Assistência ao parto e nascimento no município de Tefé–AM na perspectiva da teoria do cuidado cultural

Abstract

The childbirth and birth care need must be humanized and qualified. Thus, it is necessary to broaden the analysis of care and promote the exchange of knowledge, developing evidence-based and culturally consistent actions and care decisions. Under this view the study had as general objective to analyze the delivery and delivery care in the municipality of Tefé-AM under the perspective of cultural care; The specific objectives:Discuss factors of the dimensions of the cultural and social structure that influence the standard of care at birth and birth in Tefé-AM; Describe knowledge and popular practice of parturient care in the process of childbirth and birth; Describe the care practices used by health professionals in the process of childbirth and birth; Articulate the exchange of popular and professional knowledge for delivery and birth care. This study was carried out at the Regional Hospital of Tefé-AM between March and April 2019. The study was attended by 37 women and 30 health professionals. The instruments used were: 1) Observation-Participation-Reflection; 2) Professional characterization questionnaire; 3) Semi-structured interview. From the analysis of the data emerged the categories: Hospital attendance in the process of birth and birth from the perspective of the health professional; Popular care from the parturient perspective. It was observed that care for childbirth and birth at each shift is performed by three midwives and structural resources are incipient. The medical professionals are experts in obstetrics and act only in intercurrences and obstetric dystocias, insertion of the postpartum intra uterine device is performed by a single medical professional. There is a quantitative deficiency of obstetric nurses. The managers emphasize the budget deficiency due to the demand of other municipalities. In addition, it was highlighted by the deponents a deficiency in permanent education, in-service education and work process norms. About women, the average age is 25 years, most of them in stable consensual union, have incomplete high school, original urban center and have evangelical religion; submerged subjects such as obstetric violence, the absence of the companion in the delivery room, the absence of non-pharmacological techniques for the relief of pain, the expectation and dissatisfaction with the care that was provided. This study allowed to know delivery assistance from the perspective of health professionals and women, as well as propose culturally coherent actions and care decisions. A partir da análise dos dados emergiram as categorias: A assistência hospitalar no processo de parto e nascimento sob a perspectiva do profissional da saúde; Cuidado popular sob a perspectiva da parturiente. Observou-se que a assistência ao parto e nascimento a cada plantão é realizada por três parteiras e os recursos estruturais são incipientes. Os profissionais médicos são especialistas em obstetrícia e atuam somente em intercorrências e distócias obstétricas. A inserção do dispositivo intrauterino (DIU) pós-parto é realizada por um único profissional médico. Existe uma deficiência de quantitativo de enfermeiros obstétricos. Os gestores ressaltaram a deficiência orçamentária devido à demanda de outros municípios. Além disso, foi ressaltado pelos depoentes uma deficiência em educação permanente, educação em serviço e normas de processo de trabalho. Em relação às parturientes, observou-se que a idade média é de 25 anos, a maioria está em união consensual estável, tem ensino médio incompleto, original do centro urbano e tem religião evangélica; submergiram temas como a violência obstétrica, a ausência do acompanhante na sala de parto, a ausência de técnicas não farmacológicas para o alívio da dor, a expectativa e insatisfação com o cuidado que foi prestado.Este estudo permitiu conhecer a assistência ao parto sob a perspectiva dos profissionais de saúde e das mulheres que a receberam, assim como propor ações e decisões de cuidado culturalmente coerentes.