The implementation of a new birthing facility in a country such as Brazil requires an extensive in-depth analysis of the challenges faced. The aim of this study was to explore beliefs, values, experiences, and practices related to the provision of birthing and neonatal care with the implementation of a new birth care facility structure called alongside midwifery units in Brazil. The study utilizes an ethnographic method to evaluate members of a Brazilian public hospital’s midwifery unit. The ethnographic study focuses on the cultural theme of “between the proposed and the possible”: the following birthing care guidelines require overcoming numerous obstacles, and four other cultural subthemes toward revealing the analyzed birth care team’s perspectives. The study found that prior training and preparation of all members of the care team, as well as the provision of adequate institutional infrastructure are essential for the implementation of a new and innovative birthing care center.
Objective: 1)to assess the gestational age at the beginning of antenatal care and its covariates; 2)to assess the number of antenatal visits and its covariates; and 3)to identify the reasons for the late initiation of antenatal care and for attending less than four visits among postpartum women living in Nampula, Mozambique. Method: cross-sectional study conducted with 393 mothers who answered a structured instrument in face-to-face interviews. Logistic regression was used to analyze the covariates of having initiated antenatal care up to the 16thgestational week, having attended four or more antenatal visits, and reporting both situations simultaneously. Results: all postpartum women underwent antenatal care, but only 39.9% started it until the 16thgestational week, 49.1% attended four or more visits, and 34.1% reported both events. Having concluded high school (ORadj=1.99; 95%CI=1.19-3.31) or college (ORadj=3.87; 95%CI=1.47-10.18) were aspects associated with reporting both situations. The reasons for the late initiation of antenatal care and attending less than four visits were as follows: not finding it important to attend several visits, not having easy access to the health facility, not being aware about pregnancy, and not having a companion for the visits. Conclusion: the gestational age at the beginning of antenatal care and the number of antenatal visits are lower than the current recommendations in the country.
Objective: to describe characteristics of pregnant women at risk and analyze the relationship with type of delivery and complications during pregnancy and puerperium. Methods: a retrospective study with secondary data of 1,574 at-risk pregnant women followed up in an educational intervention by telemedicine. Results: pregnant women with an average age of 35 years and high educational level participated. Preference for normal delivery was 43.1%, but only 17.3% had normal delivery. During pregnancy, 43.5% sought emergency care. In the postpartum period, 2.0% needed an ICU. Emergency room search was associated with age and contacts with the intervention. Cesarean delivery was associated with age, physical inactivity and overweight/obesity. ICU admission was associated with age and BMI. Conclusion: pregnant women were of high age and education, the younger and who had more contacts with the intervention sought more the emergency room. Older age, physical inactivity and overweight/obesity were factors associated with cesarean delivery.
Confl itos de interesse: nada a declarar. ResumoObjetivo: Descrever o processo de adaptação transcultural e as evidências de validade e confi abilidade da versão brasileira da Escala de Bienestar Materno en Situación de Parto.Métodos: Estudo do tipo metodológico realizado por meio das etapas de tradução, retrotradução, avaliação por comitê de juízes, pré-teste e validação. O processo de validação incluiu a participação de 500 puérperas que realizaram parto vaginal. Foram realizadas análises fatoriais exploratórias e confi rmatórias.Resultados: Após a análise dos juízes, foram aplicadas as alterações sugeridas e todos os itens apresentaram concordância entre os avaliadores acima de 80%. A análise fatorial exploratória e confi rmatória indicaram um ajuste satisfatório do modelo com três dimensões e bons índices de confi abilidade (alpha = 0,95 e ômega = 0,94).Conclusão: A versão brasileira abreviada da Escala de Bienestar Materno en Situación de Parto é uma escala de 16 itens que apresenta boas evidências de validade e confi abilidade.
"Suba o primeiro degrau com fé. Não é necessário que você veja toda a escada. Apenas dê o primeiro passo". Martin Luther KingReberte LM. Efeitos do uso de uma cartilha educativa durante o pré-natal [tese]. São Paulo: Escola de Enfermagem, Universidade de São Paulo; 2012. RESUMO Introdução:A educação para a promoção da saúde no pré-natal deve ser oferecida baseada nas necessidades e avaliações das próprias gestantes. A cartilha educativa "Celebrando a Vida" deve ser disponibilizada como parte da assistência pré-natal em função dos resultados que pode proporcionar às gestantes. Objetivo Geral: Avaliar os efeitos da cartilha educativa "Celebrando a Vida" na assistência pré-natal. Método: O método foi quantitativo e o tipo de estudo foi de intervenção, longitudinal, prospectivo, controlado e não paralelo. Locais de estudo: O estudo foi realizado em duas UBS do distrito de saúde do Butantã, em São Paulo: UBS Jd. Jaqueline e a UBS Jd. São Jorge. A população do estudo foi composta por gestantes em acompanhamento pré-natal, na UBS Jd. Jaqueline: grupo controle (sem cartilha) e grupo intervenção (com cartilha), e na UBS Jd. São Jorge: grupo controle (Curso do Pré-natal sem cartilha) e grupo intervenção (Curso do Pré-natal com cartilha). A coleta de dados foi realizada em três momentos: inicial, intermediário e seguimento. Os instrumentos utilizados foram: o questionário Sociodemográfico e Obstétrico, a escala de Qualidade de Vida "Ferrans e Powers Quality of Life Index" para gestantes e o Formulário de Avaliação da Educação sobre Gravidez durante o Pré-Natal. Análise de Dados: Qui-quadrado, Análise de Variância para Medidas Repetidas (ANOVA), Testes-t, Mann-Whitney e Wilcoxson. Resultados: 135 gestantes participaram do estudo na avaliação inicial, 126 no momento intermediário e 111 no seguimento. As informações recebidas durante o pré-natal foram avaliadas como suficientes pelo grupo intervenção da UBS Jd. Jaqueline após a entrega da cartilha, passando de 69,6% no momento inicial para 87,5% no seguimento. Na UBS Jd. Jaqueline, o conjunto representado por família, amigos e vizinhos foi o recurso mais citado no momento inicial para os dois grupos (76,6% controle, 57,4% intervenção). Após a intervenção, a cartilha foi o recurso mais citado para o grupo intervenção (68,2% no momento intermediário e 70,0% no seguimento). Na UBS Jd. São Jorge, o conjunto família, amigos e vizinhos foi o mais citado no momento inicial para os dois grupos (77,8% controle, 65,2% intervenção). No momento intermediário, os profissionais de saúde foram os mais citados (94,1% controle e 80,0% intervenção) enquanto a cartilha correspondeu a 75%. Na UBS Jd. Jaqueline e na UBS Jd. São Jorge, 100% das gestantes haviam lido a cartilha ou parte dela no seguimento. Mais de 70% das gestantes perceberam um aumento do conhecimento após ler a cartilha. Houve aumento significativo na qualidade de vida das gestantes da UBS Jd. São Jorge no momento intermediário. Conclusão: Houve resposta positiva à cartilha nas duas unidades. As gestantes leem a cartilha -mesmo ...
Introduction Primary healthcare was considered by the World Health Organization as one of the ten health priorities for 2019 in the fulfillment of the specific commitments undertaken in the Declaration of Astana in 2018. The integration of the healthcare network in primary healthcare through visits to a maternity of a Brazilian Public teaching Hospital is one of the resourced for the protection and bonding of the pregnant woman. Objective To describe the experience and assessment of pregnant women in relation to visits to the maternity through a participative action between the Teaching Hospital and Primary Healthcare. Methods Qualitative study through a Community Based Participatory Research. Phases: Reduction in the number of visits was identified by the multidisciplinary team associated to actions of the Brazilian Ministry of Health; meetings with primary and hospital healthcare leaders; eight interviews with nurses from the hospital; seven workshops with 34 primary healthcare nurses and interviews with 32 pregnant women after the visit. For the purpose of this study, the interviews with the pregnant women, recorded and transcribed, were stored and organized using the webQDA ® software and thematic analysis performed. Results The pregnant women were of ages between 25 and 32, 63% were primipara and with gestational periods of between 13 and 39. Seven descriptive categories were identified: Care, bonding and health promotion of pregnant women; Challenges of communication with the pregnant women in primary healthcare; Challenges of communication with the pregnant women in hospital care; Clarification of the pregnant women's needs; Strategies for encouraging visits; Reassurance and safety in relation to the hospital; Public healthcare system image. Conclusions Countless challenges are identified by the pregnant women for the rapprochement of primary healthcare and hospital care in the attention to childbirth promoting quality healthcare, bonding and protection. Key messages Integration of healthcare network in primary healthcare through visits to a maternity is one of the resources for the protection and bonding of pregnant woman. Enhance the challenges of pregnant women as the path for rapprochement of primary healthcare and hospital care in the attention to childbirth quality healthcare, bonding and protection.
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