Abstract
Objective
To compare the care practices in normal-risk births assisted by obstetric nurses in a public hospital in Porto Alegre, Brazil in 2013, when the collaborative model was first implemented in that institute, with care practices employed in 2016.
Methods
A cross-sectional, retrospective, analytical study conducted in the obstetric center of a public hospital in Porto Alegre, Brazil with 186 women at normal-risk labor assisted by obstetric nurses in 2013–2016. Inclusion criteria were pregnant women at normal risk during prenatal care and hospital admission, with a single fetus born alive at full term (gestational age, 37–41 weeks) with a well-flexed cephalic presentation. Parturients admitted to the institute during the expulsion phase and those with incomplete information in their medical records were excluded. Data from the study were grouped into a database and analyzed using Statistical Package for the Social Sciences software, version 25.0. Pearson’s chi-square test and Fisher’s exact test were used to compare proportions.
Results
The comparison of care practices revealed a reduction in interventions such as trichotomy (−100.0%), rectal suppository use (−85.8%), lithotomic position (−85.0%), use of pain-relief medication (−79.0%), epidural analgesia (−79.0%), oxytocin use (−73.3%), venous catheterization (−60.5%), cardiotocography (−51.1%), pubic-hair trimming (−38.5%), birth ball (−31.0%), semi-sitting position (−5.4%), and an increase in practices such as change in position (+828.6%), rebozo (+167.3%), squatting position (+100.0%), all-fours position (+100.0%), right lateral position (+100.0%), left lateral position (+100.0%), use of partograms (+43.3%), therapeutic massage (+33.4%), late umbilical-cord clamping (+37.3%), skin-to-skin contact (+33.2%), amniotomy (+16.7%), and liquid diet (+11.5%).
Conclusion
In the context of the predominant model of obstetric care in Brazil, centered on the obstetric physician and interventionist practices, the collaborative model of childbirth care with the active participation of obstetric nurses is a good way to take care of women giving birth, respecting the physiology of childbirth, and the woman’s protagonism.
Obstetric nursing; Nurse midwives; Humanizing delivery; Labor, obstetric