The humanization of prenatal care under the pregnant women’s perspective / A humanização do cuidado pré-natal na perspectiva valorativa das mulheres gestantes

Abstract

Objetivo: Identificar e analisar os valores expressos nos discursos das mulheres/gestantes acompanhadas no Programa de Pré-natal, a respeito da assistência recebida. Métodos: Estudo fenomenológico com abordagem qualitativa. Foram entrevistadas 12 mulheres no período de janeiro a março de 2013 acompanhadas no pré-natal nos serviços de atenção básica do município de Niterói, Rio de Janeiro. Os depoimentos foram transcritos e submetidos a análise compreensiva para a formulação das categorias e articuladas com a Teoria dos Valores de Max Scheler. Resultados: Emergiram as seguintes categorias: O valor do acolhimento no pré-natal sob a ótica da mulher/gestante e a humanização como uma ação que implica em mudança de valores. Conclusão: Concluiu-se que o acolhimento e a humanização no cuidado durante o pré-natal são valores vitais e afetivos, portanto, valores em si mesmo. Contribuindo assim para refletir a assistência pré-natal, objetivando o direcionamento desse atendimento às necessidades específicas de cada mulher.

Humanized childbirth: the values of health professionals in daily obstetric care

“…Such modes are established in/with the co-responsibility process for the transformation of the work reality itself and in the set of actors. This highlights the close relationship between senses, motivation, satisfaction, and perception of value (3)(4)(5)(6) that configures the aspects of live work (23) .…”

“…These changes are the result of the collective construction of the movement initiated by women, professionals, health administrators, and researchers since the 1980s in favor of maternal and child health. Such changes allowed for a redefinition of the obstetric practices of health professionals, in line with Schelerian values (3)(4)(5)(6) , that is, supported by respect, quality of care, protagonism, autonomy, women's satisfaction, safety, and care anchored in scientific evidence (7)(8)(9)(10)(11) . However, the excess of unnecessary interventions is still part of daily care, including in maternity hospitals in Brazil.…”

“…Women undergo numerous obstetric procedures, such as episiotomy, Kristeller's maneuver, medicalization of oxytocics, trichotomy, enema, in addition to the cesarean epidemic in the country (2,(7)(8)(9)(10)(11)(12)(13)(14) . Studies point to obstacles in the organizational structure of work management and professional attitudes, which are sometimes discriminatory, prejudiced, violent and inconsistent with good practices in childbirth care and with evidence-based practice (8,(12)(13)(14) , going against the biopsychosocial needs of women and their care values (4)(5)(6)(15)(16)(17)(18) .…”

“…Therefore, the movement for the humanization of childbirth has expanded public health policies in the reproductive field since the 2000s to qualify maternal and childcare and provide dignified and respectful care for women, encouraging their autonomy and protagonism, guaranteeing their sexual, reproductive, and human rights, as well as their values (3)(4)(5)(6)(15)(16)(17)(18) . This movement enabled a line of interventions consistent with Goal 5 (Improving maternal health) of the Millennium Development Goals (MDGs); and currently with Goal 3 (Health and well-being) of the Sustainable Development Goals (SDGs).…”

“…Among these interventions is the creation of public policies such as: Programa de Humanização no Pré-natal e Nascimento [Prenatal and Birth Humanization Program] (PBHP) (10) ; Política Nacional de Humanização [National Humanization Policy] (NHP) (19)(20) ; Estratégia Rede Cegonha [Stork Network Strategy] (11,20) ; in addition to the new MH's National Guidelines for Assistance to Normal Childbirth (21) . Such policies promoted accessibility and resoluteness; expansion of obstetric care; construction/renovation of units; training/alteration of professional conduct; reorganization of the work process with an emphasis on the collaborative model of a multidisciplinary team; encouragement of normal/natural/physiological childbirth; and reduction of obstetric interventions (22) , with the valuation of subjectivity, individuality of care and of women's values and expectations (3)(4)(5)(6)(15)(16)(17)(18) .…”