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Necessidades espirituais da grávida durante o trabalho de parto: Projeto de desenvolvimento de competências clínicas especializadas na área de Enfermagem de Saúde Materna e Obstetrícia
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Este relatório descreve o desenvolvimento de competências específicas e comuns que desenvolvi em contexto do estágio de natureza profissional no âmbito do Mestrado em Enfermagem de Saúde Materna e Obstétrica, realizado em contexto clínico na região do Norte de Portugal, no período compreendido entre setembro de 2024 e maio de 2025, informado por evidências e numa visão crítica-reflexiva da aprendizagem e do desenvolvimento profissional.
A aprendizagem e a prática foram pautadas pela vivência de experiências através da participação ativa e observação clínica, complementadas pela mobilização de conhecimentos alinhados com a melhor evidência científica, descritas neste relatório. Este processo visou o desenvolvimento de competências no âmbito dos cuidados de enfermagem especializados, à mulher, ao recém-nascido e sua família, nas diversas fases do ciclo grávido-puerperal, tais como promoção da adaptação à gravidez, adaptação à parentalidade, trabalho de parto e pós-parto, gravidez com complicações, diagnóstico pré-natal, perda gestacional e a interrupção voluntária e médica da gravidez, formando e consolidando a atuação autónoma como Enfermeira Especialista em Enfermagem de Saúde Materna e Obstétrica. A ilustração do percurso de desenvolvimento de competências foi feita através de quatro casos clínicos, escolhidos de cada contexto.
O primeiro caso abordou o parto em gravidez de risco por diabetes gestacional e ausência de pessoa significativa, destacando a importância da comunicação, do cuidado transpessoal e dos métodos não farmacológicos para lidar com a dor do trabalho de parto; o segundo caso abordou parto eutócico fisiológico, em modelo hands-off, valorizando as necessidades espirituais, o plano de parto e o consentimento informado; o terceiro caso abordou o apoio no pós-parto tardio, com enfoque na promoção da amamentação, bem-estar emocional e rede de suporte; o quarto caso abordou o acompanhamento de gravidez de risco, reforçando o cuidado multidimensional e o empoderamento da mulher através da resinificação das experiências prévias. A importância do cuidado espiritual no contexto da enfermagem, particularmente no atendimento às necessidades espirituais da parturiente é fundamental para uma experiência de parto positiva e para a promoção da saúde integral da mulher. Para explorar esta temática foi desenvolvida uma revisão narrativa da literatura tendo em vista a identificação dessas necessidades, neste período de profunda transformação e intensidade emocional.
A revisão narrativa demonstrou que a espiritualidade é um componente fundamental no cuidado em Enfermagem de Saúde Materna e Obstétrica, favorecendo o bem-estar, a resiliência e o significado da experiência de parto. A evidência analisada revelou que a dimensão espiritual integra o cuidado, trazendo conforto e sentido, que as necessidades espirituais são universais, ainda que variáveis, e que a espiritualidade é vivida como experiência existencial e relacional, valorizando a presença sensível do profissional. Persistem, contudo, lacunas conceptuais e dificuldades na sua integração prática, concluindo-se que a sua incorporação exige formação específica, maior clareza conceptual e políticas institucionais que reconheçam o parto como uma experiência de corpo e alma. A investigação futura deve clarificar conceitos e explorar como práticas e ambientes humanizados podem potenciar esta vivência e criar um modelo integrativo de cuidado obstétrico.
This report describes the development of specific and common competencies acquired during the professional internship of the Master’s Degree in Maternal and Obstetric Health Nursing, carried out in settings in Northern Portugal, between September 2024 and May 2025. Learning and practice were guided by active participation and clinical observation, complemented by the mobilisation of knowledge aligned with the best scientific evidence, within a critical-reflective perspective. This process aimed at developing competencies in specialised nursing care for women, newborns, and their families across the different stages of the childbearing cycle, including adaptation to pregnancy and parenthood, labour and postpartum, complicated pregnancies, prenatal diagnosis, pregnancy loss, and voluntary or medical termination of pregnancy, consolidating autonomous practice as a midwife. The development of competencies was illustrated through four clinical cases selected from different contexts. The first case addressed labour in a high-risk pregnancy due to gestational diabetes and absence of a significant companion, highlighting the importance of communication, transpersonal care, and non-pharmacological methods of pain relief. The second case referred to physiological labour, in a hands-off model, emphasising spiritual needs, the birth plan, and informed consent. The third case involved late postpartum support, focused on breastfeeding promotion, emotional well-being, and support networks. The fourth case concerned the follow-up of a high-risk pregnancy, reinforcing multidimensional care and women’s empowerment through the re-signification of previous experiences. The importance of spiritual care in nursing, particularly in addressing women’s spiritual needs during childbirth, is fundamental to ensuring a positive birth experience and promoting women’s integral health. To explore this topic, a narrative literature review was conducted, aiming to identify these needs during this period of profound transformation and emotional intensity. The review demonstrated that spirituality is a fundamental component of Maternal and Obstetric Health Nursing care, fostering well-being, resilience, and meaning in childbirth. The analysed evidence revealed that spirituality integrates care by providing comfort and meaning; that spiritual needs are universal, although variable; and that spirituality is experienced as an existential and relational dimension, valuing the sensitive presence of the professional. Nonetheless, conceptual gaps and difficulties in practical integration remain. It is concluded that incorporating spirituality requires specific training, greater conceptual clarity, and institutional policies that recognise childbirth as an experience of both body and soul. Future research should clarify concepts and explore how humanised practices and environments can enhance this experience and contribute to the creation of an integrative model of obstetric care.
This report describes the development of specific and common competencies acquired during the professional internship of the Master’s Degree in Maternal and Obstetric Health Nursing, carried out in settings in Northern Portugal, between September 2024 and May 2025. Learning and practice were guided by active participation and clinical observation, complemented by the mobilisation of knowledge aligned with the best scientific evidence, within a critical-reflective perspective. This process aimed at developing competencies in specialised nursing care for women, newborns, and their families across the different stages of the childbearing cycle, including adaptation to pregnancy and parenthood, labour and postpartum, complicated pregnancies, prenatal diagnosis, pregnancy loss, and voluntary or medical termination of pregnancy, consolidating autonomous practice as a midwife. The development of competencies was illustrated through four clinical cases selected from different contexts. The first case addressed labour in a high-risk pregnancy due to gestational diabetes and absence of a significant companion, highlighting the importance of communication, transpersonal care, and non-pharmacological methods of pain relief. The second case referred to physiological labour, in a hands-off model, emphasising spiritual needs, the birth plan, and informed consent. The third case involved late postpartum support, focused on breastfeeding promotion, emotional well-being, and support networks. The fourth case concerned the follow-up of a high-risk pregnancy, reinforcing multidimensional care and women’s empowerment through the re-signification of previous experiences. The importance of spiritual care in nursing, particularly in addressing women’s spiritual needs during childbirth, is fundamental to ensuring a positive birth experience and promoting women’s integral health. To explore this topic, a narrative literature review was conducted, aiming to identify these needs during this period of profound transformation and emotional intensity. The review demonstrated that spirituality is a fundamental component of Maternal and Obstetric Health Nursing care, fostering well-being, resilience, and meaning in childbirth. The analysed evidence revealed that spirituality integrates care by providing comfort and meaning; that spiritual needs are universal, although variable; and that spirituality is experienced as an existential and relational dimension, valuing the sensitive presence of the professional. Nonetheless, conceptual gaps and difficulties in practical integration remain. It is concluded that incorporating spirituality requires specific training, greater conceptual clarity, and institutional policies that recognise childbirth as an experience of both body and soul. Future research should clarify concepts and explore how humanised practices and environments can enhance this experience and contribute to the creation of an integrative model of obstetric care.
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Necessidades espirituais Enfermagem de Saúde Materna