Erratum: Practices in childbirth care in maternity with inclusion of obstetric nurses in Belo Horizonte, Minas Gerais

Objetivo: Discutir practicas de atencion al parto en instituciones de salud donde medicos y enfermeras obstetras trabajan conjuntamente. Metodos: Estudio transversal cuya fuente de datos fue la investigacion Nacer en Belo Horizonte: un estudio de parto y nacimiento, realizada entre 2011 y 2013. Se estudiaron 230 y 238 mujeres para practicas en el trabajo de parto y parto, respectivamente. El analisis estuvo a cargo de frecuencias absolutas y relativas. Resultados: Practicas utiles: dieta oral (54,6%); libre circulacion (96%); metodos no farmacologicos para el dolor (74,2%); acompanante (95,4%); partograma (77,4%). Practicas perjudiciales: enema (0); tricotomia (0); acostado (66,8%); Kristeller (9,3%). Practicas inadecuadas: amniotomia (67,1%); oxitocina (41,7%); analgesia (14%); episiotomia (8,4%). Conclusion: Mismo en las instituciones que se esmeran por cambiar el modelo de atencion obstetrica, se identificaron practicas que reproducen el modelo tecnocratico. La transformacion de ese modelo permanece un desafio que requiere esfuerzos conjuntos entre gerentes y profesionales de salud.

Objectives: to analyze the incidence of obstetric practices in labor and childbirth care at usual risk in a tertiary hospital. Methods: cross-sectional, descriptive study with a quantitative approach. Data were collected from 314 Monitoring Sheets of Labor and Childbirth Care of women who had their birth attended at the institution, from July 2017 to July 2018. The study was approved by the research ethics committee, with the embodied opinion number 2.822.707. Results: most women in the study were between 20 and 34 years old, coming from the city of Fortaleza, Ceará; had completed high school; and had unpaid work. The prevalence of good practices was identified: umbilical cord clamping in a timely manner (81.5%), immediate skin-to-skin contact (73.9%), breastfeeding in the childbirth room (74.2%), freedom of position and movement (72.3%), completion of the partograph (66.6%), presence of a companion (66.2%), offer of a liquid diet (65%), and non-pharmacological methods for pain relief (54.8%). As for interventional practices, we identified: venoclysis (42.4%), oxytocin infusion (29%), and amniotomy (11.1%). Conclusions: advances in the adoption of good practices based on scientific evidence are noteworthy; however, the technocratic model of childbirth care for women at normal risk persists.

BackgroundIt has been hypothesized that the coronavirus disease 2019 (COVID-19) pandemic may have changed the conduct of obstetric practices at the time of labor, delivery, and birth. In Brazil, many practices lacking scientific evidence are implemented in this care, which is charcaterized by excessive use of unnecessary interventions. This scenario may have been worsened by the pandemic. Thus, we analyzed the effects of the pandemic on care during prenatal care and delivery by comparing the results of two surveys (one was administered before the pandemic and the other during the pandemic) in public hospitals in Belo Horizonte - Minas Gerais (MG), Brazil.MethodsThis cross-sectional and comparative study analyzed preliminary data from the study “Childbirth and breastfeeding in children of mothers infected with SARS-CoV-2”, which was conducted in three referral maternity hospitals in Belo Horizonte - MG during the pandemic in the first half of 2020 in Brazil. The final sample consisted of 1532 eligible women. These results were compared with data from 390 puerperae who gave birth in the three public hospitals in the study “Birth in Belo Horizonte: labor and birth survey”, conducted before the pandemic to investigate the changes in practices of labor and delivery care for the mother and her newborn, with or without COVID-19 infection, before and during the pandemic. In this research, “Birth in Belo Horizonte: labor and birth survey”, data collection was performed between November 2011 and March 2013 by previously trained nurses. Between study comparisons were performed using Pearson’s chi-square test, with a confidence level of 95%, and using Stata statistical program.ResultsWe found a significant increase in practices recommended by the World Health Organization during the pandemic including the following: diet offering (48.90 to 98.65%), non-pharmacological pain relief (43.84 to 67.57%), and breastfeeding in the newborn´s first hour of life (60.31 to 77.98%) (p < 0.001). We found a significant reduction of non-recommended interventions, such as routine use of episiotomy (15.73 to 2.09%), the Kristeller maneuver (16.55 to 0.94%), oxytocin infusion misused (45.55 to 28.07%), amniotomy (30.81 to 15.08%), and lithotomy position during labor (71.23 to 6.54%) (p < 0.001).ConclusionOur study revealed a statistically significant increase in the proportion of use of recommended practices and a reduction in non-recommended practices during labor and delivery. However, despite advances in the establishment of World Health Organization recommended practices in labor, delivery, and birth, the predominance of interventionist and medicalized practices persists, which is worsened by events, such as the pandemic.

OBJETIVO: Descrever e discutir a produção científica acerca da prática de enfermeiras na assistência ao parto. MÉTODO: Foi realizada uma revisão de literatura integrativa utilizando publicações disponíveis. A busca dos artigos ocorreu nas bases de dados LILACS, BDENF, Portal de periódicos CAPES, Biblioteca Eletrônica Científica Online SCIELO no período de 2014 a 2019, sendo selecionados e analisados 14 estudos. Para pesquisa foi utilizado os descritores “saúde da mulher”, “parto humanizado”, “parto normal”, “enfermeiras obstétricas”, “humanização da assistência” com o operador booleano AND no final de cada descritor. Os critérios de inclusão utilizados foram artigos originais e de revisão, publicados na íntegra, na língua portuguesa em periódicos nacionais. RESULTADOS: Emergiram duas categorias de análise: Prática das enfermeiras acerca das boas práticas da assistência ao parto e nascimento e fatores que interferem no trabalho de parto das parturientes. CONSIDERAÇÕES FINAIS: Verificou-se uma adesão às boas práticas de atenção ao parto e nascimento, como o uso de métodos não farmacológicos no manejo da dor, presença do acompanhante, dentre outros. No entanto, também foi observado que as mulheres são colocadas em um lugar passivo e ficam expostas devido a uma estrutura inadequada e a falta de recursos materiais.

To analyze the knowledge, attitudes, and practices of obstetricians regarding childbirth care. This was a nationwide cross-sectional study involving 1267 physicians working in 393 public and private hospitals in Brazil. A self-administered and anonymous questionnaire, developed specifically for this study, was used. Differences in proportions among obstetricians working in public, mixed, and private services were analyzed using the chi-square test, with a significance level of 0.05. High levels of knowledge, favorable attitudes, and adoption of best practices in childbirth care were observed for diet, movement, the presence of a companion, and non-pharmacological methods for pain relief. Limitations were identified regarding the participation of nurse-midwives in childbirth care, the use of instrumental delivery, promotion of upright birth positions, and the use of episiotomy. Fear of legal action and unnecessary indications for cesarean sections were frequently reported by professionals as reasons for the country's high cesarean section rates, and should be addressed in medical schools and specialization courses. A more positive perception of cesarean delivery as safe, and the defense of cesarean section as a woman's right, were more common in private services, where there was also less acceptance of births attended by nurse-midwives. Differences observed between public and private services may inform the development of new strategies and strengthen ongoing initiatives in Brazil, with the aim of reducing cesarean section rates and promoting best practices in childbirth care.

To determine the level of satisfaction with childbirth and the postpartum period. This is a longitudinal, observational study. Clinical variables of the patients and delivery were collected, and a descriptive and inferential analysis was performed. The validated state-trait anxiety inventory (STAI) and the satisfaction survey Care in Obstetrics Measure For Testing Satisfaction Scale (COMFORTS) in Spanish were used. A total of 381 women was included in the study and grouped into satisfied vs. dissatisfied (94.54% vs. 5.46%). Women having given birth by eutocic delivery (p = 0.005), as well as those who had skin-to-skin time with their newborn (p = 0.012) after delivery, report more satisfaction. Mothers who were separated from their babies reported being less satisfied (p = 0.004), as did those who did not meet the expectations raised in the birth plan (p = 0.013). All the women with minimal anxiety are satisfied (p = 0.004), the same happening for those showing postpartum anxiety (p <0.001). The percentage of satisfied women is high; it is necessary to monitor childbirth and postpartum care, promoting good practices in childbirth care, as well as in women's emotional well-being.

Objective: to analyze practices in childbirth and postpartum hospital care. Methods: cross-sectional study, conducted with 335 mothers in a reference maternity hospital. A form was used based on the indicators of the Bologna index and guidelines for childbirth and puerperium assistance. Data were analyzed using descriptive and inferential statistics (chi-square, binomial and Clopper-Pearson tests), with p&lt;0.05 being significant. Results: it was observed that 77.9% of the puerperal women considered professional assistance satisfactory. The presence of the doula (p=0.037) and breastfeeding in the first hour of life (p=0.032) had a significant relation with the evaluation of women. The Bologna index evaluation obtained an average of 2.6. Conclusion: there was a higher frequency of intermediate and inadequate practices in childbirth and postpartum care.

Objectives: to describe good practices on childbirth care and obstetric interventions performed by resident nurses in obstetrics during the obstetric childbirth risk at a public maternity hospital in Salvador. Methods: a descriptive cross-sectional study with a quantitative approach, based on the of 102 parturients, between February and April 2016. The data collection was performed through the collection of information on clinical files for analysis by using descriptive statistics with absolute and relative frequencies for the evaluated categorical variables. Results: it was observed that 100.0% of the women used some kind of non-pharmacological method for pain relief, although the method of choice was to take a hot bath; 99.0% of the women drank liquids; 94.0% had the presence of a companion of free choice; 99.0% walked during labor; 100.0% had the freedom to choose a position during childbirth. It is noteworthy that no woman in this study was submitted to episiotomy, and more than 70.0% were not submitted to any obstetric intervention. Conclusions: the Programa de Residência em Enfermagem (Residency Nursing Program) an important point in the childbirth humanization process is directly associated to the increase in the normal childbirth rates, the highest use on good practices in childbirth care, and the reduction on obstetric interventions.

Introduction: The experience of motherhood for primiparous women is a moment of passage and concerns physical and emotional changes. This experience needs to be welcomed by health teams from primary care to medium and high complexity. Therefore, in the usual risk prenatal care, the generalist nurse and the obstetrician nurse must be in the care teams, maintaining the quality of prenatal, childbirth and postpartum care. The attention to women in a humanized way can contribute to the experience of a more satisfactory postpartum period. Objectives: to recognize the perceptions of puerperal women in the care actions given by nurses in a School Hospital. Methods: qualitative, exploratory study, carried out in a Federal School Hospital, linked to a public university. The group in this study was composed of 13 primiparous women, who gave birth to their children through normal delivery or cesarean section in the second half of 2021. An interview was carried out using the Google Meet platform between the 30th and 45th day postpartum with the following question: What does it mean to me to be a woman and a puerperal for the first time? The analysis was performed using the Iramuteq software (Interface R pous les Analyses Multidimensionnelles de Textes et de Questionnaires – Version 0.7 alpha 2) Results: the corpus of the 13 interviews generated 308 Elementary Context Units (ECU). The Descending Hierarchical Classification (CHD) retained 254 UCE, with an 82.47% success rate and five classes; the most frequent lexicon was nurse (a), with a frequency of 23 citations in the text segments. Conclusions: it was possible to recognize the nurse as a professional promoter of humanized practices in childbirth care, by the participants' reports about the reception received at the time of childbirth and the immediate postpartum period.

BackgroundRespectful maternity care is a crucial part of quality care and is associated with better health outcomes. Early in the Covid-19 pandemic, reports from across the world indicated that infection containment measures were often implemented in ways that resulted in disrespectful care of women during facility-based childbirths in violation of evidence-based practices. This study aimed to explore the associations between childbirth care practices and perceptions of care as satisfactory and respectful among women who delivered in Israeli hospitals during the first six months of the Covid-19 pandemic.MethodsA cross-sectional self-administered online survey was conducted to explore women’s perceptions of maternity care using an adapted version of the WHO Community Survey Tool for measuring how women are treated during facility-based childbirth. Multivariate logistic regression models evaluated the associations between sociodemographic characteristics, obstetric information, and measurements of childbirth experiences and women’s perceptions of receiving respectful and satisfactory care.ResultsThe responses of 981 women were included in the analysis. While the majority of women perceived the care they received as both respectful (86.54%) and satisfactory (80.22%), almost 3 in 4 women (72.68%) reported experiencing at least one type of disrespectful care. Positive communication with the medical staff and respect for autonomy were associated with a more positive birth experience for women. Women were more likely to perceive their care as respectful if they did not feel ignored (AOR = 40.11;22.87–70.34). Perception of satisfactory care was more likely among women who had the opportunity to discuss preferences with the medical staff (AOR = 10.15; 6.93–14.86). Having Covid-19 procedures explained increased the likelihood of reporting respectful and satisfactory care (AOR = 2.89;1.91–4.36; AOR = 2.83;2.01–4).ConclusionUnderstanding which care practices are associated with women’s perceptions of care at facility-based births is critical to ensuring quality care. The findings of this study can inform future work and research aimed at enhancing respectful maternity care during times of crisis and beyond.

Reducing Maternal and Perinatal Mortality Through a Community Collaborative Approach: Introduction to a Special Issue on the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP)

As a part of the process of implementing Early Essential Newborn Care (EENC) in China, which are evidence-based interventions recommended by the World Health Organization (WHO), we sought to understand whether current hospital policies are consistent with WHO-recommended standards and what factors influence their use. Data from the study will help inform policy changes needed to support the introduction of evidence-based childbirth and early newborn care practices effectively and to inform further scale up of EENC nationwide. Ten randomly selected hospitals in 4 early-introducing provinces participated in the study. We collected data from 20 simulated delivery scenario observations and focus group discussions and individual interviews with 10 hospital management staff. Policies, protocols, and guidelines related to childbirth and newborn care practice were also collected and reviewed at each hospital. Additionally, a survey was emailed to 15 childbirth and newborn experts from the 4 selected provinces and completed by 13. Data were compared with WHO EENC evidence-based standards to calculate the agreement rates. Barriers to introducing evidence-based guidelines were identified in focus groups and key informant interviews, then combined into common categories. Hospital policies were not consistent with WHO recommendations in 10 (59%) of the 17 delivery and early newborn care practices. Delayed cord clamping was recommended by 30% of hospital protocols and prolonged skin-to-skin contact by 13%, neither of which were observed in the delivery simulations. Kangaroo mother care (KMC) for stable preterm babies was required in only 17% of the hospitals; no preterm babies had KMC initiated, with all immediately separated from their mothers and admitted to neonatal intensive care units. Newborn resuscitation equipment was required to be placed within 2 meters of the delivery bed in 84% of hospital protocols, but was prepared in only 40% of cases. Immediate drying after birth was required in 48% of hospital protocols, but was initiated in only 20% of observed cases. Current childbirth and early newborn care policy and practice in China is not aligned with WHO recommendations for some major interventions. To make it easier and safer for hospital workers to practice EENC, expert working groups and national policies must be established to address inconsistencies and cultural beliefs and provide a strong, evidence-based set of guidelines for hospitals and health workers to follow.

Clinical Implant Dentistry and Related ResearchEarly View LETTER TO THE EDITOR How the use of xenogeneic grafts can impact the relationship with some social groups and blood donor patients Elton Gonçalves Zenóbio PhD, Corresponding Author Elton Gonçalves Zenóbio PhD [email protected] Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil Correspondence Elton Gonçalves Zenóbio, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Dom José Gaspar Av. 500, Coração Eucarístico, Belo Horizonte, MG 30535-901, Brazil. Email: [email protected]Search for more papers by this authorDayane Ferreira Resende, Dayane Ferreira Resende Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorVitória Netto de Albuquerque, Vitória Netto de Albuquerque Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorPolianne Alves Mendes, Polianne Alves Mendes Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorFernando Antônio Mauad de Abreu PhD, Fernando Antônio Mauad de Abreu PhD Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorMaurício Greco Côsso PhD, Maurício Greco Côsso PhD Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this author Elton Gonçalves Zenóbio PhD, Corresponding Author Elton Gonçalves Zenóbio PhD [email protected] Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil Correspondence Elton Gonçalves Zenóbio, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Dom José Gaspar Av. 500, Coração Eucarístico, Belo Horizonte, MG 30535-901, Brazil. Email: [email protected]Search for more papers by this authorDayane Ferreira Resende, Dayane Ferreira Resende Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorVitória Netto de Albuquerque, Vitória Netto de Albuquerque Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorPolianne Alves Mendes, Polianne Alves Mendes Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorFernando Antônio Mauad de Abreu PhD, Fernando Antônio Mauad de Abreu PhD Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this authorMaurício Greco Côsso PhD, Maurício Greco Côsso PhD Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, BrazilSearch for more papers by this author First published: 10 May 2023 https://doi.org/10.1111/cid.13215Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Background: The skills of midwives in childbirth care competence are still inadequate. This problem is influenced by limitation experience of midwifery students of childbirth care in the field of practice area. That condition related to the proportion of midwifery students and case of childbirth woman was an imbalance. Midwifery students must prepare this competence in an education with childbirth care experience from practice in the laboratory and in the field of practice. Reflective learning is an appropriate learning method that uses experience as the basis of learning to improve childbirth care competence of midwifery students. Objective: This study is to analyze the effect of reflective learning implementation in childbirth care practice to improve students’ competence. Method: This research uses quasi-experimental design with non-equivalent control group design. The respondents were midwifery students in the fourth semester who had experienced the theory of childbirth care. There were totally 64 samples, 34 samples for treatment group and 30 samples for control group. Data were analyzed by using unpaired t test, Mann Whitney U and linear regression. Results: The respondents were homogeny in motivation and grade point of average (GPA). The improvement of childbirth care competency is influenced by treatment of 19.064 with R2 = 57.7%. Conclusion: The implementation of reflective learning in childbirth care practice affected the improvement of students’ competence.

ObjectiveTo explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).DesignA pre-comparison and post-comparison study.SettingThe study was conducted in...