Childbirth experience of women in a maternity hospital signatory of the Adequate Childbirth Project: mixed study

Abstract

Objective To understand the childbirth experience of women assisted in a maternity hospital signatory of the Adequate Childbirth Project. Methodology Mixed study, carried out in 2018. Applied the Free Word Association Test in 62 pregnant women and then conducted an open interview with 18 of them, then puerperal women, and, for analysis, the Central Nucleus Theory, Word Cloud, and thematic Categories, respectively. Results The predominant words revealed in the quantitative stage were: pain, wonderful, recovery, anxiety, and desires. The qualitative analysis is presented by thematic categories “Women’s insecurities in the PPA model” and “New perspectives from experience in the PPA model”. Conclusions The women’s experiences demonstrated that the model favored the remodeling of childbirth care. However, they still experience pain, dissatisfaction, and lack of autonomy. The impossibility of choosing a trusted professional was a source of insecurity, and nurses had no voice in decisions and actions in care.

Violation of the rights of the companion during hospitalization for childbirth in public maternity hospitals

“…The preference of women for having companions who are their partners/fathers of the babies during childbirth has been reported in the literature (2,8,12,14) . The inclusion of the partner in prenatal care and the social claims for the father's rights contribute to the inclusion of men in pregnancy and childbirth (19)(20) .…”

“…The implementation of welcoming actions requires changes in professional perspectives so that the prominent role of those involved is understood, and in obstetric care companions play a relevant role (19,21) . Reorganization of the service is necessary to create care flows that respect regulations and contribute to the satisfaction of those involved (8,12,(16)(17) .…”

“…The few and limited investigations on the experience of companions have shown feelings of dissatisfaction and fear, associated with the hostility of the hospital environment (6,(9)(10) . The mismatch between legislation and institutional practices regarding the presence of companions during childbirth is attributed to lack of knowledge of their rights, precarious physical structure, maintenance of care flows and technical professional attitudes (7,(9)(10)(11)(12)(13) .…”

Violação de direitos do acompanhante durante a internação para o parto em maternidades públicas

“…A preferência da mulher pelo companheiro/pai do bebê como acompanhante no parto tem sido registrada na literatura (2,8,12,14) . A inclusão do parceiro no pré-natal e as reinvindicações sociais pelo direito do pai contribuem para a inclusão do homem na gestação e no parto (19)(20) .…”

“…As poucas e limitadas investigações sobre a experiência do acompanhante têm registrado sentimentos de insatisfação e medo, associados à hostilidade do ambiente hospitalar (6,(9)(10) . O descompasso entre a legislação e as práticas institucionais quanto à presença do acompanhante no parto é atribuído ao desconhecimento de seus direitos, à precariedade da estrutura física, à manutenção de fluxos assistenciais e atitudes profissionais tecnicistas (7,(9)(10)(11)(12)(13) .…”