0248/2020 - Atenção ao parto por enfermeira obstétrica emmaternidades vinculadas à Rede Cegonha, Brasil – 2017 Childbirth care for obstetric nurse in maternities linked to the Rede Cegonha, Brazil – 2017
O objetivo foi avaliar se a presença da enfermeira na atenção ao parto em maternidades da Rede Cegonha promove o acesso às boas práticas de atenção obstétrica ao trabalho de parto e parto. Avaliação conduzida em 2017, em todas as 606 maternidades do SUS que aderiram à essa política estratégica em todos os estados do Brasil. Utilizamos dados coletados com gestores das maternidades e puérperas. A análise ocorreu em dois níveis: hospitalar, com ou sem assistência ao parto por enfermeiras; e profissional que assistiu ao parto vaginal, médico ou enfermeira. Como variáveis dependentes incluímos boas práticas e intervenções no parto vaginal e taxa de cesariana. Foram incluídas na análise dos partos vaginais 5.016 puérperas e no cálculo da taxa de cesariana 9.692. Análises múltiplas foram ajustadas por região geográfica, localização, tamanho da maternidade, cor da pele e paridade da puérpera. Maternidades com enfermeira na assistência ao parto usam mais partograma; e menos ocitocina, litotomia, episiotomia e cesariana. Em partos assistidos por enfermeiras foi mais frequente o preenchimento do partograma; e menor a chance de litotomia e episiotomia. A inserção da enfermeira na assistência ao parto vaginal tem se mostrado bem sucedida, trazendo às mulheres um parto mais fisiológico e respeitoso.
Palavras-chave:
Enfermeira; Rede Cegonha; boas práticas obstétricas; parto vaginal
Abstract:
The objective was to assess whether the presence of nurse-midwives promotes best obstetric practices during labour and birth care in maternities linked to Stork Network program. We conducted an evaluative study in 2017, in all 606 SUS maternities that adhered to this strategic policy in all states of Brazil. We collected datamaternity managers and postpartum women. Delivery care was analysed by hospital level - whether it included or not nurse in delivery care; and by individual level - whether a nurse or a physician assisted delivery. As outcomes, we included best practices and interventions for vaginal births and caesarean section rates. 5.016 subjects were included for analyses of vaginal births and 9.692 for caesarean section rates. Multiple regressions were adjusted by geographic region, maternity size, skin color and parity. Maternities with nurse used more the partograph and less oxytocin during labour, lithotomy, episiotomy and caesarean section. Similar results were found when delivery was assisted by nurse, in contrast with the ones assisted by physicians, with more use of the partograph and lower use of lithotomy and episiotomy. The inclusion of nurse-midwives in vaginal delivery care has been successful in bringing women a more physiological and respectful birth.
Keywords:
Nurse-Midwife, Stork Network, Best Practices, Labor and Birth
Childbirth care for obstetric nurse in maternities linked to the Rede Cegonha, Brazil – 2017
Resumo (abstract):
The objective was to assess whether the presence of nurse-midwives promotes best obstetric practices during labour and birth care in maternities linked to Stork Network program. We conducted an evaluative study in 2017, in all 606 SUS maternities that adhered to this strategic policy in all states of Brazil. We collected datamaternity managers and postpartum women. Delivery care was analysed by hospital level - whether it included or not nurse in delivery care; and by individual level - whether a nurse or a physician assisted delivery. As outcomes, we included best practices and interventions for vaginal births and caesarean section rates. 5.016 subjects were included for analyses of vaginal births and 9.692 for caesarean section rates. Multiple regressions were adjusted by geographic region, maternity size, skin color and parity. Maternities with nurse used more the partograph and less oxytocin during labour, lithotomy, episiotomy and caesarean section. Similar results were found when delivery was assisted by nurse, in contrast with the ones assisted by physicians, with more use of the partograph and lower use of lithotomy and episiotomy. The inclusion of nurse-midwives in vaginal delivery care has been successful in bringing women a more physiological and respectful birth.
Palavras-chave (keywords):
Nurse-Midwife, Stork Network, Best Practices, Labor and Birth
Gama, S.G.N, Viellas, E.F, Medina, E.T, Angulo-Tuesta, A, Silva, C.K.R.T, Silva, S.D, Santos, Y.R.P, Esteves-Pereira, A.P. Atenção ao parto por enfermeira obstétrica emmaternidades vinculadas à Rede Cegonha, Brasil – 2017. Cien Saude Colet [periódico na internet] (2020/ago). [Citado em 30/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/atencao-ao-parto-por-enfermeira-obstetrica-emmaternidades-vinculadas-a-rede-cegonha-brasil-2017/17730?id=17730
