Childbirth care by health professionals: conflicting practices in obstetrics.
Greici Naiara Mattei, Gabriela Marcellino de Melo Lanzoni, Giovana Dorneles Callegaro Higashi and 2 others
PMID 39699350WHAT IT FOUND
Attending physicians often enforced outdated, interventionist practices like routine episiotomy and the Kristeller maneuver, overriding women’s choices.
Nurses and residents advocated for evidence-based care, including non-pharmacological pain relief and birth plans, creating conflict within the team.
Key findings
01Attending physicians demonstrated resistance to good practices and applied inappropriate interventions, violating women's autonomy.
02Nurses and medical residents guided women toward non-pharmacological pain relief and supported birth plans, contrasting with attending physicians who viewed these as obstacles.
03Decisions by attending physicians prevailed over women's choices and team opinions due to hierarchy and civil responsibility concerns.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was limited to a single teaching hospital in western Paraná, so findings may not apply to other settings. Data collection occurred during the early stages of the pandemic (December 2019 to October 2020), which may have influenced hospital routines and patient interactions. Participants were selected by convenience, and all agreed to participate, which may introduce selection bias.
Declared interests
The study was funded by the National Council for Scientific and Technological Development (CNPq) in Brazil. No conflicts of interest were declared by the authors.
The easy way to misread this
Do not interpret the nurses' advocacy as evidence that their practices improved clinical outcomes. This qualitative study describes perceptions and conflicts within the care team, not the effectiveness of the interventions on maternal or neonatal health.