scholarly journals Being in an oasis: a restorative and reassuring place - women’s experiences of a valuable antenatal diabetes midwifery consultation

2013 ◽  
Vol 3 (1) ◽  
pp. 2
Author(s):  
Christina Furskog Risa ◽  
Febe Friberg ◽  
Eva Lidén

The prevalence of diabetes in the childbearing population is increasing globally. Pregnant diabetic women are considered to be at high risk, and thus require specialized, multidisciplinary prenatal care in which midwives play an integral part. These women&rsquo;s views and experiences of encounters with midwives during diabetes care have not yet been investigated. Our aim was to use an exploratory interpretive approach to investigate the experiences of pregnant women and their perceptions towards the meaning of prenatal consultation provided by midwives in the prenatal care team. A purposive sample was recruited from four hospital-based prenatal diabetes outpatient clinics in the urban areas of Norway: 10 pregnant women (5 primiparous, 5 multiparous) aged 28-45 and diagnosed with different types of diabetes. Data from semi-structured interviews were transcribed and subjected to thematic analysis. Three main themes emerged: being in an open atmosphere, being seen as a person, and being reassured. Together, these themes created a construct that we labeled <em>being in an oasis-a restorative and reassuring place</em>. The counterpoint of this view was a more negative perspective described as having insufficient time, feelings of being objectified and rushed, and diseaseoriented care. The women valued the focus on surveillance in the consultations, although at their best, the midwife-woman encounters complemented and counteracted the iatrogenic effect of the biomedical focus in specialist prenatal care. However, the organization of care may have contributed to and created feelings of suffering, as these women had limited scope for addressing their concerns in the consultation. We conclude that these consultations are complex co-created activities in which interpersonal aspects of the midwifewoman encounters, such as the midwives&rsquo; openness and responsiveness to the women, seem to be significant in developing a personal approach.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Ciciliotti da Silva ◽  
B Heintze Ferreira ◽  
D Fraga Santos ◽  
F Fernandes ◽  
Bersot Magalhães ◽  
...  

Abstract Introduction The pregnancy-puerperal cycle is defined as a moment that involves physical, psychological and social changes. There are pregnancies that require specialized care and attention due to the presence of risk factors that may be prior to pregnancy and / or that may be associated with the pregnancy condition itself, which characterize them as high-risk pregnancies. Currently, prenatal care with risk stratification is the main care strategy for pregnant women, once the risk classification is identified, it is possible to promote interventions according to the health needs of each pregnant woman. For this, the risk assessment is carried out at each prenatal consultation, so that, depending on the course of pregnancy, hospitalization becomes necessary. The diagnosis of high-risk pregnancies accompanied by hospitalization has impacts on the woman's life, such as loss of autonomy, a sense of failure and the incidence of greater care and interventions by the health team and the family that can configure practices to control their bodies. Objective This work aims to identify the hospitalization process during high-risk pregnancy as a space for the production of projects, resistance and protagonism through the protocols and regulations that configure the hospital context. Methodology This is an exploratory analysis of a qualitative approach in public health. A reference maternity hospital in high-risk pregnancy located in a teaching hospital in Greater Vitória was chosen. It will be used to define sampling for convenience. The data will be collected through semi-structured interviews and on-site observations by the researcher. The data analysis methodology used will be content analysis. Expected Results It is expected to understand the various practices of protagonism and resistance that permeate the care of hospitalized pregnant women. Key messages This work has an impact on the improvement of the maternal and child care network of the public health system in Brazil. This work allows to evaluate the quality of the assistance provided in the public maternity.


2017 ◽  
Vol 11 (12) ◽  
pp. 4970
Author(s):  
Lucimare Ferraz ◽  
Paula Marco Marchiori ◽  
Patricia Pereira Oliveira

RESUMO Objetivo: conhecer a assistência pré-natal desenvolvida na Estratégia Saúde da Família. Método: estudo descritivo, de abordagem qualitativa, com a participação de gestantes, médicos e enfermeiros do meio rural. A coleta de dados foi por meio de entrevistas semiestruturadas e a análise por meio da técnica de Análise de conteúdo na modalidade Análise Temática. Resultados: constatou-se que as consultas de pré-natal são centradas no profissional médico, que os profissionais de saúde não abordam o ambiente e o processo de trabalho das gestantes agricultoras e, nas orientações, evidenciou-se que o processo de comunicação entre os profissionais e a gestante precisa ser melhorado. Conclusão: a assistência ao pré-natal de baixo risco na Estratégia Saúde da Familia no meio rural é focada no modelo Biomédico, sendo que poucos profissionais (re)conhecem o ambiente e os processos de trabalho das gestantes agricultoras. Descritores: Trabalhadores Rurais; Cuidado Pré-Natal; Estratégia Saúde da Família. ABSTRACTObjective: to know prenatal care developed in the Family Health Strategy. Method: this is a descriptive study with a qualitative approach, with the participation of pregnant women, doctors and nurses from rural areas. The data collection was through semi-structured interviews and the analysis through the technique of Content Analysis in the Thematic Analysis modality. Results: it was verified that the prenatal consultations are focused on the medical professional, that the health professionals do not approach the environment and the work process of pregnant farmers. The guidelines showed that the process of communication between the professionals and the pregnant woman needs to be improved. Conclusion: low-risk prenatal care in the Family Health Strategy in rural areas is focused on the Biomedical model, and few professionals recognize/know the environment and the work processes of pregnant women farmers. Descriptors: Rural Workers; Prenatal Care; Family Health Strategy.RESUMENObjetivo: conocer la asistencia prenatal desarrollada en la Estrategia Salud de la Familia. Método: estudio descriptivo, de enfoque cualitativo, con la participación de gestantes, médicos y enfermeros del área rural. La recolección de datos fue por medio de entrevistas semi-estructuradas y el análisis por medio de la técnica de Análisis de contenido en la modalidad Análisis Temático. Resultados: se constató que las consultas de prenatal son centradas en el profesional médico, que los profesionales de salud no enfocan el ambiente y el proceso de trabajo de las gestantes agricultoras. En las orientaciones se evidenció que el proceso de comunicación entre los profesionales y la gestante precisa ser mejorado. Conclusión: la asistencia al prenatal de bajo riego en la Estrategia Salud de la Familia en el área rural es enfocada en el modelo Biomédico, siendo que pocos profesionales (re) conocen el ambiente y los procesos de trabajo de las gestantes agricultoras. Descriptores: Trabajadores Rurales; Atención Prenatal; Estrategia de Salud Familiar.


2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Lisa Jones ◽  
Nyoman Anita Damayanti ◽  
Nicola Wiseman ◽  
Neil Harris

Five focus group discussions (FGDs) with 61 pregnant women were conducted in June and July 2019 at primary health care (PHC) services within five urban areas of Surabaya, Indonesia. In addition, five semi-structured interviews with five midwives were carried out to explore the experiences of pregnant women accessing Antenatal Care (ANC) and the factors shaping uptake of ANC services. Data were audio-recorded, transcribed, and translated into English, and analyzed using thematic analysis. Findings from focus group discussions suggested that fears of negative diagnosis before initial ANC appointment and personal beliefs and myths surrounding pregnancy may delay uptake of ANC. Further, the influence of husbands, family, and friends and long waiting times with overcrowding leading to limited seating shaped timely access and return visits. In addition, feeling comfortable with the quality of the service and receiving a friendly service from the practitioners assisted women in feeling comfortable to return. Finally, midwives acknowledged feeling afraid of being referred to a hospital if deemed a high-risk pregnancy-shaped return ANC visits. The findings highlighted several factors needing to be addressed to increase the promptness of first ANC visits and ensure return visits to achieve great ANC coverage.


2017 ◽  
Vol 11 (12) ◽  
pp. 4875
Author(s):  
Jacqueline Targino Nunes ◽  
Ana Caroline Viana Marinho ◽  
Rejane Marie Barbosa Davim ◽  
Gabriela Gonçalo de Oliveira Silva ◽  
Rayane Saraiva Félix ◽  
...  

RESUMOObjetivos: discutir as ações do enfermeiro na atenção pré-natal a gestantes com sífilis e identificar dificuldades encontradas pelos profissionais na adesão ao tratamento das gestantes e parceiros. Método: estudo qualitativo, tipo descritivo-exploratório, desenvolvido com quatro mulheres na faixa etária entre 40 e 55 anos, com a produção de dados a partir de entrevistas semiestruturadas, analisada pela Técnica Análise Conteúdo na modalidade Análise Categorial. Resultado: das falas emergiram três categorias << Ações dos enfermeiros no acompanhamento à gestante com sífilis >>; << Aspectos que dificultam a eficácia no tratamento da sífilis gestacional >>; << Importância da notificação compulsória da sífilis >>. Conclusão: a ação do enfermeiro às gestantes com sífilis tem condutas adequadas segundo o Ministério da Saúde. Nas dificuldades ao tratamento citaram falta do medicamento, resistência das gestantes e tratamento doloroso. A notificação compulsória foi identificada apenas na unidade de referência, dificultando a real incidência de gestantes com sífilis e deficiências na qualidade da assistência. Descritores: Enfermeiro; Pré-Natal; Gestante; Saúde da Mulher; Neurossífilis; Sífilis Congênita.ABSTRACT Objectives: to discuss nurses' actions in prenatal care for pregnant women with syphilis and to identify difficulties found by professionals in adhering to the treatment of pregnant women and their partners. Method: this is a qualitative study, descriptive-exploratory type, developed with four women in the age group between 40 and 55 years old, with the production of data from semi-structured interviews, analyzed by the Content Analysis Technique in the Categorical Analysis modality. Result: three categories of nurses' actions in the follow-up of pregnant women with syphilis emerged from the speeches: << Aspects that hinder effectiveness in the treatment of gestational syphilis >>; << Importance of compulsory notification of syphilis >>. Conclusion: the nurse's action on pregnant women with syphilis has adequate behavior according to the Ministry of Health. In the difficulties to treatment, they mentioned lack of medication, the resistance to pregnant women and painful treatment. Compulsory notification was identified only in the reference unit hindering the real incidence of pregnant women with syphilis and deficiencies in the quality of care. Descriptors: Nurse; Prenatal Care; Pregnancy; Women´s Health; Neurosyphilis; Congenital Syphilis.RESUMENObjetivos: discutir las acciones del enfermero en la atención prenatal a gestantes con sífilis e identificar dificultades encontradas por los profesionales en la adherencia al tratamiento de las gestantes y compañeros. Método: estudio cualitativo, tipo descriptivo-exploratorio, desarrollado con cuatro mujeres entre 40 y 55 años, con la producción de datos a partir de entrevistas semi-estructuradas, analizada por la Técnica Análisis de Contenido en la modalidad Análisis Categorial. Resultado: de los discursos surgieron tres categorías << Acciones de los enfermeros en el acompañamiento a la gestante con sífilis >>; << Aspectos que dificultan la eficacia en el tratamiento de sífilis gestacional >>; << Importancia de la notificación compulsoria de sífilis >>. Conclusión: la acción del enfermero a las gestantes con sífilis tienen conductas adecuadas según el Ministerio de la Salud. En las dificultades al tratamiento citaron falta de medicamento, resistencia de las gestantes y tratamiento doloroso. La notificación compulsoria fue identificada apenas en la unidad de referencia dificultando la real incidencia de gestantes con sífilis y deficiencias en la calidad de la asistencia. Descriptores: Enfermería; Atención Prenatal; Embarazo; Salud de la Mujer; Neurosífilis; Sífilis Congénita.


2018 ◽  
Vol 7 (2) ◽  
pp. 223-235
Author(s):  
Rita De Cássia Gubert Trajano ◽  
Luciane Bisognin Ceretta ◽  
Maria Tereza Soratto

Estudo com o objetivo de introduzir a consulta de enfermagem no pré-natal de baixo risco em uma unidade integrada de saúde, bem como descrever a experiência de mulheres grávidas no atendimento pré-natal de baixo risco nas consultas. A enfermeira está amparada por lei para realizar a consulta de enfermagem contribuindo dessa forma, para uma melhor qualidade nas orientações à gestante, diminuição do número de consultas para a médica ginecologista, maior vínculo com a gestante, como também, dar maior autonomia para que a enfermeira da unidade possa desenvolver ações de educação em saúde durante o pré-natal. Pesquisa de abordagem qualitativa, descritiva, exploratória e de campo. O estudo foi desenvolvido em um município do Extremo Sul de Santa Catarina. Foi aplicada entrevista semiestruturada com duas profissionais da equipe multiprofissional e sete gestantes. A análise dos dados foi realizada a partir da análise de conteúdo, por meio de categorização dos dados, com a ordenação, classificação e análise final dos dados pesquisados. O resultado da pesquisa evidenciou a importância da implantação da consulta de enfermagem durante o período pré-natal, pois contribui significativamente na qualidade das orientações às gestantes, o contato e o vínculo entre profissional e gestante se ampliam, e, por conseguinte, estabelece-se uma relação maior de acolhimento e humanização para com as gestantes.Palavras-chave: Cuidado Pré-Natal. Cuidados de Enfermagem. Gestação. THE NURSING CONSULTATION ON PRENATAL LOW-RISK IN THE FAMILY HEALTH STRATEGYABSTRACT: This study aims to introduce the nursing appointment in the low risk prenatal in an integrated health unit and it also aims to describe the experience of pregnant women in the low risk prenatal care, in its medical appointments. The law supports the nurse to perform the nursing appointment, thus contributing to a better quality in the orientations for pregnant women and to the decreased number of visits to the gynecologist. The nursing appointment can also collaborates to create a closer bond with the pregnant women and give more autonomy to the nurse of the integrated health unit to develop health educational actions during the prenatal. The approach of this field research is qualitative, descriptive and exploratory. This study was developed in a town in the extreme south of Santa Catarina state. It was applied semi structured interviews with two professionals of the multi-professional team and seven pregnant women. The data analysis was performed from the content analysis, by means of the categorization of data, with the ordination, classification and final analysis of surveyed data. The result of this research evidenced the importance of the implementation of nursing appointments during the low risk prenatal period because it contributes significantly in the quality of the orientations for pregnant women. The contact and the bond between the professional and the pregnant women are extended, and therefore is established a greater relationship of reception and humanization with pregnant women, seeking to create confidence and security ties during prenatal care.Keywords: Prenatal Care. Nursing Care. Pregnancy.


2016 ◽  
Vol 21 (5) ◽  
pp. 1647-1658 ◽  
Author(s):  
Katrini Guidolini Martinelli ◽  
Edson Theodoro dos Santos Neto ◽  
Silvana Granado Nogueira da Gama ◽  
Adauto Emmerich Oliveira

Abstract Aim This article aims to evaluate access to prenatal care according to the dimensions of availability, affordability and acceptability in the SUS microregion of southeastern Brazil. Methods A cross-sectional study conducted in 2012-2013 that selected 742 postpartum women in seven hospitals in the region chosen for the research. The information was collected, processed and submitted to the chi-square test and the nonparametric Spearman’s test, with p-values less than 5% (p < 0.05). Results Although the SUS constitutionally guarantees universal access to health care, there are still inequalities between pregnant women from rural and urban areas in terms of the availability of health care and among families earning up to minimum wage and more than one minimum wage per month in terms of affordability; however, the acceptability of health care was equal, regardless of the modality of the health services. Conclusion The location, transport resources and financing of health services should be reorganised, and the training of health professionals should be enhanced to provide more equitable health care access to pregnant women.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Danielle J. Hurst ◽  
Nicholas B. Schmuhl ◽  
Corrine I. Voils ◽  
Kathleen M. Antony

Abstract Background Stigma and bias experienced during prenatal care can affect quality of care and, ultimately, the health of pregnant women with obesity and their infants. We sought to 1) better understand the bias and stigma that women with BMIs ≥40 kg/m2 experience while receiving prenatal care, 2) gauge women’s interest in group prenatal education for women with obesity, and 3) gather feedback about their preferred weight-related terminology. Methods We conducted and thematically content-analyzed 30 semi-structured interviews of women with BMIs ≥40 kg/m2 who received prenatal care at a university-affiliated teaching hospital in the Midwest region of the United States. Results All women recalled positive experiences during their perinatal care during which they felt listened to and respected by providers. However, many also described a fear of weight-related bias or recalled weight-based discrimination. Women reacted favorably to a proposed group prenatal care option for pregnant women with obesity that focused on nutrition, physical activity, and weight management. Women rated “weight” and “BMI” as the most desirable terms for describing weight, while “large size” and “obesity” were rated least desirable. Conclusions Many pregnant women with BMIs ≥40 kg/m2 experience bias in the prenatal care setting. Potential steps to mitigate bias towards weight include improving provider awareness of the experiences and perspectives of this population, expanding prenatal care options targeted towards women with high BMIs, including group care, and using patient-preferred weight-related terminology. Through the remainder of this manuscript, wherever possible, the term “high BMI” will be used in place of the term “obesity” to describe women with BMI ≥ 30 kg/m2 in order to respect the preferred terminology of the women we interviewed.


PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1192-1197 ◽  
Author(s):  
Gary L. Euler ◽  
Karen G. Wooten ◽  
Andrew L. Baughman ◽  
Walter W. Williams

Objectives. To estimate race/ethnicity-specific prevalence of hepatitis B surface antigen (HBsAg) in pregnant urban women and to evaluate factors associated with maternal HBsAg testing. Methods. A multicenter, retrospective chart review was conducted of a racially/ethnically stratified random sample of maternal/infant charts of 10 523 women who gave birth to live infants during 1990–1993 in 4 urban areas in the United States. Data were collected on multiple variables, including demographic variables, HBsAg test dates and results, prenatal care type, and amount and source of payment. Results. HBsAg prevalence among white non-Hispanics was 0.60% (95% confidence interval [CI]: 0.22–0.98), black non-Hispanics 0.97% (95% CI: 0.48–1.47), Hispanics 0.14% (95% CI: 0.01–0.26), and Asians 5.79% (95% CI: 4.42–7.16). HBsAg testing rates increased from 56.6% in 1990 to 78.2% in 1993. Factors associated with not being tested varied by urban area, but in the combined area model, they were having no or private prenatal care (odds ratios: 18.75 and 5.07, respectively) and being black (odds ratios: 2.08). Only 20.9% (95% CI: 19.1%–22.8%) of those not tested prenatally were tested at delivery. The expected number of infants born to HBsAg-positive study-area women was 3327 using study prevalence rates, compared with 1761 using national rates. Conclusions. To help ensure that all urban infants who are born to HBsAg-positive women receive appropriate prophylaxis, health officials in urban areas should use urban-area prevalence rates to ascertain completeness of reporting maternal HBsAg positivity. Needed steps to increase maternal HBsAg testing rates include ensuring that more pregnant women receive prenatal care, promoting testing by private providers, educating providers about testing in all racial and ethnic groups, and reminding providers to test at delivery those women not tested prenatally.


Rev Rene ◽  
2020 ◽  
Vol 21 ◽  
pp. e44521
Author(s):  
Herla Maria Furtado Jorge ◽  
Raimunda Magalhães da Silva ◽  
Maria Yolanda Makuch

Objective: to unveil nurses’ perceptions about humanized care in high-risk prenatal care. Methods: a qualitative study, with six nurses who worked in high-risk prenatal care. Data collection took place using semi-structured interviews. To analyze the results, the content analysis technique was used. Results: the adoption of humanized care consisted of actions related to user embracement, personalized care, dialogue with pregnant women and the establishment of a trustful relationship. The main humanization practices were guided visits to maternity hospitals; creating educational groups; the use of non-pharmacological methods for pain relief during labor; and encouraging companion support. Conclusion: participating nurses understood the humanization concept and associated humanization practices to the embracement of pregnant women, guided visits, personalized care, guidance on the use of non-pharmacological methods and the promotion of connections with pregnant women.


2018 ◽  
Vol 12 (2) ◽  
pp. 337
Author(s):  
Leidiene Ferreira Santos ◽  
Sayonara Serafim de Brito ◽  
Cintia Flôres Mutti ◽  
Nayane De Sousa Silva Santos ◽  
Danielle Rosa Evangelista ◽  
...  

RESUMOObjetivo: descrever as características da assistência pré-natal na perspectiva das usuárias do serviço em Unidades de Atenção Primária à Saúde. Método: estudo qualitativo, descritivo, exploratório, em que participaram 17 mulheres internadas em uma maternidade pública. A produção de dados aconteceu por meio de entrevistas do tipo semiestruturada e os depoimentos foram submetidos à técnica de Análise de Conteúdo. Resultados: a análise dos depoimentos resultou na proposição das categorias “Assistência inadequada às gestantes atendidas nas Unidades de Atenção Primária à saúde” e “Construção de vínculo entre equipe de saúde e gestantes atendidas nas Unidades de Atenção Primária à Saúde”. Conclusão: apesar de, no Brasil, existirem inúmeras políticas públicas que garantam à gestante o mínimo de consultas e atendimento humanizado, as mulheres percebem que, na prática, isso nem sempre acontece. Há falhas na oferta e implementação de serviços às gestantes. Descritores: Assistência à Saúde; Atenção Primária à Saúde; Cuidado Pré-Natal; Gestante.ABSTRACTObjective: to describe the characteristics of prenatal care from the perspective of the users of the service in Primary Health Care Units. Method: a qualitative, descriptive, exploratory study involving 17 women hospitalized in a public maternity hospital. The data production took place through semi-structured interviews, and the statements were submitted to the Content Analysis technique. Results: the analysis of the testimonies resulted in the proposition of the categories "Inadequate care for pregnant women attended to Primary Health Care Units" and "Construction of a link between the health team and pregnant women attending the Primary Health Care Units". Conclusion: although, there are many public policies in Brazil that guarantee the minimum number of consultations and humanized care, women realize that, this is not always the case in practice. There are flaws in the provision and implementation of services to pregnant women. Descriptors: Delivery of Health Care; Primary Health Care; Prenatal Care; Pregnant Women.RESUMENObjetivo: describir las características de la asistencia prenatal en la perspectiva de las usuarias del servicio en Unidades de Atención Primaria a la Salud. Método: estudio cualitativo, descriptivo, exploratorio, en el que participaron 17 mujeres internadas en una maternidad pública. La producción de datos se produjo por medio de entrevistas del tipo semiestructurada, y los testimonios fueron sometidos a la técnica de Análisis de Contenido. Resultados: el análisis de los testimonios resultó en la proposición de las categorías "Asistencia inadecuada a las gestantes atendidas en las Unidades de Atención Primaria a la salud" y "Construcción de vínculo entre equipo de salud y gestantes atendidas en las Unidades de Atención Primaria a la Salud". Conclusión: a pesar de, que en Brasil, existan innumerables políticas públicas que garanticen a la gestante el mínimo de consultas y atención humanizada, las mujeres perciben que, en la práctica, eso ni siempre sucede. Hay fallas en la oferta e implementación de servicios a las gestantes. Descriptores: Prestación de Atención de Salud; Atención Primaria de Salud; Atención Prenatal; Mujeres Embarazadas.


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