Experiência positiva de parto: fatores determinantes e influenciadores na perspectiva de mulheres

Abstract

Objective: To understand the parturition process of women by identifying the factors that influenced a positive experience of childbirth as well as their apprehension of this process. Method: It is a mixed explanatory sequential research. In the quantitative Stage (1st), the study used a cross-sectional design, applying the T-IHAMC questionnaire to 265 postpartum women from cohabitation from January to June 2021. For data analysis, the study used descriptive statistics and to estimate the related risks the regression of Poisson. In the qualitative stage (2nd), the research used open interviews, applied between one and six months after birth, with 44 puerperal women who participated in the first stage and presented an understandable narrative. A thematic analysis was performed. The combination of the methods occurred in the connection and integration of the results and discussion. Results and discussion: Factors closest to a positive experience: knew how the vagina looked (98.02%) and did not consider minor lacerations as a bad experience; newborns presented Apgar ≥ 7/5th minute (96.92%), indications of the inductions met recommendations (96.43%), used misoprostol for induction (84.38%), choice of companion (95.47%), were assisted in the immediate puerperium (78.11%), did not present bleeding (95.09%), postpartum complications (70.19%) or infections (83.9%). We’re not left alone (82.2%) and valued care availability and the nurse obstetrician. Were guided concerning the follow-up visit (55.08%). Were offered pain relief methods (78.9%), were allowed to drink and eat (76.36%), amniotomy (60.75%) and Kristeller (86.14%) were not performed. Visited the hospital in labor (61.89%) and in the active phase. Factors that negatively interfered with the experience: predominance of cesarean section (61.89%), women did not go into labor (64.91%), absence of birth plan (100%), separation of the binomial (100%), deprivation of skin-to-skin contact/breastfeeding during the first hour (55.09%) companion restriction (99.6%), absence of doula (99.08%), lack of analgesia and lack of knowledge by women (97.25%), directed pull (94.06%), pre-establishment of the delivery position (90.1%), excessive vaginal touch by more than one professional (56.88%), movement deprivation in labor (55.05%), maintain venous access in labor (58.26%). Feared induction. Occurrence of disrespectful situations (69.49%), lack of privacy (83.9%), choices were not taken seriously (78.39%), perineal trauma or cesarean section (84.41%). Communication and security presented divergences between the stages, contemplated only in the quantitative one. Insecurity and disrespect presented higher chances for women who gave birth normally. Conclusion: Influencing factors were closer to a positive experience when related to clinical, protocol factors, or care availability. Negative experiences were related to excessive interventions, deprivation of rights and choice, ineffective communication, insecurity, lack of privacy, and restriction of the companion. There was a preference for cesarean section for women who: feared pain and how they would be treated in labor due to lack of information, previous trauma, and suffering of other parturients. Associations regarding the type of delivery showed that women who performed cesarean section feel safer and have lower chances of suffering disrespect. This study aims to collaborate in the elaboration of policies, protocols, and norms that ensure that the woman and her baby do not only survive but also experience this moment with dignity and intensively.