Barreiras à implementação de recomendações ao parto normal no Brasil: a perspectiva das mulheres

Vidal, Ávila Teixeira; Barreto, Jorge Otávio Maia; Rattner, Daphne

doi:10.26633/rpsp.2020.164

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…Changes in childbirth care models are complex and depend on public health policies, wide dissemination of information and on the continuing education of professionals involved in care to promote a respectful childbirth [ 37 , 38 ]. In Brazil, there has been synergy between the social movements and proposals for change in childbirth care.…”

Section: Discussionmentioning

confidence: 99%

Women’s voice on changes in childbirth care practices: a qualitative approach to women’s experiences in Brazilian private hospitals participating in the Adequate Childbirth Project

et al. 2023

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Background In Brazil, childbirth practices are strongly marked by surgical events and particularly in the private sector cesarean sections reach rates above 80%. The National Supplementary Health Agency proposed the Adequate Childbirth Project (PPA), a quality improvement project developed at Brazilian hospitals with the aim of changing the current model of childbirth care and reducing unnecessary cesarean sections. The objective of this study is to assess how the participation of women in the process of improving quality childbirth care occurred in two hospitals participating in the PPA. Method Qualitative study, based on interviews with 102 women attended at two hospitals that took part in the first and second stages of the “Healthy Birth”, an evaluative hospital-based research, conducted in 2017–2018, that assessed the degree of implementation and the effects of PPA. After thematic content analysis, supported by MaxQda software, three categories emerged: (1) how women gathered knowledge about the PPA, (2) how women perceived it, and (3) which are their suggestions for the PPA improvement. Results The PPA was unknown to most women before delivery. A polysemy of terms, including adequate childbirth, promotes recognition of the “new” model of care. Visits to the maternity hospital and antenatal care groups for pregnant women are opportunities for contacts that change the perception of what childbirth can be. Women have expectations of a relationship with maternity that is not limited to the moment of delivery. The listening channels established between hospitals and women are fragile and not systematized. By increasing the supply of listening spaces, one can also increase the request to leave their suggestions and contributions, and thus gain more allies in improving the project. Women are not yet included as PPA agents and their voices are silenced. Conclusions Women’s participation to improve childbirth care is relevant and necessary. The women’s voice in the PPA is still incipient, and maternity hospitals and health plan operators should create strategies to insert and engage them. Women’s voices should be listened to not only during but also before and after childbirth.

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Section: Discussionmentioning

confidence: 99%

Women’s voice on changes in childbirth care practices: a qualitative approach to women’s experiences in Brazilian private hospitals participating in the Adequate Childbirth Project

et al. 2023

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Incorporation, adaptation and rejection of obstetric practices during the implementation of the “Adequate Childbirth Program” in Brazilian private hospitals: a qualitative study

de Oliveira,

Gomes,

Rodrigues

et al. 2024

Reprod Health

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Background The “Adequate Childbirth Program” (PPA) is a quality improvement project that aims to reduce the high rates of unnecessary cesarean section in Brazilian private hospitals. This study aimed to analyze labor and childbirth care practices after the first phase of PPA implementation. Method This study uses a qualitative approach. Eight hospitals were selected. At each hospital, during the period of 5 (five) days, from July to October 2017, the research team conducted face to face interviews with doctors (n = 21) and nurses (n = 28), using semi-structured scripts. For the selection of professionals, the Snowball technique was used. The interviews were transcribed, and the data submitted to Thematic Content Analysis, using the MaxQda software. Results The three analytical dimensions of the process of change in the care model: (1) Incorporation of care practices: understood as the practices that have been included since PPA implementation; (2) Adaptation of care practices: understood as practices carried out prior to PPA implementation, but which underwent modifications with the implementation of the project; (3) Rejection of care practices: understood as those practices that were abandoned or questioned whether or not they should be carried out by hospital professionals. Conclusions After the PPA, changes were made in hospitals and in the way, women were treated. Birth planning, prenatal hospital visits led by experts (for expecting mothers and their families), diet during labor, pharmacological analgesia for vaginal delivery, skin-to-skin contact, and breastfeeding in the first hour of life are all included. To better monitor labor and vaginal birth and to reduce CS without a clinical justification, hospitals adjusted their present practices. Finally, the professionals rejected the Kristeller maneuver since research has demonstrated that using it’s harmful.

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O ensino das boas práticas obstétricas na perspectiva dos preceptores da Residência

Carvalho

Göttems

Guilhem

2022

Ciênc. saúde coletiva

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Resumo Este trabalho teve como objetivo compreender como o tema das boas práticas obstétricas é ensinado nos programas de residência na percepção dos preceptores. Trata-se de um estudo descritivo, exploratório, com triangulação de dados, de abordagem qualitativa. Participaram da pesquisa 35 profissionais, sendo 21 médicos e 14 enfermeiros. Os dados foram coletados entre março e junho de 2018. A análise teve o suporte do Software NVivo. Os núcleos de sentidos e as categorias foram identificados nas diversas etapas: nos projetos pedagógicos - os aspectos estruturantes, perfil de competências e políticas norteadoras do parto normal; nas entrevistas - abordagem teórico-prática e as práticas presentes na formação; e na observação participante - aspectos relacionados à estrutura dos cenários e à utilização das práticas. Foram observados possibilidades e limites na atuação dos preceptores no processo de formação, configurando-se em uma área que requer atenção contínua e direcionada ao fortalecimento dos processos pedagógicos, de forma a ampliar o potencial disruptivo dos novos profissionais de saúde.

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Barreiras à implementação de recomendações ao parto normal no Brasil: a perspectiva das mulheres

Cited by 4 publications

References 18 publications

Women’s voice on changes in childbirth care practices: a qualitative approach to women’s experiences in Brazilian private hospitals participating in the Adequate Childbirth Project

Women’s voice on changes in childbirth care practices: a qualitative approach to women’s experiences in Brazilian private hospitals participating in the Adequate Childbirth Project

Incorporation, adaptation and rejection of obstetric practices during the implementation of the “Adequate Childbirth Program” in Brazilian private hospitals: a qualitative study

O ensino das boas práticas obstétricas na perspectiva dos preceptores da Residência

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