As relações de poder na atenção obstétrica e neonatal: perspectivas para o parto e o nascimento humanizados

Abstract

Objetivo: refletir a respeito das relações de poder que permeiam a atenção obstétrica e neonatal, discutindo as perspectivas para o parto e o nascimento humanizados. Método: estudo teórico e reflexivo, ancorado em referenciais sobre o processo de parturição e sobre poder, especialmente, nos estudos de Foucault: A Microfísica do Poder e o sujeito e o poder. Resultados: destaca-se que as relações de poder que permeiam a assistência obstétrica se sustentam no modelo hegemônico e no predomínio de práticas intervencionistas, ancorada nas rotinas e padrões que necessitam de aporte científico e cuidado humanizado. Revela-se que o poder profissional em relação à parturição e o protagonismo feminino, define a genealogia dessa relação. Quanto às perspectivas de rompimento do paradigma dominante, tem-se a necessidade de reapropriação do corpo e do parto feminino, por meio de novas modalidades de assistência que potencializam o poder e o saber da mulher. Considerações finais: acredita-se que a assistência obstétrica baseada em evidências científicas e nas tecnologias educacionais oportunizem mudanças e rompimentos pragmáticos no processo de parto e nascimento.

Obstetric nurse and the factors that influence care in the delivery process

“…These asymmetries can contribute to the devaluation of obstetric nurse care by both the women and the institution/ health professionals. Nurses are sometimes overshadowed because their historical trajectory was supported by the hegemonic paradigm guided by biomedical values, and so they face the lack of recognition and appreciation of their activities, which can directly interfere in their efforts, contributing to a misrepresented view on the part of patients about their work (9,14) FINAL CONSIDERATIONS This study shed light on the factors that favor and disfavor the improvement of obstetric nurse care in the delivery process. Thus, regarding professional issues, the nurses reported as collaborative factors the importance of the support of the multidisciplinary team and the technical recognition of the obstetrical nurse who has professional commitment and feels satisfaction in performing her function.…”

“…This situation is common, as hospital institutions constantly seek to standardize people by subjecting them to imposed routines, contributing to the modeling of the subjects. The bodies of women in labor are then susceptible to dominance and vulnerable to interventions (9) . Thus, pre-defined routines tend to contribute to increase the number of interventions in the women's bodies and the loss of their privacy.…”

“…The nursing occupation, under a precarious regime, works in degrading conditions, which impacts the safety and quality of their professional activities (16) . It is necessary to rethink the working conditions of nursing professionals, especially obstetric nurses, as they participate in the direct care of women in labor and delivery (9) .…”

“…The female body is controlled by health professionals, who under the perspective of a biomedical and technocratic model, dominate and manipulate the bodies of women in labor favoring unilateral care. This culminates with the disqualification of women regarding the knowledge about their bodies, their exclusion from the care process and the loss of the central role during the delivery process (9) . This situation reveals a gender inequality supported by the power relationships between women and health professionals.…”

“…However, in order to offer qualified care, nurses have better working conditions, as these directly impact the quality of care provided to women in the parturition process. Such conditions concern infrastructure, individualized beds, availability of material and human resources, as well as gender issues, and interpersonal relationships, which may differ according to the profile of each maternity hospital (7)(8)(9) .…”