Abstract
Objective: to investigate the association between pharmacological obstetric analgesia and obstetric and neonatal outcomes. Methods: it was a retrospective case-control study conducted with 393 pregnant women comprising 131 cases of pharmacological obstetric analgesia and 262 controls that did not perform this procedure. The sociodemographic and obstetric profile, the circumstances of parturient admission, obstetrical decisions, and obstetric and neonatal outcomes were investigated. Results: pregnant women submitted to pharmacological analgesia during labor presented an increased risk for the use of exogenous oxytocin (p<0.001), episiotomy (p=0.001), Kristeller maneuver (p=0.036), and forceps (p=0.004). Conclusion: pharmacological analgesia does not increase the risk of spontaneous perineal tear, abdominal delivery, and hospitalization in neonatal unit. Nevertheless, it influences the increased risk of synthetic oxytocin use, Kristeller maneuver, episiotomy, forceps, and the occurrence of lower first-minute Apgar scores.
Highlights
Humanized obstetric nursing care should be conducted with sensitivity, respect, and dignity to the mother-child binomial, creating a welcoming atmosphere with professional and institutional attitudes that break with the traditional model of impersonality and violence imposed on pregnant women
The cases/controls that had no record on the type of delivery and/or first- and fifth-minute Apgar scores were excluded from the study
The instrument used by the institution did not allow the classification by years of study, but it was noticed that most of the sample (89.6%) had only elementary or high school education
Summary
Humanized obstetric nursing care should be conducted with sensitivity, respect, and dignity to the mother-child binomial, creating a welcoming atmosphere with professional and institutional attitudes that break with the traditional model of impersonality and violence imposed on pregnant women. Obstetric humanization is structured around three essential pillars: the autonomy of women, the care conducted by a multiprofessional team, and the assistance based on scientific evidence Following this model, it is worth highlighting that all the interventions to be performed in pregnant women should be previously clarified and consented by them so that there is the humanized assistance at birth[3]. According to the National Guidelines on Care in Normal Birth, health professionals should reflect on how their own beliefs and values can influence their attitudes in dealing with the pain of childbirth In this context, professionals, including obstetric nurses, are responsible for guiding, enabling the access, and supporting women regarding the decision on using non-pharmacological and/or pharmacological analgesia during labor[4]
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