[Support during childbirth: perception of health care providers and companions chosen by women]

OBJECTIVE

To understand health care providers' perception on managing laboring women in the presence of a labor companion of their choice, and the labor companion's perception of this experience.

METHODS

A qualitative study was conducted based on a controlled randomized clinical trial. Sampling was intentional and determined through information saturation. Semi-structured interviews were carried out with 11 health care providers and 16 laboring companions in the obstetric unit of a maternity facility at the hospital complex, in Campinas, Southern Brazil, between October 2004 and March 2005. The thematic analysis of discourse was applied using the following methodological figures: central idea, key expressions and discourse of the collective subject.

RESULTS

The most remarkable central ideas of health care providers were: no difference was observed in managing laboring women with a labor companion; positive changes were noted in labor management when a labor companion was present; the companion provided emotional support to laboring women who were more pleased, and felt safer and peaceful; many positive aspects were seen in the behavior and involvement of laboring women with a labor companion; the companion caused no problems and encouraged health providers to engage in a more humane and less routine attitude. The main central ideas of labor companions were: positive feelings, emotions, a sense of satisfaction with the experience; being with the laboring woman was a great opportunity to provide her emotional support; and they felt welcome by health care providers.

CONCLUSIONS

Health providers considered positive the support provided by a labor companion and had no problems in managing laboring women in the presence of their companions. Labor companions were pleased and happy with this experience. There was no conflicting opinions.

Apoio no nascimento: percepções de profissionais e acompanhantes escolhidos pela mulher

OBJETIVO: Descrever a percepção de profissionais da saúde sobre prestar assistência à parturiente na presença do acompanhante por ela escolhido, e a percepção dos acompanhantes sobre essa experiência. MÉTODOS: Realizou-se estudo qualitativo, a partir de ensaio clínico randomizado controlado. A amostra estudada foi intencional e definida por saturação de informação. Foram entrevistados 11 profissionais da saúde e 16 acompanhantes no centro obstétrico de uma maternidade em Campinas, SP, de outubro de 2004 a março de 2005. Empregou-se a técnica de análise temática de discurso, utilizando-se as figuras metodológicas: idéia central, expressões-chave e o discurso do sujeito coletivo. RESULTADOS: Entre as idéias centrais dos profissionais destacaram-se: não houve diferença em prestar assistência com acompanhante durante o trabalho de parto e parto; com o acompanhante ocorreram mudanças positivas na assistência; o acompanhante dá apoio emocional à parturiente, que fica mais satisfeita, segura e tranqüila; existem muitos aspectos positivos no comportamento e participação das parturientes com acompanhante; o acompanhante não causou problema e fez o profissional ter atitude mais humana e menos rotineira. As principais idéias centrais dos acompanhantes foram: sentimentos positivos, emoção, satisfação com a experiência; poder ajudar ao dar apoio emocional; sentir-se bem recebido pelos profissionais. CONCLUSÕES: Os profissionais da saúde consideraram importante o apoio do acompanhante não tendo sido observado problema em prestar assistência na sua presença. Os acompanhantes se sentiram satisfeitos e recompensados com a experiência. Não foram detectados conflitos de opinião entre os envolvidos.

[Evidence on support during labor and delivery: a literature review]

The effects of support for women during labor and delivery provided by health professionals, lay women, and doulas on the maternal and neonatal outcomes have been evaluated through randomized clinical trials, meta-analyses, and systematic reviews. This article presents a review of these studies, focusing on the principal characteristics, support provider, simultaneous presence of the woman's spouse and/or family members during labor and delivery and the outcomes. The analysis included studies published from 1980 to 2004 which explicitly approached these aspects. In general, the results of such support were favorable, highlighting a reduction in the cesarean rate, analgesia/ medication for pain relief, duration of labor, and utilization of oxytocin and an increase in maternal satisfaction with the experience. The benefits were greater when the support provider was not a health professional. The available studies did not evaluate the specific companion chosen by the woman as a support provider, which constitutes a gap in the knowledge that should be filled by future research.