Obstetric practices in planned home births assisted in Brazil

Abstract

Objective: To describe obstetric practices in planned home births, assisted by qualified professionals in Brazil. Method: This is a descriptive study, with data collected in an online bank maintained by 49 professionals from December 2014 to November 2015, in which the target population was women and newborns assisted in home births. Data were analyzed through descriptive statistics. Results: A total of 667 women and 665 newborns were included. Most of the women gave birth at home (84.4%), in a nonlithotomic position (99.1%); none underwent episiotomy; 32.3% had intact perineum; and 37.8% had first-degree lacerations, some underwent amniotomy (5.4%), oxytocin administration (0.4%), and Kristeller’s maneuver (0.2%); 80.8% of the women with a previous cesarean section had home birth. The rate of transfer of parturients was 15.6%, of puerperal women was 1.9%, and of neonates 1.6%. The rate of cesarean section in the parturients that started labor at home was 9.0%. Conclusion: The obstetric practices taken are consistent with the scientific evidence; however, unnecessary interventions are still performed. The rates of cesarean sections and maternal and neonatal transfers are low. Home can be a place of birth option for women seeking a physiological delivery.

The prevalence of uterine fundal pressure during the second stage of labour for women giving birth in health facilities: a systematic review and meta-analysis

“…There are however a number of limitations. First, although use of fundal pressure in home birth and community settings has been reported [ 41 , 42 ], we included only studies reporting on women giving birth in health facilities. Therefore, our data cannot be considered as representative at a population level, particularly for countries where a substantial proportion of women give birth in home or community settings.…”

Experience of women in the transfer from planned home birth to hospital

“…Sobre a caracterização sociodemográfica, os resultados se assemelharam ao de estudo multicêntrico realizado no Brasil, quanto à escolaridade e idade média das mulheres, cujos partos foram assistidos em domicílio (9) . Quanto à situação conjugal, a presença do parceiro tem sido apontada como ação de respeito às singularidades e necessidades de cada mulher, tendo em vista que os companheiros são os principais acom-panhantes do parto, presenciando o nascimento do(a) filho(a) (10) .…”

“…No tocante à paridade e via de parto pós-transferência, em investigação realizada em várias regiões do Brasil, a taxa de cesariana foi de 9,0% das parturientes que iniciaram acompanhamento domiciliar (9) . Além disso, pesquisa na Austrália demonstrou que as taxas de nascimento vaginal aconteceram mais entre multíparas (5) , achados dissonantes ao deste estudo.…”

“…Para tanto, as práticas obstétricas em parto domiciliar planejado se constituem em alternativa às mulheres que buscam parto fisiológico respeitoso, com apropriação feminina sobre a autonomia (9) . Logo, mediante as falas obtidas nesta pesquisa, acredita-se que, para evitar a violência obstétrica, a qualidade da assistência deve perpassar pelo respeito, pela dignidade, pelo apoio emocional e pela comunicação eficaz, com linguagem positiva.…”

Processo De Enfermagem À Criança Com Microcefalia Por Zika Vírus Em Serviço De Cuidado Domiciliar Fundamentado Na Teoria Do Autocuidado

“…( Santos SS dos, Boeckmann LMM, Baraldi ACP, Melo MC, 2018 e Ayres LFA, Henriques BD, Amorim WM, 2018). Bruggemann OM, Freita PF, Riesco LG,Costa R, 2018 e Koettker JG, Brüggemann OM, Dufloth RM, Monticelli M, Knobel R, 2015. Então, o parto domiciliar planejado se apresenta como uma possibilidade para o cuidado humanizado que rompe com o modelo hegemônico e que atende as demandas femininas.…”