Analysis of assistance procedures to normal birth in primiparous

Abstract

Introduction: Current medical technologies in care in birth increased maternal and fetal benefits persist, despite numerous unnecessary procedures. The purpose of the normal childbirth care is to have healthy women and newborns, using a minimum of safe interventions. Objective: To analyze the assistance to normal delivery in secondary care maternity. Methodology: A total of 100 primiparous mothers who had vaginal delivery were included, in which care practices used were categorized: 1) according to the WHO classification for assistance to normal childbirth: effective, harmful, used with caution and used inappropriately; 2) associating calculations with the Bologna Index parameters: presence of a birth partner, partograph, no stimulation of labor, delivery in non-supine position, and mother-newborn skin-to-skin contact. Results: Birth partners (85%), correctly filled partographs (62%), mother-newborn skin-to-skin contact (36%), use of oxytocin (87%), use of parenteral nutrition during labor (86%) and at delivery (74%), episiotomy (94%) and uterine fundal pressure in the expulsion stage (58%). The overall average value of the Bologna Index of the mothers analyzed was 1.95. Conclusions: Some effective procedures recommended by WHO (presence of a birth partner), some effective and mandatory practices were not complied with (partograph completely filled), potentially harmful or ineffective procedures were used (oxytocin in labor/post-partum), as well as inadequate procedures (uterine fundal pressure during the expulsion stage, use of forceps and episiotomy). The maternity’s care model did not offer excellence procedures in natural birth to their mothers in primiparity, (BI=1.95).