Expectativas sobre a assistência ao parto de mulheres usuárias de uma maternidade pública do Rio de Janeiro, Brasil: os desafios de uma política pública de humanização da assistência

Abstract

This study analyzes patients' expectations at a public maternity hospital in Rio de Janeiro, Brazil, concerning childbirth care. The methodology was based on a thematic analysis of interviews held during the eighth and ninth months of pregnancy. The study analyzed women's information on humanization of childbirth care, experience pertaining to care received during previous deliveries, their notions of ideal treatment during the current delivery, and attention received from the health care team. The results show that women's expectations focus on three main elements: speedy hospital admission, guaranteed admission to the maternity hospital, and treatment by an attentive and skilled team that cares for the patient's own health and that of her infant. Conflicting information on quality of care in the maternity hospital is a source of additional stress for these women, since in their view quality of care is more a matter of luck than routine institutional management. Based on these expectations, the authors assess the challenges for humanization of childbirth care currently under implementation in the city of Rio de Janeiro.

Aconselhamento sobre o teste rápido anti-HIV em parturientes

“…The moment of delivery requires special attention due to women's emotional and physical vulnerability 11,15 . In this context, counseling becomes a key tool, aiming to reduce the anguish caused by doubts and lack of information about the performance of the HIV rapid test.…”

“…It is based on active listening, through which health professionals seek to establish a relationship of trust, providing strategies that facilitate the recognition of users as participants in their own health condition 10 . Delivery and postpartum are not ideal moments to perform an anti-HIV test 1,11 ; however, it is recommended that fast tests should be performed in parturients who met the criteria for its recommendation as instructions on its benefits, advantages and need were given. It is important to record the request for an anti-HIV test or its refusal by parturients in the patient chart, to provide emotional support and to guarantee the right to information about test results 2 .…”

Concern of primiparous women with regard to labor and birth

“…In our study, the presence of a professional (usually in nursing) who gave some sort of warning during labour, associated with the absence of complications with the woman or the baby was pointed to as a reason for satisfaction in relation to previous birth assistance. 20 The main role of the nurse's care, and, in the case of the woman in labor and birth, you need to be attentive to the individual woman, and not only the expulsion of the baby.…”

A iniciativa hospital amigo da criança sob a ótica dos atores sociais que a vivenciam em Teresina, Piauí

“…Os depoimentos acima demonstram a insatisfação das depoentes em relação ao atendimento recebido dos profissionais de saúde. Segundo Dias & Deslandes 30 , o acolhimento proporcionado através da escuta atenta e o tratamento respeitoso e educado por parte da equipe de saúde se apresentam como parte de uma solução inicial para melhorar as expectativas das mulheres e que pode aumentar a confiança das usuárias nas unidades dentro de uma perspectiva mais ampla que possibilite a concepção de que um bom atendimento não deve ser mais uma rotina de saúde, e sim direito que ela pode exigir.…”