Superando tensões entre paradigmas de atenção ao parto: intervenções e uso de tecnologias na prática de obstetrizes

Abstract

In a context of increasing medicalisation of childbirth care, emerged a social movement demanding the humanisation of delivery. Within this movement, it is possible to witness the contrast between discourses that emphasise women’s natural ability to give birth and the occasional need for interventions. Having this in mind, our aim is to comprehend how certified midwives intervene in the process of labour and use the technologies they have at their disposal. To fulfill this aim, we conducted semi-structured interviews with five professionals, following the criteria that they are accompanying home births in the city of São Paulo. We used maps of association of ideas to analyse the information produced in those interviews, an analytical resource developed within the scope of the research with discursive practices. Faced with the need to deepen certain aspects of their practice, we conducted a second round of interviews, which resulted in the cases discussed in the last chapter of this thesis. Our results indicate that the humanised practice of the certified midwives is characterised by partnership between professional and parturient, in which the need for interventions is not ruled out. We defend the thesis that it is necessary to strengthen a childbirth care in which the use of technologies is aligned with women’s needs. In order to do so, we must re-signify the notion of intervention, so that it is no longer reduced to biomedical procedures. This reduction creates a category of procedures and technologies that must be avoided in an humanised labour, dislocating the decision-making process from each woman to a predetermined consensus. Finally, it is imperative to focus on the women we tend to, so that our positioning regarding interventions and the use of technologies in childbirth is always situated