Ensino da reanimação neonatal para parteiras tradicionais - do aprendizado à prática nas Regiões Norte e Nordeste do Brasil
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Data
2013-09-16
Autores
Pinheiro, Rossiclei de Souza [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
No Brasil, a maioria dos partos é hospitalar, mas nas zonas rurais, ribeirinhas e de difícil acesso ocorrem partos domiciliares e são as parteiras tradicionais que prestam assistência à mulher e ao recém-nascido.Descrever quem são as parteiras tradicionais das regiões norte e nordeste do Brasil, quais suas percepções sobre asfixia e reanimação neonatal e quais são suas práticas no parto domiciliar. Estudo observacional de corte transversal, com entrevista das parteiras antes do treinamento em reanimação neonatal, durante o ano de 2012. Foram incluídas 155 parteiras não indígenas, do Amazonas, Amapá, Sergipe, Paraíba e Pernambuco. Variáveis independentes: idade, escolaridade e experiência prévia. Desfecho: respostas às questões da entrevista. Para os dados categorizados foram calculadas as frequências absolutas e relativas. As parteiras são mulheres maduras, com baixa escolaridade e pouca experiência. Identificam o risco de asfixia no neonato que não chora ou chora pouco. Não ligam o cordão umbilical até a saída da placenta, enxugam o recém-nascido com panos secos e aquecidos, aspiram boca e narina do bebê com a própria boca e para estimular a respiração sacodem e sopram sua boca e nariz. Se o neonato não chora ou não melhora pedem ajuda e encaminham para o hospital. A maioria das parteiras acompanha o bebê no transporte. As parteiras sabem pouco sobre reanimação neonatal, atuam de forma precária, mas realizam os passos iniciais da reanimação. Capacitações periódicas para parteiras podem melhorar o atendimento ao nascimento no domicílio
In Brazil, most births occur in hospitals, but in rural, riparian and remote areas, home births happen frequently, and traditional birth attendants (TBAs or midwives) assist the women and their newborns. Describe the traditional TBAs in North and Northeast regions of Brazil, including their perceptions on neonatal asphyxia and resuscitation and their practices regarding home birth. An observational cross-sectional study which interviewed TBAs before a neonatal resuscitation training conducted during the year 2012. We included 155 non-indigenous midwives from Amazonas, Amapá, Sergipe, Pernambuco and Paraíba. Independent variables: age, education and prior experience. Endpoint: answers given during the interview. For categorical data we calculated absolute and relative frequencies. These midwives are middle-aged women with low education and little experience. The risk of birth asphyxia is detected when the newborn does not cry or shows a weak cry after delivery. These TBAs do not cut the umbilical cord until the delivery of the placenta. Common practices are wiping the baby with dry and warm cloths, aspiring the newborn mouth and nostril with their own mouth and stimulating breathing shaking the baby and blowing air into the newborn’s nose and mouth. When the infant does not cry or does not show any improvement, these women ask for help to send the baby to a hospital. Most midwives accompany the newborn baby to the hospital. Brazilian midwives know little about neonatal resuscitation, their work happen in a precarious way, but they do perform the initial steps of resuscitation. Regular training for midwives might improve their service during home births
In Brazil, most births occur in hospitals, but in rural, riparian and remote areas, home births happen frequently, and traditional birth attendants (TBAs or midwives) assist the women and their newborns. Describe the traditional TBAs in North and Northeast regions of Brazil, including their perceptions on neonatal asphyxia and resuscitation and their practices regarding home birth. An observational cross-sectional study which interviewed TBAs before a neonatal resuscitation training conducted during the year 2012. We included 155 non-indigenous midwives from Amazonas, Amapá, Sergipe, Pernambuco and Paraíba. Independent variables: age, education and prior experience. Endpoint: answers given during the interview. For categorical data we calculated absolute and relative frequencies. These midwives are middle-aged women with low education and little experience. The risk of birth asphyxia is detected when the newborn does not cry or shows a weak cry after delivery. These TBAs do not cut the umbilical cord until the delivery of the placenta. Common practices are wiping the baby with dry and warm cloths, aspiring the newborn mouth and nostril with their own mouth and stimulating breathing shaking the baby and blowing air into the newborn’s nose and mouth. When the infant does not cry or does not show any improvement, these women ask for help to send the baby to a hospital. Most midwives accompany the newborn baby to the hospital. Brazilian midwives know little about neonatal resuscitation, their work happen in a precarious way, but they do perform the initial steps of resuscitation. Regular training for midwives might improve their service during home births
Descrição
Palavras-chave
Parteiras - Entrevistas, Emergencias neonatais, Formação profissional, Educação permanente, Parto em casa, Neonatal emergencies
Como citar
PINHEIRO, Rossiclei de Souza. Ensino da reanimação neonatal para parteiras tradicionais - do aprendizado à prática nas Regiões Norte e Nordeste do Brasil. 2013. 67 f. Tese (doutorado) - Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2013.