Hospital obstetric practices and their repercussions on maternal welfare

Alvares, Aline Spanevello; Corrêa, Áurea Christina de Paula; Nakagawa, Janete Tamami Tomiyoshi; Valim, Marília Duarte; Jamas, Milena Temer; Medeiros, Renata Marien Knupp

doi:10.1590/S1980-220X2018039003606

Brasil

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 54 • 2020 • https://doi.org/10.1590/S1980-220X2018039003606 linkcopy

Hospital obstetric practices and their repercussions on maternal welfare^*

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective To analyze the association of care practices performed by obstetric professionals with maternal welfare/malaise levels.

Method A quantitative study conducted in a Prepartum/Childbirth/Postpartum Unit of a Teaching Hospital with puerperal women who underwent vaginal births. An association was performed between obstetric practices and maternal welfare/malaise levels.

Results There were 104 puerperal women who participated. Obstetric practices which caused mothers to feel unwell and which obtained statistical significance were: amniotomy (p = 0.018), episiotomy (p = 0.05), adoption of horizontal positions in the expulsive period (p = 0.04), the non-use of non-invasive care technologies (p = 0.029), and non-skin-to-skin contact between mother and child (p = 0.002). For most women, the presence of a companion favored welfare, even though it did not have a statistically significant association. After performing logistic regression, non-performance of amniotomy was the only variable which showed significance in maternal welfare.

Conclusion Humanized obstetric practices have greater potential to promote maternal welfare. The importance of obstetric nurses conducting practices which provide greater welfare to mothers is emphasized.

Maternal Welfare; Obstetric Nursing; Humanizing Delivery; Maternal-Child Nursing

Variables	Scale classification		TOTAL	PR* (95%CI^†)	p-value‡ Fisher’s Exact test
Variables	Malaise	Satisfactory welfare / Optimal welfare	TOTAL	PR* (95%CI^†)	p-value‡ Fisher’s Exact test
Professional
Doctor	7	53	60	2.1 (0.46-9.56) 1	0.270
Nurse	2	34	36	2.1 (0.46-9.56) 1	0.270
Non-invasive technologies
No	4	12	16	4.4 (1.32-14.63) 1	0.029
Yes	5	83	88	4.4 (1.32-14.63) 1	0.029
Presence of a companion
Yes	9	88	97	-	0.52
No	0	7	7
Vaginal touch discomfort
Yes	1	13	14	0.8 (0.10-5.94) 1	0.652
No	8	82	90	0.8 (0.10-5.94) 1	0.652
Amniotomy
Yes	7	34	41	5.3 (1.17-24.62) 1	0.018
No	2	61	63	5.3 (1.17-24.62) 1	0.018
Position
Horizontal	3	7	10	4.7 (1.38-15.96) 1	0.040
Vertical	6	88	94	4.7 (1.38-15.96) 1	0.040
Laceration
Yes	6	60	66	1.1 (0.30-4.34) 1	0.571
No	3	35	38	1.1 (0.30-4.34) 1	0.571
Episiotomy
Yes	2	3	5	5.6 (1.55-20.53) 1	0.05
No	7	92	99	5.6 (1.55-20.53) 1	0.05
Skin-to-skin contact
No	7	24	31	8.2 (1.81-37.46) 1	0.002
Yes	2	71	73	8.2 (1.81-37.46) 1	0.002
Breastfeeding
No	3	11	14	3.2 (0.9-11.4) 1	0.1
Yes	6	84	90	3.2 (0.9-11.4) 1	0.1

Variables	Coefficient	SE* Coefficient	Wald test	P-value†	OR‡	OR‡ (§95.0%CI)
Variables	Coefficient	SE* Coefficient	Wald test	P-value†	OR‡	LS	LI
Constant	-2.086	1.555	-1.341	0.179
Use of Non-Invasive Technologies	1.036	0.982	1.054	0.291	2.819	0.410	19.353
Non-performance of amniotomy	1.990	1.008	1.974	0.048	7.315	1.014	52.758
Vertical Position	1.272	1.183	1.075	0.282	3.568	0.351	36.287
Non-performance of episiotomy	1.099	1.233	0.891	0.372	3.004	0.267	33.691
Stimulation of skin-to-skin contact	1.666	1.000	1.665	0.095	5.293	0.745	37.612
Encouraging breastfeeding	0.070	0.975	0.072	0.942	1.072	0.158	7.256
Log-likelihood \|\| = 19.2595			p-value†0.0037

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[TFN1001] * PR - Prevalence Ratio

[TFN2001] † CI – Confidence Interval

[TFN3001] ‡ P-value – Level of significance

Hospital obstetric practices and their repercussions on maternal welfare*

ABSTRACT

Hospital obstetric practices and their repercussions on maternal welfare^*