Assistance to Normal Delivery in Two Public Maternities: Perception of the Health Professionals

Abstract

Purpose To evaluate the perception of health professionals involved in the labor process and the assistance to normal delivery, comparing two hospitals in the city of Goiânia, Brazil, regarding the perception of these professionals when they are performing the routines and practices recommended by the World Health Organization (WHO). Methods This is an analytical comparative study with a quantitative approach, performed in two public hospitals in the city of Goiânia, in the state of Goiás, Brazil. The study included 86 professionals working in assistance to immediate labor in two hospitals. A questionnaire containing 40 questions was applied. The questionnaire related to the Program for the Humanization of Prenatal and Childbirth Care (PHPN, in the Portuguese acronym) of the Brazilian Ministry of Health, the presence of a companion, and the procedures performed. For the data analysis, we used the chisquare and Fisher's exact tests. Results Most of the professionals claimed to know about the PHPN proposed by Brazilian Ministry of Health in the two hospitals. With regard to good practices, most professionals said that they are performed in maternity ward 2, while on maternity 1, although many of them are present, there are still many unnecessary interventions. Conclusion When comparing the two maternity hospitals, maternity 2, which was created as a routine humanization model, manages to better adhere to the WHO recommendations. In maternity 1, there was a series of interventions considered by the WHO as ineffective, or used in an inappropriate manner.

Profile on childbirth care at a public maternity hospital

“…The acceleration of labor with amniotomy and/or oxytocin, plays an important role in the "cascade of interventions" and the reduction rate on spontaneous delivery. 16 Data from a study conducted in the State of Goiás, 17 containing a sample of 43 deliveries, described amniotomy at 16.3% of the deliveries, similar to that found in this study (15.2% and 17.2%), and the administration of oxytocin at 32.6%, higher than the values found at the maternity in query (26.5% and 14.6%), which monitors its use in the first and second periods of delivery.…”

“…This fact emphasizes the importance of moni-toring the indicators on practices and non-recommended interventions, once, if they appear in the WHO guidelines it is because there are indications of their performance, confirmed by national and regional research spheres. 1,[8][9][10][11][15][16][17][18] This study allowed to comprehend the indicators on childbirth care present at the service and by analyzing them based on the WHO recommendations. It is expected to contribute to the services and professionals to understand the importance of registering the indicators and assessing childbirth care and their possible progress in the aspects that are necessary.…”

Effects of the addition of transcutaneous electrical stimulation to non-pharmacological measures in labor pain: study protocol for a randomized controlled trial

“…Non-pharmacological methods of pain relief can be used alone or together with the multidisciplinary team (physiotherapists, nurses, nursing technicians, doctors, and doulas), depending on the parturient’s choice and the hospital’s infrastructure [ 3 – 6 ]. Some studies have demonstrated the effectiveness of walking and massage in reducing pain and increasing pain tolerance during labor [ 7 – 9 ].…”