As relações com a parturiente na assistência ao parto domiciliar: perspectivas tradicionais e modernas

Abstract

General objective: to analyze the relationships in the construction of the care in the home delivery by traditional midwives and trained midwives. Specific objectives: describe the assistance provided to women in home birth accompanied by traditional midwives and trained midwives; describe the relationships between parturients / family and the teams of traditional midwives and trained midwives; to analyze how the professionals experience the development of this relationship in the home delivery attendance accompanied by traditional midwives and trained midwives. Methodological trajectory: this is a qualitative study, exploratory and descriptive, with a methodological approach based on theory based on data. Data were collected through semi-structured interviews with 19 midwives attending home births, among them obstetricians, midwives, midwives, midwives in the tradition, and traditional birth attendants in Brazil. Data were collected between July 2016 and December 2017. Results: in the analysis of the interviews two thematic categories emerged: work philosophy, covering comprehensiveness, naturalness and rigor; and the relationship, encompassing identity construction, the midwife’s professional self, the involvement with the woman, the woman as a person, the personal relationship with the woman at work and the relationship that remains. Both professionals with academic backgrounds, as well as those with traditional training, perceive their profession much more than a job, as a life practice. The midwife's work philosophy is tied to her professional identity. It supports a deeply personal midwife-parturient relationship, which follows a two-way channel. Philosophy is linked to integrality, naturalness and rigor based on a deep involvement with the emotional and subjective experience of the parturient. This vision of childbirth, and of the woman as the main character of this event, guarantees autonomy and empowerment. In the home, an immersion of the midwife in the life and history of the pregnant woman. This intimate relationship enables surrender by the woman. Unlike the hospital context, the relationship developed by midwives at home does not end at the end with the final follow-up appointment. It is a relationship for life, permeated by trust. Final thoughts: we describe, in this work, a reciprocal relationship between the work philosophy in the assistance to the home delivery midwifery and the construction of the relationship with the parturient. Both are based on values of spontaneity, personal involvement and humanization of care. The work philosophy continues in search for integrality in the care. Midwives tend to adopt natural practices. The way in which the relationship is built and the factors that permeate it are guiding in the construction of this identity. In the way it relates to the parturient, homebirth care assumes an integral vision, promotes empowerment and respect for the autonomy of women during childbirth.