A trajetória de mulheres assistidas em um centro de parto normal e sua relação com as escolhas no parto e no nascimento

Abstract

Womens trajectory in the health network can give us much information about what motivates women to search specifics services and what do they expect from care. Brazil faces challenges related to obstetric assistance due to the increased quantity of cesarean surgery,neonatal and maternal mortality, unnecessary intervention during parturition and birth. Such facts expose the need to know the trajectories of women in the heath network and what make them peregrinate, what are the motivations for them to search for specifics health services andhow have assistance in those places been. The incentive to the creation of new assistance structures, such as Normal Parturition Centers and health professionals qualification are strategies to change of the model of obstetric assistance in Brazil. This is a descriptive study, of qualitative approach, accomplished at a Normal Birth Center (CPN, in Portuguese) birth center, which objective is to know the trajectory of women assisted in a birth center and its relation to therapeutics choices in parturition and birth. Twenty-eight women were interviewed between May to July, 2014. As a methodologic referential for data analysis, it was used thematic analysis of content. The concept of health care system described by Arthur Kleinman and therapeutic itinerary approach were used as a theoretical reference. Results of this study show the influence of personal conviction, family, society and community in the construction of women`s trajectory during parturition. Women related difficulties in healthnetwork to access exams and attendance according to the needed care. Women have been gathering information about parturition and claimed for integral care, without unnecessary intervention. Formation of women` s groups have favored experience exchange between themand each other`s strengthening. The birth center is shown in results as a familiar, cozy place, where is found constant support from obstetric nurse and encouragement of natural childbirth. It is concluded that health network management should include health care system in iscomplexity, considering its cultural and relational aspects. The conception of a network and sensitive listening of women can predict much about what kind of care should be given to them.