The care by obstetric nurses: the encounter between self care bodies and other woman who is cared for

Abstract

The care by obstetric nurses: the encounter between self care bodies and other woman who is cared for O cuidado para enfermeiras obstétricas: encontro entre o corpo de si e da mulher cuidadaEl cuidado para enfermeras obstétricas: el encuentro entre su cuerpo y el de la mujer atendida AbstrAct Objective: To analyze the obstetric nurses' discourse on self-care and decisions make of their life and body, and their relation with care for other women. Method: A qualitative, post-structuralist research with 14 obstetric nurses. Data were obtained from in-depth interviews and submitted to discourse analysis, based on the concepts of Foucault. Results: The findings reveal that caring of obstetric nurses is produced in the encounter between their own body and the body of the women under their care.The nursing profession was presented not only as a means of work and support but as an essential device for the training of women as subjects. The collective narrative is marked by the attitude of compassion, by the processes of subjectivity incited by the professional practice, by indicators of critical and political care, and by the construction of an interlocking network among obstetrical nurses. Conclusions and implications for practice: Acting in obstetric nursing results in self-care and care(less) effects of other women. The study contributes to the analysis and knowledge of the life and work scenario of obstetrical nurses.It also reassures the potential of care as an art that is present in the women's practices.Objetivo: Analisar os discursos de enfermeiras obstétricas sobre o cuidado de si e as decisões sobre sua vida e seu corpo, bem como a relação com o cuidado destinado a outras mulheres. Metódo: Pesquisa qualitativa, de referencial pós-estruturalista.Dados obtidos de entrevistas em profundidade com 14 enfermeiras obstétricas e submetidos à analítica do discurso, tendo como base conceitual Foucault. Resultados: Os achados revelam que o cuidado para a enfermeira obstétrica é produzido no encontro entre o corpo de si e o corpo das mulheres sob cuidados. A profissão de enfermagem apresentou-se não apenas enquanto meio de trabalho e sustento, mas como importante dispositivo para formação das mulheres enquanto sujeitos. A narrativa coletiva é marcada pela atitude de compaixão, por processos de subjetivação incitados pela prática profissional, por indicativos de um cuidado crítico e político, e pela construção de uma rede de imbricamento entre as enfermeiras obstétricas. Conclusões e implicações para a prática:A atuação em enfermagem obstétrica resulta em efeitos produtores de cuidado de si e de (des)cuidado de outras mulheres. O estudo contribui para a análise e o conhecimento do cenário de vida e de trabalho das enfermeiras obstétricas e a reafirmação do potencial de cuidado presente nas práticas destas mulheres.Palavras-chave: Enfermagem obstétrica; Feminismo; Parto Humanizado; Saúde da Mulher.resumen Objetivo: Analizar los discursos de enfermeras obstétricas sobre su propio cuidado y las decisiones sobre su vida y cuerp...

Theories for interventions to reduce physical and verbal abuse: A mixed methods review of the health and social care literature to inform future maternity care

“…The date of publication ranged from 1988–2022, and they were undertaken in all regions of the world. For maternity focused papers with theory, 48/58 were based in low or middle income countries [ 20 , 22 , 26 , 30 , 31 , 38 , 39 , 44 , 46 , 53 , 54 , 59 , 60 , 63 , 75 , 100 – 102 , 120 , 122 , 124 , 140 , 148 , 150 , 151 , 154 , 156 , 157 , 159 – 161 , 167 , 171 – 173 , 217 , 219 – 222 , 224 , 225 , 226 , 229 , 230 , 235 , 236 ], with larger numbers of studies from Ethiopia [ 31 , 38 , 59 , 60 , 154 , 221 ], India [ 44 , 75 , 120 , 124 , 154 …”

“…About half of the maternity papers mentioned explicit theories. These included gender inequalities (theory developed using USAID Gender Analysis Framework [ 43 ]; and feminist critique [ 219 ], gender theory [ 97 ]; (structural) gender inequality [ 161 , 172 ]; oppressed groups theory [ 54 ] in relation to hospital hierarchies; gender based violence [ 75 , 140 ]; overmedicalisation of childbirth [ 53 , 75 , 117 , 218 , 230 ], and associated patriarchy [ 75 ]; cultural health capital [ 157 ]; stigma [ 140 , 151 , 172 ] and moral evaluation of patients [ 123 ]; Foucault’s (1979) theory of Inscription [ 88 ], in which the risk of being judged “abnormal” by others is internalized, making powerful norms work from within, and Foucaults theories of power/resistance to power [ 225 ]; and Jacobson’s taxonomy of dignity [ 88 ], and learned helplessness [ 88 ]. One paper [ 159 ] explored behavioural concepts of mental models , and of ‘automaticity’ (based on the concept of cognitive availability/scarcity , in which a hegemonous focus on death avoidance left no space for consideration of other aspects of good quality maternity care.…”

“…Two conceptual frameworks were cited: The Conceptual Framework for Disrespectful Care in Maternity which includes drivers of mistreatment and abuse [ 53 , 54 ], and the Framework of Obstetric Violence , which includes both facilitators of such behaviour (social factors, harmful cultural practices, systemic barriers, historic normalisation), and solutions for change [ 157 ]. The general concept of obstetric violence featured in a number of studies [eg, 216 , 218 , 222 , 225 , 226 , 229 , 230 ].…”

“…In 18 studies the intervention was based on an underlying theory (7 RCTs/CCTs and 11 before and after studies) [ 175 , 159 , 161 , 162 , 164 – 167 , 169 , 172 – 176 , 180 , 181 , 224 , 225 ]. The interventions were predominantly either multicomponent (n = 33) [ 175 , 176 , 177 , 182 – 190 , 195 – 198 , 200 , 202 , 206 , 208 , 209 , 211 , 243 , 244 , 246 – 250 , 251 , 253 – 255 ] or educational/training (n = 12) [ 175 , 178 , 199 , 191 – 194 , 199 , 207 , 208 , 210 , 212 ] They were all compared with usual care (including baseline standard practice for before and after studies).…”

Satisfação e insatisfação no parto normal sob o enfoque dos atributos da qualidade da assistência

“…Destaca-se a disponibilidade profissional em uma dinâmica de valorização da subjetividade, voltada para o atendimento das necessidades e dos anseios da parturiente, a qual ultrapassa as práticas rotineiras e normativas institucionais 16 .…”