Search

Aim To identify a set of scientific, systematic and clinically applicable nursing‐sensitive quality indicators for pernicious placenta previa (PPP). Design A modified Delphi‐Consensus Technique. Methods According to literature retrieval published between 2009–2019, 38 nursing‐sensitive quality indicators were chosen and a questionnaire was designed. An online survey was conducted in 20 hospitals in China, and data of experts’ opinions were collected and analysed by improved Delphi method. Results 38 nursing‐sensitive quality indicators were identified. The response rates in the two rounds of expert consultation were 97.4% and 100%, and the authoritative coefficients were 0.89 and 0.92. The coefficients of variation ranged from 0.04–0.28. The nursing‐sensitive quality indicators were successfully constructed based on the modified Delphi technique.

Background. Puerperal sepsis is infection of the genital tract occurring at any time between the onset of rupture of membranes or labor and the 42 day postpartum. It's one of the fifth common causes of maternal mortality worldwide. The aim of this study is To assess Knowledge and practices of postnatal mothers regarding prevention of puerperal sepsis . Research Design: A descriptive cross sectional research design. Subject: Purposive samples composed of (87) postnatal mothers from Minia University Hospital for obstetric and pediatric at postnatal department. Tools of data collection: include - A structured interview questionnaire, knowledge assessment tool and practical assessment tool. Results: the study revealed that (87.4%) of the studied women had unsatisfactory knowledge level regarding puerperal sepsis and (74.7%) of the studied sample had poor practice about prevention of puerperal sepsis. There is positive association between total knowledge score and total practices level (p. value < .ooo1) Conclusion: The study concluded that majority of postnatal mothers had poor level of knowledge regarding puerperal sepsis , and around three quarters of them had poor practice about prevention of puerperal sepsis. A positive fair association was found between knowledge and practice scores regarding prevention of puerperal sepsis. Recommendation: - The obstetric nurse could play and implement their role as health educator, counselor, coordinator, and supervisor and help post natal mothers to improve their knowledge and practices regarding puerperal sepsis and its prevention.

Objetivo: Compreender as desordens vivenciadas pelo enfermeiro em sua prática do cuidado no parto, à luz da Complexidade. Método: Estudo qualitativo com delineamento da Teoria Fundamentada nos Dados como referencial metodológico e a Teoria da Complexidade como suporte teórico. Foram entrevistados 31 participantes de maternidades do Rio Grande do Norte, Brasil organizados em três grupos amostrais de enfermeiros, gestores de saúde e médicos. Resultados: Os enfermeiros obstetras vivenciam desordens em relação à sua autonomia, ao poder do médico e a violência obstétrica no processo de parto, à falta de apoio da gestão de saúde e gestão das maternidades, à falta de organização da rede e, como consequência, vivenciam sentimentos negativos na atuação. Conclusão: Essas deverão ser superadas como possibilidade de mudança no modelo de atenção do enfermeiro obstetra.

Objective To review obstetric personnel absences at a hospital during the initial peak of coronavirus disease 2019 (COVID-19) infection risk in New York City from March 25 to April 21, 2020. Study Design This retrospective study evaluated absences at Morgan Stanley Children's Hospital. Clinical absences for (1) Columbia University ultrasonographers, (2) inpatient nurses, (3) labor and delivery operating room (OR) technicians, (4) inpatient obstetric nurse assistants, and (5) attending physicians providing inpatient obstetric services were analyzed. Causes of absences were analyzed and classified as illness, vacation and holidays, leave, and other causes. Categorical variables were compared with the chi-square test or Fisher's exact test. Results For nurses, absences accounted for 1,052 nursing workdays in 2020 (17.2% of all workdays) compared with 670 (11.1%) workdays in 2019 (p Conclusion COVID-19 outbreak surge planning represents a major operational issue for medical specialties such as critical care due to increased clinical volume. Findings from this analysis suggest it is prudent to devise backup staffing plans. Key Points

Objetivo: Analisar o quanto a implementação do projeto Apice On contribuiu para a redução de casos de violência obstétrica vivenciadas por puérperas atendidas em um Hospital Universitário no interior de Minas Gerais. Método: Estudo exploratório, descritivo, transversal e de caráter qualitativo, desenvolvido com 46 puérperas atendidas em um Hospital Universitário. Os dados foram coletados por meio de um instrumento semiestruturado, os quais foram analisados posteriormente utilizando a técnica de Bardin e o uso do software Iramuteq. Resultados: As puérperas entrevistadas são empoderadas frente aos seus direitos, reconhecem as possí­veis faces da violência obstétrica, e possuem preferência pelo parto normal humanizado, tendo conhecimento sobre a abordagem correta do atendimento profissional. Conclusão: Conclui-se que a implementação do projeto Apice On e da enfermeira obstétrica contribuiu para a redução de casos de violência obstétrica e cumpriu com seus objetivos frente a humanização dos partos normais realizados no Hospital Universitário do interior de Minas Gerais.

Introdução: Uma das fases da vida na qual o ser humano está mais sujeito a sofrer com o processo de morbimortalidade é na infância, isso é ocasionada por diversos fatores, tem-se, portanto foco nesse público quando se trata do estudo de mortalidade e morbidade infantil. Objetivo: analisar a morbidade hospitalar e mortalidade infantil por causas perinatais em menores de um ano no nordeste brasileiro no período de 2013 a 2017. Metodologia: Caracteriza-se como estudo do tipo ecológico, realizado a partir de dados secundários extraídos do Departamento de Informática do Sistema Único de Saúde (DATASUS) oriundos do Sistema de Informação de Mortalidade (SIM) e o Sistema de Informação Hospitalar do SUS (SIH/SUS), no período de 2013 a 2017. Resultados: Revelaram que as causas perinatais são grandes contribuintes para a mortalidade. Dos fatores que mais matam estão à septicemia bacteriana (30,7%) e afecções maternas (42,3%). O ano de 2013 e o estado da Bahia revelaram um maior número de óbitos. Quanto à morbidade pode-se observar os agravos afecções do período perinatal (33,8%) e transtornos respiratórios do período perinatal (49,7%) sendo aqueles com maior número de casos, além do ano de 2017 e o estado da Bahia como sendo os que apresentaram maior número de internações. Conclusões: As causas perinatais são um dos principais fatores responsáveis por gerar vítimas, tornando-se necessária a tomada de medidas. Deve-se melhorar a transmissão de conhecimentos a fim de prevenir as doenças e fortalecer a promoção à saúde e reduzir as taxas de morbimortalidade. Palavras-Chave: Mortalidade infantil; Mortalidade neonatal; Enfermagem perinatal; Cuidado perinatal; Morbidade; Mortalidade perinatal.

Objetivo: Investigar as dificuldades vivenciadas pelos enfermeiros obstetras na promoção do parto domiciliar, no sentido de confrontar com os dados apresentados pela literatura. Métodos: Estudo descritivo, de abordagem qualitativa, realizado entre os meses de agosto e outubro de 2019, com sete enfermeiros obstetras de dois municí­pios de Minas Gerais. A coleta de dados ocorreu por meio de entrevistas individuais guiadas por um roteiro semiestruturado, seguida de análise de conteúdo temático categorial. Resultados: A partir da leitura e interpretação do conteúdo, foi possí­vel estabelecer as seguintes categorias: 1) Domiciliar ou Hospitalar? Os motivos da escolha pela lente dos enfermeiros obstetras; 2) Forças constituintes do trabalho das enfermeiras obstetras na promoção do parto domiciliar. Conclusão: Enfermeiros obstetras enfrentam desafios na promoção do parto domiciliar, sendo muitos desses, relacionados ao conhecimento do paradigma curativista comum disseminado tanto pela população, quanto pelos próprios profissionais da equipe, que consideram o parto domiciliar uma prática inadequada.

One of the most complex clinical problems in obstetrics and neonatology is caring for pregnant women at the threshold of viability. Births near viability boundaries are grave events that carry a high prevalence of neonatal death or an increased potential for severe lifelong complications and disabilities among those who survive. Compared with several decades ago, premature infants receiving neonatal care by today's standards have better outcomes than those born in other eras. However, preterm labor at periviability represents a more complex counseling and management challenge. Although preterm birth incidence between 20/7 and 25/7 weeks has remained unchanged, survival rates at earlier gestational ages have increased as perinatal and neonatal specialties have become more adept at caring for this at-risk population. Women face difficult choices about obstetric and neonatal interventions in light of uncertainties around survival and outcomes. This article reviews current neonatal statistics in reference to short- and long-term outcomes, key concepts in obstetric clinical management of an anticipated periviable birth, and counseling guidance to ensure shared-decision making.

Esta pesquisa teve como principal objetivo descrever a importância do processo de educacao em saude desenvolvido pelo enfermeiro obstetra no periodo gestacional. Trata-se de um estudo bibliografico narrativo com o intuito de expressar e registrar a importância desse processo para uma assistencia mais humanizada, tornando as mulheres conscientes e aptas a serem protagonistas do proprio cuidado sem deixar de recorrer ao profissional de saude quando necessario. Logo, esse profissional pode ter um contato mais proximo com a cliente durante o ciclo gravidico-puerperal, desenvolvendo atividades de educacao em saude, de modo que o parto e o pos-parto sejam eventos livres de incertezas e questionamentos e bem enfrentados diante de possiveis intercorrencias. Fica explicita a necessidade de investir na formacao do enfermeiro, habilitando-o a desenvolver seu papel de educador com responsabilidade e efetividade, tanto no pre-natal quanto durante o parto e no pos-parto, atendendo as mulheres que, em sua maioria, desconhecem a fisiologia da gravidez e o processo de parto, prevenindo a violencia obstetrica e lidando com puerperio, aleitamento e cuidados com o recem-nascido. Espera-se, assim, que este estudo contribua para o desenvolvimento da enfermagem como protagonista da educacao em saude e ciencia do cuidar, enfatizando o papel do enfermeiro obstetra em diferentes âmbitos da saude materna e neonatal. Ha, ainda, a possibilidade de ressaltar a autonomia da enfermagem em sua atuacao dentro da equipe multidisciplinar, proporcionando a construcao do saber por meio de oportunidades criadas para que a populacao em questao se torne competente a discutir sobre intervencoes nos contextos do pre-natal e do parto. Consequentemente, o vinculo criado com a comunidade torna-se um importante meio de promover saude.

Trata-se de uma pesquisa qualitativa que se fundamentou na Fenomenologia, na modalidade da análise da estrutura do fenômeno situado. O objetivo foi compreender o significado de experiências frente ao óbito fetal para os enfermeiros obstetras de um hospital universitário. Os dados foram coletados por meio da questão norteadora: “Como é para você vivenciar o óbito fetal?”. Para a análise dos discursos, foram realizadas a análise ideográfica e nomotética. Os resultados evidenciaram o despreparo profissional, gerando angústias e inseguranças, nos levando a acreditar que é preciso uma formação específica sobre luto e morrer para os profissionais de saúde. O suporte à mãe e família, também emergiu e verificou-se a necessidade de uma readequação das instituições de saúde quanto ao espaço físico para receber os pais que vivenciam o luto fetal, proporcionando privacidade e assistência humanizada. A presença do enfermeiro obstetra emerge como de suma importância neste cenário.

Objective: To summarize the nursing experience of induced labor of upper gastrointestinal bleeding in pregnancy complicated with decompensated cirrhosis. Methods: To treat two pregnant women with upper gastrointestinal bleeding complicated with decompensated cirrhosis with early labor induction, strengthen the nursing of upper gastrointestinal bleeding before operation, monitor changes of the patient’s condition closely after operation, and strengthen the prevention and treatment of postpartum complications and health guidance. Results: No serious complications occurred in the 2 patients after operation. They were hospitalized for 11 and 17 days after operation and were discharged stably. Conclusion: The pregnant women with upper gastrointestinal bleeding complicated with decompensated cirrhosis should terminate pregnancy in time and strengthen perinatal nursing, which can improve the liver function and blood coagulation and improve the prognosis of the patients.

A cesarean hysterectomy (CH) is an emergency procedure that can save a woman's life in the event of postpartum hemorrhaging. If the CH is anticipated, it can take place in the general OR; however, more complex patients with multiple comorbidities are undergoing cesarean deliveries, resulting in unanticipated CHs and emergent procedures occurring in the obstetric OR. Many perinatal nurses believe they are not properly trained to provide the level of perioperative care required during a CH. Perinatal nurse leaders implemented a perinatal perioperative simulation program to address this knowledge gap. Feedback from perinatal nurses after completing the simulation revealed they gained a comprehensive understanding of the flow of the procedure and the instrumentation needed to perform it. The simulation also improved communication and leadership skills in the obstetric OR. Simulations may help perinatal nurses provide safer, higher quality care when a delivery develops into a high-risk operative procedure.

OBJETIVO: Descrever a responsabilidade legal da enfermeira obstétrica na assistência ao parto. MÉTODO: Foi realizado uma revisão integrativa de literatura, utilizando publicações disponíveis nas bases dados LILACS e MEDLINE, através da Biblioteca Virtual de Saúde, com publicação nos últimos 10 anos. RESULTADOS: A partir da leitura exaustiva dos artigos, foram delimitadas duas categorias de análise, denominadas: A legislação da enfermagem obstétrica brasileira e Responsabilidade profissional, sob o ponto de vista ético, penal e civil. CONCLUSÃO: A enfermeira obstetra precisa conhecer a legislação que rege o seu trabalho, proporcionando uma melhor assistência e delimitando seus direitos e deveres na sua jornada.

Aims and objective To examine whether nurses' assessment of their relationships and communication with lesbian women seeking perinatal care is associated with their personal and professional characteristics and knowledge of homosexuality. Background Recently, there has been a growing incidence of same-sex parenthood. Nurses administer health care to lesbian women from pregnancy planning through birth, providing consultation. Although there has been a shift in attitudes towards homosexuality, discrimination is still quite common. Design This research is part of a larger cross-sectional study carried out at women's healthcare centres, concerning nurses' perceived quality of perinatal care provided to lesbian women. Methods The study was conducted from December 2015-April 2016 at women's health centres in Israel encompassing 184 registered nurses who completed self-report questionnaires. They were assessed as to their knowledge of homosexuality and nurse-patient relationships and communication. The Squire checklist was used. Results Most (73.4%) had prior acquaintance with lesbian women; only 17.9% had been educated as to lesbian women's unique health needs; of these, 66.7% thought that they had been given professional tools for working with lesbian women; 60.4% were unaware of the importance of knowing the patient's sexual orientation. The average score on a homosexuality knowledge questionnaire was 10.4 on a scale of 0-17, indicating moderate levels of factual knowledge about homosexuality. A significant positive correlation was found between nurses' knowledge of homosexuality and assessment of their relationships and communication with lesbian women seeking perinatal care. In addition, nurses' personal and professional characteristics, such as place of birth, religiosity and familiarity with lesbian women, were related to their assessment of their relationships and communication. Conclusion Nurses' knowledge of homosexuality and personal and professional characteristics were associated with their perceptions regarding relationships and communication with lesbian women seeking perinatal care. Relevance to clinical practice Further training might broaden, refine rigid perceptions and contribute to advancing equal perinatal nursing care of lesbian women.

Orientador: Antonieta Keiko Kakuda Shimo Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas Resumo: Objetivo: Avaliar o nível de ruído em sala de parto durante o processo de nascimento em duas maternidades públicas do interior do Estado de São Paulo, sendo uma com atividades de ensino (H1), segundo o tipo de parto. Metodologia:Trata-se de um estudo exploratório, descritivo e observacional. Utilizou-se o decibelímetro para registrar os níveis de pressão sonora em decibéis (dB) que permaneceu ligado durante o momento do parto e também um formulário do tipo checklist para anotação de variáveis (tempo de duração, número de pessoas em sala, valor máximo, médio e mínimo do ruído). A coleta de dados segue as normas da NBR 10-151 e foi realizada de agosto de 2010 a janeiro de 2011. O tamanho amostral foi constituído de 34 partos para o H1 e 45 para o H2. Utilizou-se o teste de Kolmogorv-Smiinov para avaliar a aderência das variáveis à distribuição normal. Os níveis de ruídos foram comparados segundo o hospital, utilizando-se o teste de Mann-Whiteney, e o tipo de parto, empregando-se o teste de Kruskal-Wallis. Resultados: O nível de ruído médio global foi de 64dB; sendo 61,2dB para o H1 e 65,3dB para o H2. O parto vaginal sem analgesia obteve ruído médio de 66,9dB, seguindo-se de 63dB para o parto vaginal com analgesia e 61,8dB para a cesárea. O número de pessoas em sala foi superior no hospital de ensino (p=0,0008) e para o parto cesáreo (p=

Objective To assess if nurses’ perioperative knowledge of and confidence in perioperative skills for emergency cesarean birth improved after didactic learning and high-fidelity simulation. Design Descriptive, one-group pretest and posttest design. Setting/Local Problem Level 3 labor and birth unit that averages 3,000 births per year. At the site, there were no current evidence-based programs specifically focused on perioperative skills sustainment of the maternity nursing professional. Participants Registered nurses on a labor and birth unit with at least 1 year of experience completed an online educational course and simulation activity. Interventions/Measurements Participants were given pretests and posttests to assess knowledge and confidence in emergency cesarean birth perioperative skills. Observations of nurses’ pretest and posttest interventions in cesarean births were made to assess changes in competency. Chart reviews were completed to assess changes in decision-to-incision time before and after the intervention. Results Nurses reported greater confidence and knowledge during emergency cesarean birth after participating in the interventions. Other results included decreased decision-to-incision times. None of these results held statistical significance. Conclusion This project highlights the need for evidence-based, standardized perioperative maternity education across labor and birth nursing practice.

Fetal compressive intrapericardial teratoma is a rare and life-threatening condition, qualifying as a high-acuity low-occurrence (HALO) event. To prepare for delivery and immediate neonatal management, specialists from pediatric cardiology, cardiac surgery, maternal-fetal-medicine, neonatology, cardiac anesthesia, critical care, clinical perfusion, obstetrical nursing, and operating room nursing convened. An in situ operating room simulation was used to identify and introduce key team members, derive and practice the anticipated clinical management algorithm, position human and equipment resources strategically, and ensure that each specialist team was familiar with the environment and available equipment. As rehearsed in the simulation, the cesarean delivery of the patient and neonatal cardiac surgery was uncomplicated and yielded a favourable clinical outcome. A patient-specific HALO simulation preparation (PSHSP) can facilitate positive clinical outcomes and improve health care team confidence in HALO scenarios such as the birth of newborns anticipated to have cardiorespiratory instabilty.

Objective To examine birth narratives of primiparous women who experienced unplanned cesarean births to improve nursing care. Design Descriptive, qualitative. Setting The family/newborn units of a large teaching hospital in the Northeast United States. Participants Fourteen women who experienced unplanned cesarean births of singleton infants at term. Methods We used semistructured interviews to analyze the participants’ birth narratives. Within 48 hours of birth, participants answered the prompt: “Tell us your birth story.” Four perinatal nurse experts in consultation with a qualitative research expert ordered, analyzed, and coded data into themes and subthemes. Results We identified the following four themes: Changing Reality: Transition to Labor, Expectations Meeting Reality: Navigating the Unknown, Transition to Motherhood: The Cesarean Birth Experience, and Accepting the New Reality. Conclusion Childbearing women need time immediately after birth to process their experiences. Our findings highlight avenues for changes in clinical care to optimize women’s experiences of unplanned cesarean births. Participants wanted clearer communication with the maternity care team, voices in the decision-making process, and inclusion of support persons to optimize their birth experiences. Because negative birth experiences affect maternal and child well-being, it is important to understand women’s perceptions and develop strategies to assist them in the construction of their birth narratives.

Objective: to analyze the professional trajectory of obstetric nurses, who work in planned home childbirth. Method: a descriptive and exploratory study with a qualitative approach, conducted with 12 obstetric nurses who work in planned home childbirth. The participants were recruited using the non-probabilistic Snowball Sampling technique. In this perspective, semi-structured interviews were used, applied during the months of August to November 2018, in private places in the city of Rio de Janeiro. The collected data were submitted to content analysis in the thematic modality. Results: the research pointed out the value of experience and professional training - important milestones - in the setting of planned home childbirth, and motivators for the work of the professionals, as they enable autonomy. It is also emphasized the need for the obstetric nurse to acquire different skills for home childbirth, not covered during the training process. Conclusion: the results consolidate that obstetric nurses, who work in planned home childbirth and have a professional trajectory focused on the constant theoretical improvement associated with an approximation with “experts” in the area, provide experience, safety and quality of obstetric care, as well as autonomous action, in this care-related setting. RESUMEN Objetivo: analizar la trayectoria profesional de las enfermeras especializadas en Obstetricia, que se desempeñan en el parto domiciliario planificado. Método: estudio descriptivo y exploratorio con enfoque cualitativo, realizado con 12 enfermeras especializadas en Obstetricia que se desempeñan en el parto domiciliario planificado. Las participantes fueron captadas por medio de la técnica no probabilística Snowball Sampling. Desde esta perspectiva, se emplearon entrevistas semiestructuradas, aplicadas durante los meses de agosto a noviembre de 2018, en lugares privados de la ciudad de Río de Janeiro. Los datos recolectados fueron sometidos a análisis de contenido bajo la modalidad temática. Resultados: la investigación señaló el valor de la experiencia y de la capacitación profesional, marcos importantes en el ámbito del parto domiciliario planificado, además de ser factores motivadores para el desempeño de las profesionales, por posibilitar su autonomía. También se destaca la necesidad de que las enfermeras especializadas en Obstetricia adquieran habilidades diferenciadas para el parto domiciliario, no contempladas durante el proceso de formación académica. Conclusión: los resultados consolidan que las enfermeras especializadas en Obstetricia, que se desempeñan en el parto domiciliario planificado y tienen una trayectoria profesional enfocada, en la mejora teórica constante asociada a un acercamiento a “expertos” en el área, proporcionan experiencia, seguridad y calidad de asistencia obstétrica, así como un desempeño autónoma, en este ámbito de atención. RESUMO Objetivo: analisar a trajetória profissional das enfermeiras obstétricas, que atuam em parto domiciliar planejado. Método: estudo descritivo, exploratório, com abordagem qualitativa, realizado com 12 enfermeiras obstétricas que atuam no parto domiciliar planejado. O recrutamento das participantes ocorreu por meio da técnica não probabilística Snowball Sampling. Nessa perspectiva, foram utilizadas entrevistas semiestruturadas, aplicadas durante os meses de agosto a novembro de 2018, em locais privados na cidade do Rio de Janeiro. Os dados coletados foram submetidos à análise de conteúdo na modalidade temática. Resultados: a pesquisa apontou o valor da experiência e da capacitação profissional - marcos importantes - no cenário do parto domiciliar planejado, e motivadores para a atuação das profissionais, por possibilitarem a autonomia. Ressalta-se, também, a necessidade da enfermeira obstétrica em adquirir habilidades diferenciadas para o parto domiciliar, não contempladas durante o processo de formação. Conclusão: os resultados consolidam que as enfermeiras obstétricas, as quais atuam no parto domiciliar planejado têm uma trajetória profissional focada, no constante aprimoramento teórico associado a uma aproximação com “experts” na área, conferindo experiência, segurança e qualidade da assistência obstétrica, bem como uma atuação autônoma, neste cenário de cuidado.

Introduction: Non-pharmacological methods of pain relief are based on structured knowledge, which does not require sophisticated equipment to be used, being based on the structured knowledge of health professionals, used both to relieve pain and to humanize childbirth. Objective: To investigate the possibility of performing the normal delivery procedure using non-pharmacological methods, to describe the main non-pharmacological methods of pain relief, identifying the obstetric nurse's action in this scenario. Method: This is an exploratory study of literature review carried out in the databases of the Virtual Health Library and Scientific Electronic Library Online, in articles published from 2005 to 2017. Results and Discussion: They were identified as non-pharmacological methods in the relief of pain in normal childbirth: hydrotherapy, ambulation and change of position, relaxation exercises, aromatherapy, breathing technique, massage, music therapy, delivery ball, electrical stimulation and acupuncture. Conclusion: Non-pharmacological methods of pain relief have been highlighted by movements in favor of humanizing childbirth practices, seeking to decrease the use of drugs and introducing women as protagonists in this scenario.

Objective: To analyze the factors associated with the performance of episiotomy. Methods: Cross-sectional study, developed with data from the research “Born in Belo Horizonte: Labor and birth survey, “conducted with 577 women who had their children via vaginal birth. In order to verify the magnitude of the association between episiotomy and its possible determinants, logistic regression models were constructed to estimate the odds ratio. Results: Episiotomy was performed in 26.34% of women, and 59.21% knew they had been subjected to it. We observed that younger women, primiparous women, women assisted by a professional other than the obstetric nurse and women who had their babies in a private hospital have an increased chance of being submitted to this procedure. Conclusion: Considering the rates of episiotomy, this study highlights the need for the absolute contraindication to indiscriminate performing it. RESUMEN Objetivo: Evaluar los factores relacionados a la realización de episiotomía. Métodos: Estudio transversal, desarrollado con datos de la investigación “Nascer en Belo Horizonte: Averiguación sobre el parto y nacimiento”, realizada con 577 mujeres que tuvieron sus hijos por vía vaginal. Para verificar la magnitud de la relación entre la realización de episiotomía y sus posibles determinantes, han sido construidos modelos de regresión logística para estimar la odds ratio. Resultados: La episiotomía ha sido realizada en 26,34% de las mujeres; y, de estas, 59,21% sabían que habían sido sometidas a ella. Se observó que mujeres más jóvenes, primigestas, mujeres asistidas por profesional que no sea enfermero obstetra y mujeres que tuvieron sus bebés en hospital privado presentan aumento en la chance de ser sometidas a eso procedimiento. Conclusión: Considerando las tajas del uso de la episiotomía, este estudio destaca la necesidad de contraindicación absoluta de su realización indiscriminada. RESUMO Objetivo: Avaliar os fatores associados à realização de episiotomia. Métodos: Estudo transversal, desenvolvido com dados da pesquisa “Nascer em Belo Horizonte: Inquérito sobre o parto e nascimento”, realizada com 577 mulheres que tiveram seus filhos por via vaginal. Para verificar a magnitude da associação entre a realização de episiotomia e seus possíveis determinantes, foram construídos modelos de regressão logística para estimar a odds ratio. Resultados: A episiotomia foi realizada em 26,34% das mulheres; e, destas, 59,21% sabiam que haviam sido submetidas a ela. Observou-se que mulheres mais jovens, primigestas, mulheres assistidas por profissional que não o enfermeiro obstetra e mulheres que tiveram seus bebês em hospital privado apresentam aumento na chance de serem submetidas a esse procedimento. Conclusão: Considerando as taxas do uso da episiotomia, este estudo destaca a necessidade de contraindicação absoluta de sua realização indiscriminada.

O objetivo do estudo foi conhecer a opinião da equipe de enfermagem de um hospital público sobre a inserção de enfermeiras obstétricas na atenção ao parto normal. Estudo de campo, qualitativo, onde participaram dez profissionais de enfermagem, que atuam na maternidade de um hospital do município de Volta Redonda (RJ). A análise de dados foi construída a partir do material proveniente dos questionários e permitiu uma apreensão de significados positivos atribuídos pelas participantes à inserção de enfermeiras obstétricas na sala de parto. Como resultados surgiram as seguintes categorias: Acolhimento como forma de humanização do parto; Papel da Enfermeira na Ambientação para o Parto Humanizado e Enfermeira obstétrica como referência no parto. A equipe espera que com a inserção da enfermeira obstétrica atuando na assistência, proporcione experiências de educação em saúde para equipe de enfermagem e também para as parturientes para que estas estejam conscientes de seus direitos. Conclui-se que a equipe espera que a enfermeira seja uma referência para humanização do atendimento ao parto.Palavras-chave: Parto humanizado. Enfermeira obstetra. Saúde da mulher. ABSTRACT: The objective of the study was to know the opinion of the nursing team of a public hospital about the insertion of obstetrical nurses in the attention to normal delivery. Field study, qualitative, where ten nursing professionals participated, who work in the maternity of a hospital in the city of Volta Redonda (RJ). The data analysis was constructed from the questionnaires' material and allowed the apprehension of positive meanings attributed by the participants to the insertion of obstetric nurses in the delivery room. As results the following categories emerged: Welcoming as a form of humanization of childbirth; Role of the Nurse in the Setting for Humanized Delivery and Obstetric Nurse as reference in childbirth. The team hopes that with the insertion of the obstetric nurse acting in the assistance, provide experiences of health education for nursing staff and also for the parturients so that they are aware of their rights. It is concluded that the team expects the nurse to be a reference for the humanization of childbirth care.Keywords: Humanized birth. Midwife. Women's health.

Objetivo: Relatar a experiência de uma capacitação para residentes em enfermagem obstétrica, acerca de temas relevantes na área, por meio da prática baseada em evidências. Síntese dos Dados: Os dados podem ser sintetizados do seguinte modo: trata-se de um trabalho oriundo de atividade desenvolvida na disciplina de Tecnologias Inovadoras e Empreendedorismo em Enfermagem e Saúde, do Mestrado Profissional em Saúde Materno Infantil. A tecnologia de cuidado que emergiu foi uma capacitação para residentes em enfermagem obstétrica de uma instituição de ensino superior. O trabalho foi realizado no segundo semestre de 2016 e seguiu os passos elencados por um diagrama teórico da disciplina, baseado na pesquisa-ação. Importa acentuar que foi realizada a capacitação na disciplina de Seminários Integrados, com residentes em enfermagem obstétrica, a partir da percepção das mesmas, de dificuldades na implementação da prática baseada em evidências em seu cotidiano. A capacitação pode ser considerada uma tecnologia de cuidado, visto que, possibilita a educação em saúde das pós-graduandas e instiga a realização de pesquisas bem delineadas na área obstétrica. Conclusão: Acentua-se existir grande necessidade de valorização da profissão de enfermeiras obstetras nas maternidades e de se dever explorar mais sua importância na mudança do modelo obstétrico assistencial brasileiro.

It is important for nurse educators to develop deliberate experiences within the curriculum to educate future nurses not only on the benefits of breastfeeding but also on how to advocate and support the breastfeeding woman. A breastfeeding workshop utilizing innovative teaching strategies was implemented during an obstetrical nursing course in the fall 2017 semester. After the workshop, students reported an increase in knowledge, skills, and attitudes surrounding breastfeeding. The students were able to aptly demonstrate their new breastfeeding knowledge during simulation.

Objetivos: Identificar as boas práticas desenvolvidas pela Enfermeira Obstétrica em uma Maternidade Municipal do Rio de Janeiro e analisar a assistência das Enfermeiras Obstétricas nas Boas Práticas no momento do parto. Método: Estudo documental, que foi realizado em uma maternidade municipal da cidade do Rio de Janeiro no período de janeiro a julho de 2015. O estudo foi encaminhado à Plataforma Brasil e o Parecer liberado com o nº CAAE: 51008015.0.0000.5285. Resultados: Foi constatado que as Enfermeiras Obstétricas ofereceram assistência à 367 parturientes utilizando as boas práticas de forma segura. O estudo demonstrou que o uso das boas práticas tem grande influência na recuperação da fisiologia materna, na adaptação do recém-nascido e redução da anemia na primeira infância. Conclusão: Ocorre a assistência dentro das boas práticas obstétricas no parto e nascimento de forma humanizada e no contexto das evidências científicas como segue as recomendações do Ministério da Saúde.Descritores: Enfermeira Obstétrica, Parto Humanizado, Assistência ao Parto.

Introdução: A Enfermagem Obstétrica possui perfil e competências para acompanhar o processo fisiológico do nascimento, contribuindo para a sua evolução natural, reconhecendo e corrigindo os desvios da normalidade, e encaminhando aquelas que demandem assistência especializada Objetivos: Analisar a atuação das enfermeiras obstétricas no trabalho de parto e identificar os principais desafios encontrados na literatura, na assistência ao parto pela enfermeira obstétrica. Metodologia: Este estudo é uma pesquisa bibliográfica de abordagem qualitativa. Cabe ressaltar que a pesquisa bibliográfica que é desenvolvida com auxílio de material já elaborado, constituído principalmente de livros e artigos científicos. A seleção dos artigos levou em consideração os artigos científicos referentes ao assunto publicado entre os anos de 2015 a 2020. Após a associação de todos os descritores foram encontrados 85 artigos, excluídos 75 e selecionados 10 artigos. Discussão e Resultados: Perante isso, tornou-se possível a construção de 2 categorias: Atuação das enfermeiras obstétricas no trabalho de parto e Desafios encontrados pelas enfermeiras obstétrica na assistência a mulher em trabalho de parto. Conclusão: O atendimento da enfermeira obstétrica é indispensável no processo de trabalho de parto, parto e nascimento, sendo este um profissional que, no momento do trabalho de parto e parto, torna-se uma referência de apoio, segurança e conhecimento para a parturiente.

Objetivo: relatar a implantação do Programa Nacional de Residência em Enfermagem Obstétrica na perspectiva das enfermeiras obstetras formadas na primeira turma da região sul do Brasil. Método: relato de experiência. Os cenários da formação das enfermeiras obstetras são representados por uma maternidade pública, uma Unidade Básica de Saúde e duas Estratégias de Saúde da Família. Resultados: muitos avanços foram conquistados a partir de discussões conjuntas e trocas de conhecimento entre todos os atores envolvidos no processo de implantação do programa. Atualmente é possível o trabalho em equipe, a discussão de condutas e prescrições e a confiança no trabalho das residentes. Considerações finais: o Programa de Residência em Enfermagem Obstétrica está em processo de implantação e, por isso, a cada ano surgem novos desafios, e em alguns casos, limitações e dificuldades, o que contribui para seu aprimoramento e reorienta as ações de qualificação das enfermeiras obstetras.

This study aims to identify satisfaction levels of adult chronic patients regarding the care they received at the hospital. The descriptive and cross-sectional study was conducted at Cukurova University Faculty of Medicine Balcali Hospital between 01.08.2016-31.10.2016. The sample consisted of 910 patients. The data was collected with “Personal Information Form” and "Patient Assessment of Chronic Illness Care (PACIC)." The data were analyzed via IBM 20.0 program. Ethical committee approval, permission from the institution and verbal consent from the patients were obtained for the study. The average age of the participants was 50.88±16.55. The average hospitalization duration was 9.22±11.55 days. It was indicated that 38% of the respondents have cardiovascular diseases, 94.6% use a kind of medication,91.7% have their medications on time, 85.5% take recommended dosages, 45.5% know the name and the number of the medication they take. The average score for chronic patient care evaluation scale was 3.11±0.74. When the subscales of the scale are analyzed, it was found that the average score for patient participation subscale is 3.75±0.93, decision-making support subscale is 3.46±3.33, target-setting subscale is 2.95±0.78, problem-solving subscale is 3.28±0.97 and monitoring/coordination subscale is 2.51±1.03. Significant correlations were found between the respondents’ education level and health education with their evaluations of chronic care. It was indicated that the patients’ satisfaction with the nursing care is medium, the highest average scores are in decision-making subscale while the average score for monitoring/coordination subscale is the lowest. In order to raise the satisfaction levels of chronic patients regarding nursing care, chronic patient care should be prioritized in organized education and on-the-job training for nurses. By emphasizing the importance of monitoring and coordinating the patients, better management of chronic diseases can be achieved. Article DOI: https://dx.doi.org/10.20319/lijhls.2017.32.3850 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

Objectives: The aim of this study was to identify the willingness of nurses working in surgical units to provide care to obese surgical patients and related factors. Methods: This descriptive study was conducted with 250 nurses from surgical units of the 3 hospitals. Data analysis was performed by using frequency, percentage, mean, standard deviation, and chi-square test. Results: It was found that 85.6% of nurses were unwilling to provide care to obese surgical patients. The reasons of nurses' unwillingness to provide care included back/low-back pain, fears of dropping the patient, and inability to meet patients' care needs. It was determined that the intensive care nurses, who provided care to one to three patients a month, who were untrained in obese patient care, who worked with inadequate staff during nursing care procedures, and those who experienced emotional problems during care delivery were unwilling to provide caring. It was also found that most of the equipment required for obese patient care ...

Support staff work closely with their patients and members of the multidisciplinary team to deliver high-quality care. Often this care will have been planned by a nurse using ‘the nursing process’. It is therefore important for the support worker to understand how the patient has been assessed and that the care they are providing has been planned. Within this article, the author will be discussing the nursing process, explaining the different stages and how these are used to deliver quality care. Relevant sections of the Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ) will be highlighted. Support workers have a clear and important role in making sure the nursing process is successful and patients receive the best quality care.

Aims and objectives To identify the contribution of hospital, unit, staff characteristics, staffing adequacy and teamwork to missed nursing care in Iceland hospitals. Background A recently identified quality indicator for nursing care and patient safety is missed nursing care defined as any standard, required nursing care omitted or significantly delayed, indicating an error of omission. Former studies point to contributing factors to missed nursing care regarding hospital, unit and staff characteristics, perceptions of staffing adequacy as well as nursing teamwork, displayed in the Missed Nursing Care Model. Design This was a quantitative cross-sectional survey study. Methods The samples were all registered nurses and practical nurses (n = 864) working on 27 medical, surgical and intensive care inpatient units in eight hospitals throughout Iceland. Response rate was 69·3%. Data were collected in March–April 2012 using the combined MISSCARE Survey-Icelandic and the Nursing Teamwork Survey-Icelandic. Descriptive, correlational and regression statistics were used for data analysis. Results Missed nursing care was significantly related to hospital and unit type, participants’ age and role and their perception of adequate staffing and level of teamwork. The multiple regression testing of Model 1 indicated unit type, role, age and staffing adequacy to predict 16% of the variance in missed nursing care. Controlling for unit type, role, age and perceptions of staffing adequacy, the multiple regression testing of Model 2 showed that nursing teamwork predicted an additional 14% of the variance in missed nursing care. Conclusions The results shed light on the correlates and predictors of missed nursing care in hospitals. This study gives direction as to the development of strategies for decreasing missed nursing care, including ensuring appropriate staffing levels and enhanced teamwork. Relevance to clinical practice By identifying contributing factors to missed nursing care, appropriate interventions can be developed and tested.

To examine access to perinatal nurse home visiting services for high-risk pregnant women who have diabetes or hypertension.Secondary data analysis.Philadelphia, PA.Pregnant women who had a live birth during 2012 and those referred to a community-based agency for perinatal nurse home visiting because of their diagnosis of diabetes or hypertension.Access to services was measured by examining referral information (dosage, diagnosis, gestational age at time of referral, and insurance type) retrieved from administrative logs of the community-based organization that provides perinatal home visiting to high-risk pregnant women. The population-based prevalence rates of hypertension and diabetes were calculated from birth record data provided by the Philadelphia Department of Public Health.During 2012, 595 pregnant women were referred for perinatal nurse home visiting services. The mean gestational age when referred for services was 24.9 weeks (standard deviation = 8.5) with a mean number of 8.8 authorized visits (standard deviation = 8). Associated with more authorized visits was having Medicaid as the insurance type and medical diagnoses that included hypertension (p .01). Philadelphia prevalence rates for diabetes and hypertension varied by race and ethnicity (p .001); Asian mothers had the greatest rates for diabetes and Black mothers the greatest rates for hypertension.Various models of home visiting programs exist to improve maternal and child health outcomes. Because maternal morbidity and mortality rates are rising in the United States, further research about perinatal nurse home visiting programs for pregnant women with diabetes and hypertension is warranted.

Objective: To evaluate the knowledge and behaviors of nurses on the oral health of pregnant women. Material and Methods: This was a qualitative study, whose data collection was performed with 12 nurses from Belem, Brazil, through questionnaire, with recorded interview applied by a single researcher, according to a semi-structured script composed of five guiding questions, and whose results were analyzed by Content Analysis. Results: Four thematic issues were originated: 1) "All have dental caries", referring to the nurse’s perception on oral health related to the biological aspect; 2) "We refer", addresses the issue of nursing care and the nurse's responsibility for prenatal care; 3) "I do not know much", reveals the nurse's sometimes limited knowledge about oral health and discusses the breadth of dental care; and 4) "The demand is very large", brings up the view of nurses regarding the difficulties of accessing dental service in SUS. Conclusion: Nurses know prenatal protocols and refer patients to dental care, but their perception about dental care during pregnancy is not very comprehensive, which instigates the strengthening of interdisciplinary work.

This article describes the current state of cancer nursing and the various challenges that hinder the provision of effective nursing care to cancer patients in Nigeria. The major issue identified was the lack of specialized oncology nursing education which should actually form a basis for nurses to practice in the oncology setting. Other issues include poor facilities for oncology nursing care, lack of specific cancer centers resulting in the management of cancer patients in non-specialist wards. It is therefore recommended that solidified structure be put in place in order to establish and strengthen the nursing curriculum which has a strong potential for improving the knowledge and skills of nurses to care for people living with cancer in Nigeria.

The German poet Heinrich Heine is reported to have said, “When the world comes to an end, I shall go to Holland, for everything there happens fi fty years later.” For some, this Dutch “quaintness” explains the unusual system of obstetric care found in the Netherlands, a system where nearly one-third of births occur at home and where midwives have a degree of professional independence unrivaled by midwives in any other country. Heine’s observation about the Netherlands suggests that the unique Dutch way of birth is a vestige from a bygone era—a credible conclusion if you believe that humans are helpless in the face of technology. But the stubborn persistence of midwifery and home birth in the Netherlands, in spite of the declaration of medical professionals elsewhere that midwife-attended birth at home is a dangerous anachronism, forces us to conclude that Dutch obstetrics can be the vanguard of the future.

Obstetrical nursing offers unique challenges as a specialty clinical area as the process of birth and the nature of the setting are unpredictable. Traditional undergraduate baccalaureate nursing students may not have experience with maternal/newborn care. An eight-hour OB Boot Camp was developed to prepare students for their first obstetrical clinical rotation. An explanatory sequential mixed-method research study was used to explore student perceptions and evaluate the experience. On the basis of the results of this research study, the OB Boot Camp was a valuable instructional method to prepare students for obstetrical clinical rotations and coursework.

Objectives This study aimed to explore childbirth fear and childbirth preparation among primigravid women in the late pregnancy from 36 to 40 weeks gestation. Methods We purposively recruited 18 primigravid women into in-depth interviews, 21 birth companions, and 13 health workers into focus group discussions. Participants were recruited from two community hospitals’ maternity waiting homes in Lilongwe, Malawi. Semi-structured interview guides were used to collect data that were analyzed using content analysis. NVivo11 computer software was used to organize the data. Results The four categories developed were: “ambivalent pregnancy feelings” , “dependence on traditional childbirth counseling” ,“inadequate prenatal childbirth instruction” and “inconsistent roles of a birth companion” . The findings suggest that primigravid women who were mainly exposed to traditional childbirth mentoring rather than professional care providers, experienced childbirth fear, and lacked proper psychosocial childbirth preparation. Conclusions Childbirth fear among primigravid women emanate from personal; family; ineffective traditional counseling; and inadequate antenatal childbirth instruction. Birth companions may increase childbirth stress. However, our findings highlight birth companions as readily available psychosocial support resources among primigravid women. We recommend that professional childbirth instruction during antenatal care should be strengthened to surpass traditional childbirth counseling. Appropriateness and effectiveness of birth companions need to be carefully assessed.

Objective To develop and evaluate an instrument designed to measure the confidence of nurses in their ability to provide neutral, compassionate care to unique families in perinatal settings: the Nurses’ Confidence Scale: Unique Families. Design Prospective instrument development and psychometric study. Setting Health system in the U.S. Mountain West region. Participants Convenience sample of 62 perinatal/neonatal nurses. Methods We developed a two-part scale to measure the confidence of nurses in their ability to care for complex/nontraditional families, termed unique families. Part A was focused on nursing care behaviors for any unique family; Part B was focused on providing care to seven specific unique family populations. Five experts in perinatal nursing or adoption evaluated the scale’s content validity. To test the psychometric properties of the scale, we used item analysis, reliability analysis, and exploratory factor analysis. Results The content validity index was 0.82. The Cronbach’s alpha coefficient estimate of internal consistency for Part A was .92. Principal component analysis resulted in two factors that explained 64% of the total variance: skills and resources (Cronbach’s alpha coefficient = .89) and awareness and sensitivity (Cronbach’s alpha coefficient = .87). Part B had a Cronbach’s alpha coefficient of .90. Parts A and B showed a strong positive relationship with one another (r = .77). The general self-efficacy measure was strongly and positively correlated with Part A (r = .81) and moderately and positively correlated with Part B (r = .48). Conclusion The Nurses’ Confidence Scale: Unique Families is a new tool with which to measure the confidence of perinatal/neonatal nurses in providing sensitive, specific care to complex/nontraditional families. Results of our psychometric evaluation supported initial acceptable reliability and validity of the scale.

O modelo de atencao a saude ressalta a importância do enfermeiro obstetra na melhoria do atendimento a mulher no ciclo gravidico-puerperal. No entanto, consolidar a atuacao deste profissional na assistencia ao parto de risco habitual constitui um desafio devido as crencas, valores, condicoes estruturais e organizacionais das instituicoes que definem o poder-saber das relacoes sociais nos locais de trabalho. O objetivo dessa pesquisa e construir uma abordagem teorico explicativa da autonomia do enfermeiro obstetra na assistencia ao parto de risco habitual no âmbito da cultura hospitalar. Estudo qualitativo, com delineamento teorico-metodologico da Etnografia, desenvolvido em tres maternidades publicas no estado do Rio Grande do Norte, Brasil. Participaram tres gestores e vinte e tres enfermeiros obstetras. A coleta de dados ocorreu de julho a outubro de 2016, apos a aprovacao do Comite de Etica em Pesquisa da Universidade Federal do Rio Grande do Norte, CAAE n° 55187716.9.0000.5537. As informacoes foram coletadas mediante a observacao participante, diario de campo, entrevistas semiestruturadas e de grupo focal. Utilizou-se o Atlas.ti software e os preceitos do metodo etnografico de Spradley para a analise dos dados, realizada simultaneamente a coleta. Tres termos cobertos emergiram: Vivencia do enfermeiro obstetra em diferentes contextos de atuacao hospitalar; Relacoes sociais e de poder no âmbito hospitalar; Aspectos profissionais e gerenciais relacionados a autonomia do enfermeiro obstetra. Os temas foram conceptualizados com base em Foucault sobre o poder na construcao da autonomia. Os conceitos e as suas relacoes compreenderam uma explicacao teorica da autonomia do enfermeiro obstetra na assistencia ao parto de risco habitual no âmbito da cultura hospitalar. O modelo construido neste estudo desvelou que o enfermeiro obstetra vivencia diferentes contextos estruturais, organizacionais e culturais capazes de influenciar o seu poder decisorio na assistencia ao parto. Nesses espacos, desencadeiam-se relacoes sociais e de poder que reproduzem o conceito de autonomia vinculado ao paradigma dominante de individualismo e de relacoes de dominio e submissao. Vislumbra-se a autonomia constituida por um saber-poder que amplia e respalda a atuacao do enfermeiro obstetra por meio de um valor etico enaltecedor do trabalho multiprofissional. Deste modo, a autonomia e conquistada por aqueles que assumem o papel na transformacao da sua praxis a partir das relacoes de poder estabelecidas com o outro na perspectiva do crescimento conjunto.

Most of the problems related to women’s health, which are responsible for the higher incidence of diseases and mortality rates, occur during the reproductive period, especially during pregnancy, childbirth and puerperium due to the intense changes that occur during this period, especially in the gestation. Among the most frequent complications in pregnancy, hypertensive syndromes are identified, being the first cause of maternal mortality in Brazil and main responsible for the high rate of perinatal deaths, in addition to the growing number of sequelae neonates. Maternal mortality is an indicator of health and economic impact that impacts the lives of the people who are in their environment. Since hypertension is the first cause of maternal death, absolutely avoidable, this study aimed to study the risk factors associated with hypertension in pregnant women. This is a cross-sectional, quantitative approach. The sample consisted of 254 pregnant women in prenatal care at the Family Health Units (USF) and at the High Risk Outpatient Clinic of the Cândida Vargas Institute (ICV), a reference in Health Care in High Risk Pregnancy, both services located in the municipality of João Pessoa-PB. The data were collected during the months of October to December 2018. Data were analyzed by means of descriptive statistics through SPSS software and the construction of the Decision Tree model was done through WEKA software (WaikatoEnvironmentforKnowledgeAnalysis).The results showed that the risk factors are involved in the development of arterial hypertension in pregnant women, as well as the identification of the explanatory power of the factors in relation to the outcome by calculating the Information Value (IV). The factors present in the decision tree were: chronic hypertension, history of hypertensive syndrome in gestation, gestational diabetes, low income, black race, low socioeconomic level and overweight or obesity. On the other hand, the significant risk factors according to Odds Ratio with force majeure according to IV were: history of hypertensive syndrome in pregnancy and chronic hypertension; mean degree: gestational diabetes, overweight or obesity, family history of HAC, number of prenatal consultations

Resumo: Este artigo tem como objetivo descrever os primeiros resultados de dois estudos avaliativos, um sobre a Rede Cegonha e outro sobre o projeto Parto Adequado, denominados, respectivamente, de avaliação da Rede Cegonha e Nascer Saudável, e identificar possíveis melhorias em comparação ao estudo Nascer no Brasil. Ambos os estudos têm desenho seccional, realizados em 2017. O estudo avaliação da Rede Cegonha incluiu todas as 606 maternidades públicas e mistas envolvidas na Rede Cegonha e um total de 10.675 puérperas. O estudo Nascer Saudável incluiu uma amostra de conveniência de 12 hospitais da rede privada e um total de 4.798 mulheres. Os indicadores de atenção ao parto e nascimento avaliados foram: presença de acompanhante, atendimento por enfermeira obstétrica, preenchimento de partograma, uso de métodos não farmacológicos, deambulação, alimentação, uso de cateter venoso periférico, analgesia, posição da mulher para o parto, episiotomia e manobra de Kristeler. Esses indicadores foram comparados aos encontrados no Nascer no Brasil, estudo de base nacional realizado em 2011-2012, antes do início dos dois programas de intervenção. Para as comparações utilizamos o teste do qui-quadrado para amostras independentes e nível de 95% de confiança. Houve um aumento significativo do número de mulheres com acesso à tecnologia apropriada ao parto entre os anos de 2011 e 2017 e redução de práticas consideradas prejudiciais. No setor privado, observou-se também redução nas taxas de cesariana e aumento da idade gestacional ao nascer. Os resultados deste estudo mostram que políticas públicas bem conduzidas podem mudar o cenário da atenção ao parto e nascimento, promovendo a redução de desfechos maternos e neonatais negativos. Resumen: El objetivo de este artículo es describir los primeros resultados de dos estudios evaluativos, uno sobre la Red Cigüeña y otro sobre el proyecto Parto Adecuado, denominados respectivamente como evaluación de la Red Cigüeña y Nacer Sano, e identificar posibles mejorías en comparación con el estudio Nacer en Brasil. Ambos estudios tienen un diseño transversal, realizados en 2017. El estudio evaluación de la Red Cigüeña incluyó todas las maternidades públicas (606) y mixtas implicadas en la Red Cigüeña y a un total de 10.675 puérperas. El estudio Nacer Sano incluyó una muestra de conveniencia de 12 hospitales privados y a un total de 4.798 mujeres. Los indicadores de atención al parto y nacimiento evaluados fueron: presencia de acompañante, atención por enfermera obstetra, cumplimentación de partograma, uso de métodos no farmacológicos, deambulación, alimentación, uso de catéter venoso periférico, analgesia, posición de la mujer para el parto, episiotomía y maniobra de Kristeler. Estos indicadores se compararon con los encontrados en Nacer en Brasil, un estudio a nivel nacional, realizado en 2011-2012, antes del inicio de los dos programas de intervención. Para las comparaciones utilizamos el test del chi-cuadrado para muestras independientes y nivel de confianza de un 95%. Hubo un aumento significativo del número de mujeres con acceso a la tecnología apropiada para el parto entre los años de 2011 y 2017 y una reducción de las prácticas consideradas perjudiciales. En el sector privado, se observó también una reducción en las tasas de cesárea y aumento de la edad gestacional al nacer. Los resultados de este estudio muestran que las políticas públicas bien dirigidas pueden cambiar el escenario de la atención al parto y nacimiento, promoviendo la reducción de desenlaces maternos y neonatales negativos. Abstract: This article aims to describe the preliminary results of two evaluations studies, one about the Stork Network program and the other about the Adequate Birth program, called Stork Network Assessment and Healthy Birth, and to identify possible improvements in comparison to the Birth in Brazil study. Both studies used a cross-sectional design and were conducted in 2017. The Stork Network Assessment study included all 606 public and mixed maternity hospitals from the Stork Network and a total of 10,675 postpartum women. The Healthy Birth study included a convenience sample of 12 private hospitals and 4,798 women. Indicators of labour and childbirth care were: presence of a companion person, care by obstetric nurse, use of partograph, use of non-pharmacological methods, walking during labor, eating, use of peripheral venous catheter, position for delivery, episiotomy, and Kristeller maneuver. The indicators were compared to those verified in Birth in Brazil, a nationwide population-based study in 2011-2012, before the start of the two intervention programs. Comparisons used the chi-square test for independent samples and 95% confidence interval. There was a significant increase in the number of women with access to appropriate technology for labour and childbirth from 2011 to 2017 and a reduction in harmful practices. The private sector also showed a decrease in cesarean rates and an increase in gestational age at birth. The study’s results show that properly conducted public policies can change the scenario of care for labor and childbirth, helping to reduce in negative maternal and neonatal outcomes.