The Current State of Obstetric Nursing in Brazil

Oliveira, Ana Paula Cavalcante de; Ventura, Carla Aparecida Arena; Galante, Mariana; Padilla, Mónica; Cunha, Anna; Mendes, Isabel Amélia Costa; Souza, Kleyde Ventura de; Silva, Manoel Carlos Neri da; Pinheiro, Mayra Isabel Correia; Ramalho, Nádia Mattos; Acioli, Sônia; Azevedo, Vinícius Nunes

doi:10.1590/1518-8345.0000.3510

Cited by 7 publications

(8 citation statements)

References 2 publications

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“…Thus, obstetrics services must attend 4.5 million pregnancies per year by 2030, to guarantee universal access to maternal and child care. Currently, 2049 nurse midwives are registered with the Brazilian Nursing Council [ 45 ]. Therefore, the low number of available nurse-midwives is in itself a limiting factor for the expansion of childbirth care by nurse-midwives.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project

et al. 2023

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Background In 2015, a quality improvement project—the “Adequate Childbirth Project” (Projeto Parto Adequado, or PPA)—was implemented in Brazilian private hospitals with the goal of reducing unnecessary cesarean sections. One of the strategies adopted by the PPA was the implementation of labor and childbirth care by nurse-midwives. The objective of this study is to evaluate the results of the PPA in the implementation and adequacy of labor and childbirth care by nurse-midwives in Brazilian private hospitals. Methods Cross-sectional, hospital-based study, carried out in 2017, in 12 hospitals participating in the PPA. We assessed the proportion of women assisted by nurse-midwives during labor and childbirth care and the adequacy of 13 care practices following parameters of the World Health Organization. Women assisted in the PPA model of care and in the standard of care model were compared using the chi-square statistical test. Results 4798 women were interviewed. Women in the PPA model of care had a higher proportion of labor (53% × 24.2%, p value < 0.001) and vaginal birth (32.7% × 11.3%, p value < 0.001), but no significant differences were observed in the proportion of women assisted by nurse-midwives during labor (54.8% × 50.1%, p value = 0.191) and vaginal birth (2.2% × 0.7%, p value = 0.142). The implementation of recommended practices was adequate, except the use of epidural analgesia for pain relief, which was intermediate. There was a greater use of recommended practices including “oral fluid and food”, “maternal mobility and position”, “monitoring of labor”, “use of non-pharmacological methods for pain relief” and “epidural analgesia for pain relief” in women assisted by nurse-midwives in relation to those assisted only by doctors. Many non-recommended practices were frequently used during labor by nurse-midwives and doctors. Conclusions There was an increase in the proportion of women with labor and vaginal birth in the PPA model of care and an appropriate use of recommended practices in women assisted by nurse-midwives. However, there was no difference in the proportion of women assisted by nurse-midwives in the two models of care. The expansion of nursing participation and the reduction of overused practices remain challenges.

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Section: Discussionmentioning

confidence: 99%

Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project

et al. 2023

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“…Adolescent pregnancies in the Brazilian territory are classified as at high risk (12) , and, in these cases, obstetric nurses can work fully during prenatal and postnatal care (42)(43) . However, their role is often restricted to the initial care and specific actions of health education (42) .…”

Section: Discussionmentioning

confidence: 99%

Adolescent pregnancies and adherence to puerperal consultation

Pinto

Silva

Parra

et al. 2022

Rev. Latino-Am. Enfermagem

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Objective: to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais. Method: cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy - dependent variable; sociodemographic, clinical and obstetric - independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher’s exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance. Results: we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women. Conclusion: adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance.

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“…As gestações na adolescência no território nacional são classificadas como alto risco (12) , e nestes casos, os enfermeiros obstetras podem atuar integralmente durante os cuidados pré e pós-natais (42)(43) . No entanto, observa-se a restrição de sua atuação, que muitas vezes resume-se no acolhimento e ações pontuais de educação em saúde (42) .…”

Section: Discussionunclassified

Gestações na adolescência e adesão à consulta puerperal

Pinto

Silva

Parra

et al. 2022

Rev. Latino-Am. Enfermagem

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Resumo Objetivo: identificar o perfil das gestações e prevalência de adesão à consulta puerperal entre puérperas adolescentes comparadas a não adolescentes, assistidas em um ambulatório de hospital de ensino do interior de Minas Gerais. Método: estudo transversal aninhado a uma coorte de puérperas; amostra não probabilística, por conveniência; gestação na adolescência - variável dependente; sociodemográficas, clínicas e obstétricas - variáveis independentes. Utilizado instrumento próprio, testado mediante piloto. Calculadas razões de prevalência e intervalos de confiança; aplicados testes qui-quadrado e exato de Fisher, considerando nível de significância de 5%, e regressão de Poisson com variância robusta. Resultados: entrevistadas 121 puérperas, 18,2% (22) adolescentes, verificou-se entre elas baixa escolaridade (p<0,001); menor número de gestações cursando com patologias (p = 0,016); predomínio de primíparas (p<0,001) e maiores índices de parto normal (p = 0,032). A prevalência de adesão à consulta puerperal foi de 34,7% e de 31,8% para adolescentes. Não houve diferenças em relação à adesão e idade das puérperas. Conclusão: adolescentes não apresentaram desfechos obstétricos e neonatais negativos, embora tenha sido observada menor escolaridade. Identificou-se associação entre idade precoce e ausência de doenças na gestação e maiores índices de partos vaginais normais. A adesão ao retorno puerperal apresentou-se pouco inferior, porém sem significância estatística.

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The Current State of Obstetric Nursing in Brazil

Cited by 7 publications

References 2 publications

Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project

Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project

Adolescent pregnancies and adherence to puerperal consultation

Gestações na adolescência e adesão à consulta puerperal

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