Silva, Gabriella Barros. Mendonça, Tamires. The role of the obstetric nurse in humanized normal childbirth. Revista científica multidisciplinar núcleo do conhecimento. Year. 06, ed. 09, vol. 01, pp. 05-25. September 2021. ISSN: 2448-0959, Access link: https://www.nucleodoconhecimento.com.br/health/humanized-normal-childbirth
This study aims to describe the importance of the obstetric nurse during childbirth, establishing strategies that facilitate the implementation of a more humanized care and, consequently, free from complications considered irrelevant, which provides greater independence for women related to childbirth. The issue of this research sought to answer: how the obstetrician nurse contributes to humanized natural childbirth? This study aims to understand the role of the obstetric nurse in humanized childbirth. This is a literature review research of a qualitative nature and elaborated through bibliographical investigation, consisting mainly of scientific articles, monographs, magazines, Laws and Ordinances found on the website of the Public Ministry and COFEN. Therefore, it is concluded with this study, that the obstetric nurse is one of the professionals with knowledge who can recover childbirth as something physiological, where the woman returns to be the subject, the protagonist in the period of the birth of her child. In this way, it helps to strengthen a more humanized childbirth.
Keywords: Humanization, Normal Childbirth, Obstetric Nursing.
To humanize is to think of others with compassion and respect, it is to be human. Therefore, it is understood that humanization in childbirth is to provide full care to women and their child, taking into account their wills and choices, seeking to make the patient feel safe, comfortable, welcomed by health professionals at the time of delivery, a moment expected and full of emotions in a woman’s life (FIALHO, 2008).
Obstetric nursing plays a very important role during birth, building human and quality care, generating significant changes in childbirth care. Humanized care is based on the attention directed to pregnant women and their families, respecting the woman as the main character of the event, offering the right to choose the best way to give birth, ensuring a welcoming place and enabling the presence of a companion (VIEIRA et al., 2016).
This work seeks to justify the performance of the obstetricnurse in humanized childbirth and show how this professional can directly impact society, looking for a way to try to end the irrelevant interferences in childbirth, which can cause risks to both the mother and the baby. It is to understand that the nurse is the one who identifies the problems or difficulties in a labor and makes the decisions if complications occur until the arrival of the doctor. Moreover, it is to prove how safe and important the choice of a humanized birth is to show that, what is stuck in this type of delivery is the mother-baby bond.
Childbirth provides the woman and her family with a moment of great joy, anxiety, apprehension and fear, having the need to have a professional side prepared to offer physical and emotional support, clarifying their doubts and reassuring them. Therefore, the study sought to answer how the obstetric nurse contributes to humanized natural childbirth?
This study has as general objective to understand the role of obstetrician nurses in humanized natural childbirth. Its specific objectives are: to describe the need for humanization in the care of normal delivery; to present the benefits that humanized care brings to women during childbirth and discuss the performance of the obstetricnurse.
This is a qualitative literature review research. This study was elaborated through bibliographic research, because it was developed based on material already formulated, consisting mainly of scientific articles, monographs, journals, and also documentary, because it includes Laws and Ordinances found on the website of the Public Prosecutor’s Office and COFEN. The research was surveyed in the database of the Virtual Health Library (VHL) and Google Scholar, in the Databases Medical Literature Analysis and Retrieval System Online (MEDLINE), such as The Latin American and Caribbean Center for Information on Health Science (LILACS), Nursing Database (BDENF) and Scientific Electronic Library Online (SciELO). The following descriptors were used to search: humanization, normal delivery and obstetric nursing. In the filtering of the key words, a result was found from a total of 77 articles. Documents with full text available are chosen as inclusion criteria; articles in Portuguese, which is available in full; and documents with a time frame of eleven years (2007 to 2017). After the use of the inclusion criteria, 47 articles were found, where the analytical reading was performed, selecting 15 articles in the VHL, which were in accordance with the subject to be treated. This study also contains 19 articles from Google academic and the remaining 7 are Ordinances, Laws and Decrees found on the website of the Ministry of Health, resulting in a quantitative of 41 articles. The exclusion criteria used were documents in a foreign language; duplicate articles in the database; and documents whose interest was not objective for this study.
2. HUMANIZATION IN NORMAL CHILDBIRTH
According to Gonçalves (2008), humanization must be understood, at least, by two essential points. The first refers, that it is the duty of hospitals and places of health care to perform an adequate reception, with respect and integrity, the pregnant woman, their families and the newborn. Health professionals should be the ethics, companionship, care, monitoring of women and institutions should create an environment where they can feel safe and welcomed, breaking the isolation imposed by society. Regarding the second aspect, it concerns the admission of actions and methods that bring improvements for the follow-up of childbirth and postpartum, preventing irrelevant interventions from occurring, which, although usually practiced, do not bring benefits to the mother and the baby, and that can cause life risks.
Pregnancy brings the woman physical modifications to the formation of the fetus providing this mother and family members with moments of emotion, joy, anxiety and fear, having the need to have exclusive care and explanations, especially the type of appropriate delivery such as quality in obstetric care and complications that may occur for the pregnant woman and the child (FEITOSA et al., 2017).
Thus, in an attempt to improve the quality of care, the Prenatal and Birth Humanization Program (PHPN) was created, as provided for in Ordinance No. 569, in Art. 1/6/2000, which aims to reduce the maternal and child morbidity and mortality rate, provide improvement in access, coverage and quality of prenatal care, childbirth and postpartum care (MATOS et al., 2017).
It is noted that the rescue to natural childbirth was made so that it could bring a better comfort, safety and freedom to the pregnant woman, where she could return to opine on how she would like to be delivered, place, position and even the power of choice of the companion for the time of birth of the newborn, as provided for in Law 11.108/05, which regulates the Companion’s Law under the Unified Health System (SUS) (SOUZA; GUALDA, 2016).
According to Velho, Oliveira e Santos (2010) the World Health Organization (WHO) has developed several studies on normal delivery and propagates that the purpose of this care is to provide the lowest rate of interventions, thus obtaining a healthy mother and child, that is, there has to be an evident cause to intervene in the physiological order.
Humanized normal childbirth is important for the whole society, besides being a safe way, where women and children are the key point for this process. In this type of childbirth what is stuck, according to Vieira et al. (2016), is the mother-baby bond, as soon as the birth happens the child is delivered to his mother and only after not having more beats or breathing that the umbilical cord is cut and during this time nurses have the role of encouraging this woman to breastfeed her child, thus increasing the maternal bond. It should also be understood that it can also contribute to the reduction of mortality in the country that is often due by cesarean section.
2.1 REDE CEGONHA (STORK NETWORK)
Brazil has been dedicated to the development of public policies, which are aimed at humanization and quality to obstetric and neonatal care. However, the decrease in maternal and infant morbidity and mortality remains a challenge, since they still have errors related to coverage, due to the insistence on the routine pattern, in which women are subject to hospital conduct, removing from their autonomy the parturition technique and submitted to procedures without scientific proof that favor its use, often inappropriate and causing harm to maternal and child health (FUJITA; SHIMO, 2014).
For these reasons, seeking to ensure better access, coverage and quality of care to pregnant women and newborns in childbirth and postpartum, the Stork Network was created, under the Unified Health System, as provided for in Ordinance No. 1,459/11, which consists of:
In a care network that aims to guarantee women the right to reproductive planning and humanized care for pregnancy, childbirth and the puerperium, as well as the child’s right to safe birth and healthy growth and development, called Stork Network (BRASIL, 2011, p. 109).
The Network adds the PHPN proposal and, with it, according to Martinelli et al. (2014) aims to promote the elaboration of a new standard of care for women’s and children’s health, from parturition to 24 months; prepare the Maternal and Child Health Care Network to ensure access and reception; and to decrease maternal and child mortality, especially neonatal mortality.
It is a model that ensures the woman and newborn a care of excellence, guaranteed and humanized, thus avoiding the use of unnecessary interventions during labor. The work seeks to promote from the care of the family, going through the moment of proof of pregnancy, prenatal care, childbirth, puerperium, reaching only the two years of life of the child, according to the Ministry of Health (2013).
Brasil (2017) announces that the cesarean rate fell in 2015 and each year has been stabilizing due to the implementation of the Stork Network that seeks a normal humanized delivery, with total assistance to pregnant women and the presence of obstetric nurses during the procedure. But the number of cesarean sections in Brazil, mainly irrelevant, is still large ‘”involving unnecessary risks for both the mother and the child, in addition to additional costs for the health system” (PINHONI, 2014, p.10).
2.2 HOUSING SET AS A FORM OF HUMANIZATION
In 1800, health facilities were considered marginalized places, which offered nothing but shelter for people with mental illness and those with some infection due to the outbreak of a pathology. Most of the time sick patients were treated in their homes, except in case of specific surgeries (ROSA et al., 2016).
In the 20th century, the number of deaths of newborns from infectious diseases and diarrhea was still high. For this reason, according to Rosa et al. (2016), hospitals began to have a more careful look at these issues, thus being inserted and better elaborated incubators, which had as its proposal at the beginning preserve the health of the baby, keeping it in total isolation preventing its contamination. However, during the 1940s, it was noticed the damage that this isolation entailed to mothers who did not feel ready, psychologically and emotionally, and not safe to perform their maternal function outside the hospital.
Therefore, in 1993, the Basic Standards for implementing the Joint Accommodation were approved, which aims to humanize birth and make the child close to their mother after delivery, and thus benefit breastfeeding, reduce the danger of acquiring hospital infection and motivate the incorporation of the multidisciplinary team. According to Brasil (1993), the joint accommodation is defined as a hospital system in which the maternal figure and the healthy newborn remain together 24 hours from birth to the hospital environment.
The joint accommodation will only be adopted if the mother does not have any disease that prevents her from having contact with the baby and if the newborn is well vitality, which would be more than 2 kilos, greater than 35 weeks of gestation and apgar greater than 6 in the 5th minute; ability for suction and thermal control (BRASIL, 1993).
Pilotto; Vargens and Progianti (2009) describe the joint accommodation as an environment that facilitates maternal care, in which the mother begins her caregiver routines, awakening to the needs of the newborn, at the same moment that is cared for by nurses. These professionals, for the most part, obey the laws and rules established by institutions that favor the care of maternal and child physical needs, the professional zeal performed in this space, besides allowing maternal advancement.
According to Pasqual; Bracciali and Volponi (2009), the acts performed in this system benefit from the receipt of motherhood and the exchange of knowledge between the puerperal women, concomitantly in which it provides them with a feeling of safety, comfort, satisfaction causing their anxiety to decrease.
It is important to emphasize that this environment also enables the opportunity for communication between nursing professionals, mother and child and their families. Faria; Magalhães and Zerbetto (2010) highlighted that one of the reasons for the harmful damage to the formation of the bond between mother and child was that they did not prepare health professionals to meet biological, psychological and social needs, in addition to the doubts of parturients. However, in the prophylactic context, the acts most performed by nurses were based on stimulating the pattern of joint accommodation, highlighting the importance of breastfeeding during the first hour of life of the NB, as well as encouraging them to take care of themselves and their children.
According to the Basic Standards, Ordinance MS/GM No. 1016, of August 26, 1993, are the duties of the nursing team, in the joint accommodation:
develop tasks in the context of preparing pregnant women in prenatal care for the System, stimulating early mother-child contact in the delivery room, and helping mothers to start breastfeeding in the first hour after birth and on free demand (BRASIL, 1993, p.5).
Hospitals today have a better situation in relation to the execution of deliveries, since they express a whole professional mechanism and are ready for assistance of any change in the process of giving birth, a fact that has not always been present (ROSA et al., 2016).
Thus, it is understood that the model of Joint Accommodation, according to Véras (2010) is essential for the emotional progress that appears in the context of contact between people, due to ensuring the maternal and child bond during the first days of life, providing a good coexistence between them and the improvement of practices related to motherhood and care. In addition to showing improvements related to the reduction of hospital infections, related to the conviviality and zeal offered by mothers to their children.
3. HUMANIZED CARE WOMEN IN CHILDBIRTH
Assistance to women during childbirth, according to Campos et al. (2016) was made over time by Caboclas, Portuguese and black, called midwives, who performed their services empirically, but without scientific knowledge. These could be mothers, friends, neighbors, or chosen people in the communities, considered more experienced in the role. Midwives, in addition to giving birth, they still cared for diseases that were often affected by women during pregnancy and, even so, they were still responsible for performing witchcraft, promoting abortion and committing the death of babies.
According to Rosa et al. (2016) the thought of that time was valued by maternal-infant contact after the end of delivery, thus, the births that occurred at home allowed the newborn to be warmed and breastfed by the mother after delivery. However, almost no hospital offered beds for pregnant women and nurseries.
According to Menezes; Portella and Bispo (2012) until the seventeenth century was exclusive to women to perform childbirth, at this time maternal and child mortality was very high, because of the risks of diseases and complications that could happen during the procedure, because there was no obstetrics and gynecology as a specialty, and when they had some interference or some risk that the presence of a surgeon or doctor was used, because they are considered rude and ignorant men. However, with technological advances, childbirth ceased to be done by women and began to be performed by medical surgeons.
In the 20th century, with the transformation of childbirth, this event began to be seen by society as a pathological method that would need to be controlled so that maternal and baby death did not occur. Thus, midwives began to be criticized and lost the space to perform the delivery, so according to Menezes, Portella and Bispo (2012) the delivery began to be performed in public hospitals, where doctors performed the procedure surgically.
Therefore, women fail to give an opinion on the way they would like to have their child, no longer being lived privately and intimately, thus leaving the woman to be the protagonist of the procedure performed to become a public process with a male presence. According to Campos et al. (2016) they are forced to withdraw from the comfort of their home and the presence of their families to deliver their birth in a cold and unknown place, where professionals who do not pass security and confidence to that mother would perform the delivery, without at least asking permission and explaining what was being done, performing various painful interventions and procedures, as if the parturient were an object.
According to Diniz (2005 apud SILVA et al., 2016, p. 5), cesarean section has led worldwide since the middle of the 20th century, especially after the implementation of anesthesia. However, there is still an increase in the maternal and child mortality rate, bringing additional costs to the health system, which could be prevented if it had a better living condition for these women related to comprehensive health care and, mainly, care to pregnant women during pregnancy. That is why in several countries there have been movements in favor of the humanization of childbirth.
At the end of the 1990s, two programs were created aimed at assisting pregnant women in prenatal and postpartum prenatal care, such as the National Program for the Humanization of Hospital Care (PNHAH) and the Prenatal and Birth Humanization Program (PHPN), making access to health services broader and with quality care, with the minimum of invasive procedures (DAVIM et al., 2016).
The humanization of pregnant women is a model that is progressively becoming reality. Humanizing is offering care of excellence to women through pain reduction, offering a safe environment, physical and emotional well-being, the autonomy of choosing how to generate their child, offering essential material, personal and emotional support for the pregnant woman, newborn and companion to go through the whole stage in a calm and happy way (FIALHO, 2008).
According to Rios and Vieira (2007) pregnancy is one of the phases in the parturient’s life, in which she presents a series of feelings, it is during pregnancy that, if desired, produces happiness, if unwanted is capable of causing astonishment, unhappiness, and even denial. According to Durães-Pereira et al. (2007), in this gestational cycle, a change in the woman’s character can occur, and due to her exhaustion and apprehension, she needs support from qualified people.
The appropriate care to pregnant women at the moment of delivery, according to Fialho (2008), is an inevitable step to ensure that she can perform the role of mother with confidence and tranquility, this is an essential right of each pregnant woman. Health professionals should be ready to take care of the parturient, her companion and family, respecting all the importance of this stage. This should help in the construction of a more intense link with the pregnant woman, passing safety and well-being.
Humanizing the care of women and their families, in the condition of labor and childbirth, constitutes respecting the period of the pregnant woman in the process of giving birth, preventing irrelevant procedures determined by hospital practices and admitting the cultural factors particular to the woman. Thus, it becomes essential to listen to what pregnant women feel their afflictions and fears of such intensity that childbirth can happen in the most natural way possible, allowing irrelevant routines that can constantly result in contrary results for the rest of a child’s life, to be reconsidered in adaptation to women’s hopes, which aim, in this delicate period, at a sphere soured by care (FRELLO; CARRARO, 2010).
3.1 THE IMPORTANCE OF A COMPANION FOR WOMEN IN CHILDBIRTH
The experience of birth is pointed out as a special experience in the life of women and men. For this reason, it is essential to consider the period of childbirth as a profound event for parents. Both manage to experience various feelings with the coming of a new family member, which makes it necessary for health professionals to be ready to support and assure the couple a pleasant, quiet moment, collaborating so that this is a favorable moment for both (PERDOMINI; BONILHA, 2011).
In this sense, it is essential that health organizations must ensure the implementation of Law No. 11,108, of April 7, 2005, amends Law No. 8,080 of September 19, 1990, to guarantee “parturients the right to the presence of a companion during labor, childbirth and immediate postpartum, within the framework of the Unified Health System”. In this way, the pregnant woman will be able to choose to have a companion with whom she has the link to be on her side during childbirth (BRASIL, 2005).
According to Costa (2015) the participation of a companion with the option of the pregnant woman at the time of birth and/or her family relationship, in which she will offer support and will be her companion, is of essence importance in the process of giving birth, this individual will spend comfort, making the parturient feel safe and welcomed.
The Ministry of Health admits that the companion offers an advantage and that women who have a person during childbirth and in the immediate postpartum remain confident and comfortable at the time of the process, providing a reduction in the duration of delivery and the rate of cesarean sections. The companion also contributes to the reduction of the risk of depression in the puerperium, besides assisting the woman in basic functions with the newborn after birth, at the time when the mother is in the recovery period (OLIVEIRA et al., 2011).
According to Longo; Andraus and Barbosa (2010) the companion in humanized childbirth is the individual who provides support to the pregnant woman during the birthing process and according to the advisory context, this can be exercised by the health team, partner, family or friend of the woman. However, the conception of companion exposed by the National Humanization Policy, called humanizes SUS, highlights the person who will accompany the parturient as representative of the woman’s social network remaining with her while in the hospital environment.
The presence of the partner in several institutional projects and in the follow-up of the parturient in the whole reproduction procedure, including childbirth, benefits the rupture of stereotypes that intensify the attribution of women as exclusive leaders for the reproductive role. Throughout the follow-up of the birth, the partner can obtain explanations of how to become more qualified to acquire the specific duties of paternity (HOGA; PINTO, 2007).
The selected companion carries with her varied concepts regarding her presence and is able to reflect positively on the conduct of the pregnant woman at the time of delivery. Thus, the companion is a piece of the woman’s imaginary when she thinks at the time of delivery. The pregnant woman places on him the self-confidence of having someone close and reliable, as are the health professionals who delegate the role of support of the handling of childbirth. Thus, the companion cannot be the exclusive provider of care, as well as health professionals do not offer the caution that the companion offers, especially with the relationship with the strengthening of the affective bond (LONGO; ANDRAUS; BARBOSA, 2010).
The acceptance of the pregnant woman’s option in relation to her companion is considered as a considered beneficial action and should be encouraged, according to Oliveira et al. (2011). Making possible this right of women decreases the need for sedation, the event of cesarean sections and the depression of the baby in the fifth minute of life. Moreover, this experience of support is an essential component in childbirth, because it brings to the pregnant woman the feeling of safety, comfort and satisfaction.
As exposed by Hoga and Pinto (2007), the hospital organization should provide physical place and train the health team for the benefit of better living with the patient’s family. It is an action that intensifies the link of health professionals with companions and makes it possible to expose to new professionals the advantages generated by this relationship.
4. PERFORMANCE OF THE OBSTETRICIAN NURSE
The normal humanized delivery values the comfort of the parturient and the baby, seeking to be less aggressive, in which the care of the pregnant woman is defined by the continuous follow-up. Humanization and the characteristic of the assistance provided are essential for the recognition of adversities and service of expectations (MATTOS; VANDENBERGHE; MARTINS, 2014).
According to Vieira et al. (2016) the obstetricnurse has a very important role during the care of the woman, because he should explain and stimulate the premature contact between mother and newborn, providing the maternal bond, besides being an act that encourages breastfeeding. Nurses should understand how important the use of the systematic method is and have practices in the use and completion of the partogram, because it is fundamental for professionals who want to have an efficient, humanized, confident and assertive performance to parturition.
According to Decree No. 94,406 of June 8, 1987, which regulates Law No. 7,498 of June 25, 1986, which provides for the Law of Professional Nursing Practice, nurses have as their attribution in childbirth:
Provide nursing care to pregnant women, parturients, puerperal women and newborns […]
Monitoring of evolution and labor […]
Execution and obstetric assistance in emergency situations and delivery without dystocia […]
Art. 9th to professionals holding diplomas or certificates of Obstetrician or Obstetric Nurse incubate the provision of assistance to parturient and normal delivery; identification of obstetric dystocia and action until the arrival of the doctor and the performance of episiotomy and episiorrhaphy, with application of local anesthesia, when necessary (BRASIL, 1987, p. 8853).
According to the proposals of humanization in childbirth, Giantaglia et al. (2017) informs that it was essential to expand the visibility of the nurse’s work, so that transformations would happen to the insertion and conclusion of these proposals, considering that there should be investments in the field of training and performance of these professionals. Therefore, it is also analyzed that, in the process of reaching this model, it will be essential that nurses have an effort to add educational and humanized procedures to women during pregnancy to the nursing member.
According to Melo et al. (2013) health professionals need to attribute the attitude of educators who share understanding and knowledge seeking to return to women their freedom and security to appreciate pregnancy, childbirth and puerperium, taking into account prenatal care and birth as a single and special period. This moment is paramount for women’s health, as it enables the knowledge of its physiological aspect, which contributes to their comfort in labor.
The nurse admits the importance of providing appropriate care and peculiarity, so she constantly seeks the reception of women, promoting trust, identifying factors that cause exhaustion, such as pain, establishing a scope of zeal and well-being for both pregnant women and her family. Thus, nursing has been gradually making a specific history, presenting its competencies, talent and influence, combined with safety and practice in the birth ing process, always protecting the physical, emotional circumstances and principles of women (ALMEIDA; GAMMA; BAHIANA, 2015).
Focusing on humanization during labor and postpartum, the Ministry of Health established the MS/GM Ordinance 2,815, of May 28, 1998, which includes the “delivery method” in the SUS Hospital Information System table. normal without dystocia performed by an obstetric nurse” (COFEN, 2016, p. 1), which aims to identify the assistance provided by this professional. Thus, according to Giantaglia et al. (2017) the service of these professionals has been stimulated by the health systems, even the Ministry of Health has stimulated, technically and financed, with the production of qualification courses in Nursing due to the new care method of care for women in childbirth. Thus, the obstetric nurse is gaining better spaces in care and recognition, especially for humanizing in a qualified way.
Fialho (2008) proposes the relevance of respect for the parturient and her family members, seeking to call by name, authorize her to recognize each professional, communicate it about different actions that will be exposed, offer a clean, receptive, pleasant and calm environment, respond to some indecisions, calm her anxieties. These are moderately simple behaviors that require a little more dedication from the health team. There is not a single “perfect” sensu latu aid, but different ways to lead the pregnant woman during the dilation phase, depending on the state of the place and the health professionals who will perform this follow-up.
Thus, the nursing professional usually seeks to provide care according to the characteristics of each pregnant woman, constantly commending with the importance of humanization in parturition, performing a planning, stimulating and enabling the highlight of the physiology of childbirth, where the woman has management, since it is something that belongs to the female universe (SOUZA; SANTO, 2011).
Nurses should be able to respect the clients and their families, understand the extremes of the physiology of the body during the normal procedure of delivery and be able to face the risks, have scientific understanding to recognize the probable problems and have the vulnerability to act at the correct moment of interference cases (MATTOS; VANDENBERGHE; MARTINS, 2014).
According to Martins and Remoaldo (2014), it is the nurse’s responsibility to independently interfere in the realization of health promotion. Therefore, the nurse graduated in the area of maternal and obstetric health plays an essential role as part of a multidisciplinary team, since she declares herself as the most skilled health professional to perform educational activities, willing to benefit pregnant women and their families to witness childbirth in a healthy and natural way. Therefore, we must not forget that nursing is a profession that cares for and determines patient assistance relationships, always focused on the search for adequate care and the elaboration of attributions.
According to Almeida e Silva (2008) nursing care must not only meet health needs, but also that their attitudes can communicate and direct, based on peculiar needs, with looks for beneficial reception. Even if it collaborates to create a gender thinking, aiming at the participation of women in the battle for the evolution of quality in health and as opposed to gender segregation, normal in health organizations that serve women.
In this context, Oliveira, Rodrigues and Guedes (2011) emphasizes the nurse as an essential professional to assist the parturient, because it welcomes the pregnant woman when arriving in the delivery room; shares with her anxieties about the fear of childbirth propagated in society throughout history; promotes reception and well-being during childbirth, encouraging to appropriate this moment as the main person of the procedure. The nurse has, therefore, a position to help the woman in this passage, because she is able to use transforming techniques of the place in which she operates, converting everything that was understood into humanistic models and considering the parturient’s rights to a safe maternity.
5. FINAL CONSIDERATIONS
With the institutionalization of childbirth, there were changes in the care of the parturient. The woman loses the role of subject at birth, thus the need to rescue the normal humanized delivery, in which the parturient needs to be accompanied by qualified professionals, in order to minimize the complications during childbirth.
The obstetrician nurse contributes to the humanized natural delivery, having an important function in childbirth, because he accompanies the pregnant woman in the period of childbirth; guides parturients with regard to the methods to be performed and provides care that produces affectionate bond of the whole family, respecting both physical and sentimental needs. The insertion of this professional in obstetric care determines one of the techniques that simplify the elaboration of a more humanized care and, therefore, free of complications pointed out as irrelevant, thus producing a greater independence of women related to childbirth.
Therefore, it is understood with this study that the obstetrician nurse is one of the professionals with knowledge that manages to recover the delivery as something physiological, where the woman returns to be the subject, the protagonist in the period of the birth of her child. Thus, it contributes to the strengthening of a more humanized birth, producing care options and strategies generating the right to choose the way it wishes to perform its delivery.
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 Graduation in nursing.
 Guidance counselor.
Submitted: May, 2021.
Approved: September, 2021.