Obstetricians' Attitude towards Childbirth.

(1) Background: In Spain, as in other countries, there is an increase in policies and practices focused on the humanization of perinatal care. In this regard, the quality of interpersonal interactions between women and health professionals is one of the main factors, and, apart from other factors, it is influenced by health professionals´ attitudes towards childbirth. The main objective of this study was to determine the attitudes of obstetricians towards the humanization of childbirth and the promotion of a positive childbirth experience. (2) Methods: The psychosocial task force of the Spanish Society of Obstetrics and Gynecology designed a nationwide online survey. The questionnaire on attitudes towards childbirth (CAVE, acronym for "cuestionario de actitudes sobre vivencias y experiencias en el parto") was used for the assessment. Exploratory and confirmatory factor analyses of the scale were also performed. (3) Results: A total of 384 participants completed the survey. Obstetricians showed a high-quality clinical obstetric performance, but some difficulties in identifying birth-related psychological-trauma risk factors. Some differences according to practice and gender were found in the final score and in areas regarding psychosocial risk, pain, accompaniment, and women´s expectations. (4) Conclusions: In light of the results, it is advisable to launch education initiatives aimed to improve interaction with pregnant women.

Educating future professionals in perinatal medicine: the attitude of medical and nursing students towards childbirth.

OBJECTIVES: The main objective of the present study was to evaluate what educational needs were being neglected in current perinatal educational program in the University of Malaga. METHODS: We performed a cross-sectional study using the Students' questionnaire on attitudes towards childbirth (CAVE-st) in a sample of 378 students who were finishing their undergraduate or postgraduate academic perinatal program, including medical and nursing students. RESULTS: The Cronbach's alpha reliability coefficient was 0.895. The mean score of CAVE-st in the sample was 200.34 (DT 21.0). The scores were below the median value in more than 53% of the students, especially in medical students. Female students scored systematically higher in the overall scale and its subscales, even after adjusting for study groups. On the other hand, the students with children scored significantly lower in the subscale that explored their attitudes towards unexpected results. A huge margin for improvement was recognizable in those subscales related with childbirth medicalization, respect to women decisions, and health-care prioritization. CONCLUSIONS: Students' attitude towards childbirth need to be improved as a means to improve women's childbirth experience and prevent birth-related trauma. The current undergraduate and postgraduate training in perinatal care lacks a comprehensive and biopsychosocial perspective that would improve the quality of clinical practice during childbirth.

Percepção de mulheres sobre o parto e o papel da doula / On how women perceive childbirth and the role of doula / Percepción de mujeres sobre el parto y el papel de la doula

Os cuidados oferecidos pela doula, profissional que orienta e assiste a mulher na gestação, no parto e no pós-parto, são considerados como acolhedores e tendem a promover o bem-estar emocional da parturiente, auxiliando-a no enfrentamento das situações de desconforto. O objetivo dessa pesquisa foi analisar a percepção de mulheres sobre o parto e sobre a figura da doula no processo de parturição. Foram entrevistadas nove mulheres, com idades entre 19 a 35 anos, que tiveram uma gestação de baixo risco e que foram acompanhadas por doulas durante a gestação, parto e/ou no período pós-parto. Os relatos foram transcritos na íntegra e emergiram três categorias finais: Práticas Institucionais e Ambiência; Enfrentamento da Dor; e Presença da Doula e Importância da Equipe. Concluiu-se que a doula cumpre um papel importante ao proporcionar confiança e ao utilizar técnicas para o alívio da dor, entretanto, cabe ressaltar que apenas a sua presença não garante o respeito pelos direitos e individualidade das mulheres e um parto humanizado.

The care offered by the doula, a professional who guides and assists the woman during pregnancy, childbirth and postpartum, is considered to be nurturing and tends to foster the emotional wellbeing of the parturient, helping her to cope with possible discomfort. The aim of this research was to analyze how women perceive childbirth and the doula figure in the parturition process. Nine women, aged 19-35 years, who were experiencing low-risk pregnancies and were attended to by doulas during gestation, delivery and / or in the postpartum period, were interviewed. The reports were transcribed in full and three final categories emerged: Institutional Practices and ambience; Coping with Pain; Doula Presence and Team Importance. It was concluded that the doula plays an important role in providing confidence and on in the usage of pain relief, techniques however, it should be emphasized that relying solely on this professional presence does not guarantee the respect for the mother-to-be's rights and individuality and more importantly, humanized childbirth.

Los cuidados ofrecidos por la doula, profesional que orienta y asiste a la mujer durante el embarazo, en el parto y en el posparto, son considerados como acogedores y tienden a promover el bienestar emocional de la gestante, auxiliándola a enfrentar situaciones de incomodidad. El objetivo de esta investigación fue analizar la percepción de mujeres sobre el parto y sobre la figura de la doula en ese proceso. Nueve mujeres fueron entrevistadas, con edades entre 19 y 35 años, las cuales tuvieron un embarazo de bajo riesgo y fueron acompañadas por doulas durante la gestación, parto y / o en el período posparto. Los relatos fueron totalmente transcritos, del cual surgieron tres categorías finales: Prácticas Institucionales y ambientación hospitalaria; Enfrentamiento del dolor; Y Presencia de la Doula e Importancia del Equipo. Se concluyó que la doula cumple un papel importante al proporcionar confianza y al utilizar técnicas para el alivio del dolor, sin embargo, cabe resaltar que sólo su presencia no garantiza el respeto por los derechos e individualidad de las mujeres y un parto humanizado.

A humanização e a assistência de enfermagem ao parto normal / Humanization and nursing assistance to normal childbirth

Estudo bibliográfico que buscou identificar a produção científica sobre humanização e assistência de enfermagem ao parto normal. As fontes foram artigos científicos da base de dados da SCIELO-Brasil, período 2000 a 2007. Obtivemos como resultado da busca 13 artigos que foram agrupados nas seguintes áreas temáticas: medicalização do parto, humanização da assistência ao parto, acompanhante no parto e atuação da enfermeira obstétrica. A análise apontou que o paradigma atual é centralizado na intervenção do parto, apesar do movimento da humanização defender o parto natural e fisiológico realizado por enfermeira.. Conclui-se que assistência de qualidade e humanizada ao parto e nascimento privilegia o respeito, dignidade e autonomia das mulheres, com resgate do papel ativo da mulher no processo parturitivo.

Bibliographical study that sought to identify the scientific production about humanization and nursing assistance to normal childbirth. The sources were scientific articles from SCIELO-Brasil's database, from 2000 to 2007. We obtained 13 articles as result from the search, which were grouped in the following categories: childbirth medicalization, humanization of assistance to childbirth, companion during childbirth and performance of the obstetric nurse. The analysis pointed out that the current paradigm is centralized on childbirth intervention, despite of humanization movements defending the natural and physiological childbirth made by the nurse. We concluded that qualified and humanized assistance to childbirth and birth privileges women's respect, dignity and autonomy, regarding women's active role in the birth process.

Estudio bibliográfico que buscó identificar la producción científica sobre humanización y asistencia de enfermería al parto normal. Las fuentes fueron artículos científicos de la base de datos de SCIELO-Brasil, de 2000 a 2007. Obtuvimos 13 artículos como resultado de la búsqueda, que fueron agrupados en las siguientes categorías: medicalización del parto, humanización de la asistencia al parto, acompañante en el parto y actuación de la enfermera obstétrica. El análisis apuntó que el paradigma actual es centralizado en la intervención del parto, a pesar de movimientos de la humanización defender el parto natural y fisiológico realizado por enfermera. Concluimos que asistencia de calidad y humanizada al parto y nacimiento privilegia el respecto, dignidad y autonomía de las mujeres, y también el papel activo de la mujer en el proceso de parto.