.
The way pregnant women faced these situations of
risk and their unborn was favored not only by specialized
prenatal care, which targeted their needs, but also, and
with the same value, by the possibility of having along
this journey of choosing the companion who was sig-
nificant and who could support, encourage, understand
their feelings and share the whole process of reflection-
Table 3. Risk of obstetric pregnant women who underwent
prenatal high risk in HU/UFSC-2012.
Risks obstetric n %
Fetal 07 58
Maternal - fetal 05 42
Maternal 00 -
Total 12 100
Table 4. Diagnostic risk of pregnant women who received pre-
natal care in high-risk HU/UFSC-2012.
Diagnostic risk obstetric
Maternalfetal Fetal
Sickle cell anemiaDiaphra gmatic hernia
Adolescence Dextropositioncardiac/cardiacmalformation
HPV Oligoamnion
Depression Skeletaldys plasia
Vascular disease Dandy Walker
- Cerebellar agenesis
- Down syndrome
- Twin-twin transfusion
- Congenital malformation
(clubfoot, syndactyly, etc.)
action-reflection, encouraging them to overcome the dif-
ficulties and enabling the empowerment of being a high
risk pregnant wom a n .
During pregnancy a woman goes through many situa-
tions and many of these lead pregnant women to be con-
sidered as being of greater or lesser risks, which may be
exacerbated by social and obstetric factors. Factors iden-
tified in this study denote a pregnant woman profile that
goes against institutional reality, focus of this study,
where women have some level of education, are mostly
in the company of someone of their choice, where they
already had a previous pregnancy and possessed a belief
that helps them during their journey, among others, fa-
voring reflective moments and promoting better out-
comes for the pregnant women.
To counter these moments of weakness are other no-
ticeable changes in the profile of these women, who are
increasingly seeking their independence, by becoming
pregnant over the age of 30, studying longer, with a level
of education that promotes sharing of knowledge, be-
sides having a professional occupation, showing greater
maturity in their behavior and decisions making. This
new way of seeing the future, promotes a more secure
Copyright © 2013 SciRes. OPEN ACCESS
G. P. Guimarães, J. G. Martini / Open Journal of Obstetrics and Gynecology 3 (2013) 35-40 39
and determined acting.
In line with the findings of this study are the notes
made by [6] that highlight the main reasons for an ad-
vanced maternal age pregnancy, among these, the desire
to invest in their academic training/studying and profes-
sional career; a choice for a later stable conjugal rela-
tionship; the formation of new unions; infertility prob-
lems among others.
On the other hand, the age of the women above 30
years is identified as a factor directly related to maternal
mortality, particularly when associated with multigravida
and other risk factors such as, low literacy and the ab-
sence of a companion during pregnancy. Therefore,
women in this age group should be considered as high-
risk pregnancies and will receive qualified prenatal care,
tailored to their needs [7].
Despite their maturity, sentiment of insecurity, uncer-
tainty, anxieties arise and are intensified at all times
when confronted with new scenarios. However, these
feelings are mitigated by faith and the belief of a higher
Being, regardless of religious belief. It is this greater
Being that gives strength and courage to face the diffi-
culties during the course of the high risk prenatal [8].
Factors such as maturity of the studied pregnant
women, linked to the faith that motivates them to keep
going can be associated, in most cases, to the emotional
support received from their companions, as well as their
family, where the latter two, as faith, can provide for
better emotional stability.
Although some pregnant women were not accompa-
nied by their spouses during the high risk prenatal care,
they were able to count on someon e close to them, which
proportionated a participatory presence in moments of
reflection-action-reflection. For these ladies, it is impor-
tant to build, in a collective space, their life stories,
where they can share wishes and desires [9].
Several scientific studies, both domestic and interna-
tional attest to the benefits of having the presence of a
companion. Besides feeling more secure during the
course of pregnancy, these women also demonstrated
more confidence during labo r [10].
However, we must consider that the absence of a sig-
nificant other during the prenatal care is unfavorable to
overcoming difficulties, not only during these times, but
especially regarding the continuation of the dialog and
on the return home, to the workplace and to the family.
Therefore, when the pregnant woman does not have a
person of reference, it is important that the relationship
between mother and nurse be even closer and stronger, as
many of these women consider the nurse as being this
particular provider of security and attention. Regardless
of the situation, in the world of a high risk pregnancy,
nursing consultations should be surrounded by a lot of
dialogue, reflection and action throughout the whole time
information is being shared.
Authors [11] point out to the importance of nurses in
the prenatal care, as besides answering questions to the
pregnant women and their companions during the meet-
ings, this professional class has been contributing for the
strengthening of a relationship of trust and closeness, as
well as, providing comprehensive care with educational
actions to the pregnant women, their unborn baby and
Perhaps, a strong influence over the lack of compan-
ionship during the prenatal care of high risk in this study
may be related to unplanned pregnancy. This factor also
has strong relationship to the late beginning of prenatal
care, in the second trimester of pregnancy, which is a
period where these women begin to understand the
physical and emotional changes typical of the gestational
developing period, when they seek for health services to
start the prenatal care.
In those situations where there was no planned preg-
nancy, risk factors for recurrence should be considered,
especially when the mother is a teenager [12]. Thus,
preventive care for a new pregnancy should be part of
the educational and reflective actions during the high risk
prenatal care.
For most pregnant women, the experienced risk in the
pregnancy is something unique, not previously lived,
that’s because it is their first pregnancy or for previous
pregnancy being within a favorable development and
classified as low risk.
The experience of the current pregnancy of risk, was
monitored, in almost all pregnant women, as outpatient,
in other words, it was managed to keep the situation of
fetal or maternal-fetal risk adequately controlled an d sta-
ble, with no need for hospitalization at the maternity
In spite of the wide range of diagnoses identified during
the course of pregnancy, we noticed that the most classi-
fication of obstetric risk was related to pathologies such
depressive state and even depression. The latter is con-
sidered as the disease of the century, and when combined
with hormonal and mood changes, it generates instability
and disbelief of a promising future.
Based on our findings, we realized that the high risk
pregnancy as a period that involves many factors, among
them, social and obstetric that when connected, can com-
promise the gestation process for both the mother and the
In this sense, it is essential that the nurse, as an active
professional during the prenatal care, promote a space
that allows for dialog among all individuals within the
pregnancy context, who are the pregnant woman, her
companion and healthy professionals, by offering mo-
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G. P. Guimarães, J. G. Martini / Open Journal of Obstetrics and Gynecology 3 (2013) 35-40
Copyright © 2013 SciRes.
ments of dialogue, reflections and actions that will pro-
gressively facilitate the overcoming of difficulties ex-
perienced during high risk pregnancies.
Among the study limitations, we can cite the absence
of a spouse, for we could profile the couple and family
better understand the organization as well as the lack of
studies more specifically for high-risk pregnancies.
We suggest that further studies look in depth to the
pregnant women’s social and obstetric reality in their
institution, and that they understand how to create a dia-
logue channel among professionals, pregnant women and
their companions, so that they can better d eal with issues
that permeate a risky pregnancy, promoting actions to
overcome difficulties experienced during the entire ges-
tational period, that will help these individuals play an
active role in the changes related to their own life story.
Among the recommendations, we believe that there is
a need for a broader look by professionals who assist in
high risk prenatal care, where the nur se should know the
social and obstetric situation of each of the pregnant
women and their companions, allowing them to correlate
the main risk factors in an attempt to minimize them in
the current pregnancy.
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