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Cuidar na liberdade de movimentos: uma experiência de parto positiva
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O presente relatório retrata o percurso de aquisição e desenvolvimento de competências de Mestre e Enfermeira Especialista em Enfermagem de Saúde Materna e Obstétrica (EEESMO). Simultaneamente, reflete sobre o cuidar na liberdade de movimentos e a sua influência na experiência de parto, sustentado pela Teoria do Cuidar de Kristen Swanson, que promove uma abordagem relacional centrada na mulher, restituindo o seu protagonismo através da valorização das suas competências pessoais e capacitação. Ancorada pela evidência científica, a integração da liberdade de movimentos na prática clínica promove processos de nascimento fisiológicos e satisfação com a experiência de parto, justificando o aprofundar do seu estudo. A investigação desenvolveu-se em duas etapas: uma Revisão Scoping (RS), que mapeou a evidência científica existente sobre a mobilidade e o posicionamento da grávida durante o trabalho de parto (TP); e um estudo primário, predominantemente quantitativo, descritivo e correlacional, objetivando compreender a influência da liberdade de movimentos nos resultados materno-fetais (MF) e na experiência de parto, no qual participaram 32 parturientes. A colheita de dados, através do preenchimento de um formulário e aplicação de um questionário, permitiu descrever a intervenção do EEESMO na promoção da liberdade de movimentos no TP para uma experiência de parto positiva, identificar o contributo da liberdade de movimentos no TP nos resultados MF e analisar a relação entre a liberdade de movimentos no TP e os resultados MF e a experiência de parto positiva. Os resultados mostraram que a liberdade de movimentos no TP contribui significativamente para uma experiência positiva, promovendo gestão da dor e maior controlo na experiência de parto, reforçando o empoderamento e a satisfação materna, evidenciando o suporte contínuo pelo EEESMO. Destacam-se, também, as associações estatisticamente significativas e positivas identificadas entre a liberdade de movimentos e o tipo de parto, o resultado perineal e a satisfação das expectativas no período expulsivo, demonstrando o impacto positivo desta prática na vivência do parto.
This report outlines the process of acquiring and developing competencies as a Master's-level Nurse Midwife specializing in Maternal and Obstetric Health Nursing. It also reflects on the practice of promoting freedom of movement during childbirth and its influence on the birth experience, supported by Kristen Swanson’s Theory of Caring. Swanson’s theory emphasizes a woman-centered, relational approach that restores the mother's autonomy by valuing her personal skills and empowering her throughout the process. Grounded in scientific evidence, including freedom of movement into clinical practice fosters physiological birth processes and enhances satisfaction with the childbirth experience, underscoring the need for further investigation. The research was conducted in two phases. A Scoping Review, that mapped existing scientific evidence on maternal mobility and positioning during labor; and a primary study, descriptive and correlational, predominantly quantitative, that aimed to understand the influence of freedom of movement on maternal-fetal outcomes and birth experience. Thirty-two women in labor participated. Data collection involved a structured form and a questionnaire, enabling the description of the nurse midwife’s role in promoting freedom of movement during labor for a positive birth experience, the identification of its contributions to maternal-fetal outcomes and the analysis of its relationship with maternal-fetal outcomes and birth experience. The results demonstrated that freedom of movement during labor significantly contributes to a positive birth experience, by enhancing pain management and increasing maternal control, thereby reinforcing empowerment and satisfaction. Continuous support from the nurse midwife was also emphasized as a crucial factor. Statistically significant positive associations were also identified between freedom of movement and various outcomes, including the type of delivery, perineal condition, and fulfillment of expectations during the second stage of labor, highlighting the beneficial impact of this practice on the birth experience.
This report outlines the process of acquiring and developing competencies as a Master's-level Nurse Midwife specializing in Maternal and Obstetric Health Nursing. It also reflects on the practice of promoting freedom of movement during childbirth and its influence on the birth experience, supported by Kristen Swanson’s Theory of Caring. Swanson’s theory emphasizes a woman-centered, relational approach that restores the mother's autonomy by valuing her personal skills and empowering her throughout the process. Grounded in scientific evidence, including freedom of movement into clinical practice fosters physiological birth processes and enhances satisfaction with the childbirth experience, underscoring the need for further investigation. The research was conducted in two phases. A Scoping Review, that mapped existing scientific evidence on maternal mobility and positioning during labor; and a primary study, descriptive and correlational, predominantly quantitative, that aimed to understand the influence of freedom of movement on maternal-fetal outcomes and birth experience. Thirty-two women in labor participated. Data collection involved a structured form and a questionnaire, enabling the description of the nurse midwife’s role in promoting freedom of movement during labor for a positive birth experience, the identification of its contributions to maternal-fetal outcomes and the analysis of its relationship with maternal-fetal outcomes and birth experience. The results demonstrated that freedom of movement during labor significantly contributes to a positive birth experience, by enhancing pain management and increasing maternal control, thereby reinforcing empowerment and satisfaction. Continuous support from the nurse midwife was also emphasized as a crucial factor. Statistically significant positive associations were also identified between freedom of movement and various outcomes, including the type of delivery, perineal condition, and fulfillment of expectations during the second stage of labor, highlighting the beneficial impact of this practice on the birth experience.
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Enfermagem obstétrica Gestantes Trabalho de parto Movimento Satisfação do paciente