Non-invasive technologies of obstetric nursing care: repercussions on the newborn vitality

Background: in Brazil, the adoption of the medicalized technocratic model that includes the routine practice of invasive procedures such as episiotomy, amniotomy, exogenous oxytocin infusion or analgesia, and as consequence,... [ view full abstract ]

Background: in Brazil, the adoption of the medicalized technocratic model that includes the routine practice of invasive procedures such as episiotomy, amniotomy, exogenous oxytocin infusion or analgesia, and as consequence, a high rate of cesarean section, is dominant in maternity care. Brazilian obstetric nurses, in opposition to this model, decided for adopting a demedicalized perspective. They prioritize the use of non-invasive obstetric nursing care technologies (TNICEO), whose characteristics reinforce the non-invasion of physiology in childbirth, the protagonism and autonomy of women. There are few studies on this topic and most of them do not approach, in a comparative perspective, the impact on the newborn vitality. Objective: To compare the association between the Apgar Score at first and fifth minutes of newborns’ life (NB) whose mothers used at least one of the TNICEO during labour with those whose mothers used only traditional care (TC) or who used the combination of TNICEO and TC. Methods: Descriptive, cross - sectional, retrospective study performed at a governmental Maternity Hospital in Rio de Janeiro, Brazil. The sample consisted of 6,790 parturients, who had the vaginal birth accompanied by obstetric nurses between September 2004 and December 2011. Logistic regression models were used to assess the odds ratio of TNICEO exposure in order to contribute to an Apgar Score over than 8 in the first and fifth minutes of life, when compared to other types of care. Results: neonates whose mothers used at least one TNICEO presented higher percentages of Apgar Score over than 8, in the first minute (93.41%) as well as in the fifth minute of life, (99.01%), when compared to the Apgar Score of the newborns whose mothers were submitted to some procedure related to TC (82.78%) and (94.74%) respectively. Conclusion: The odds ratio of Apgar Score over than 8 in the first and fifth minutes of life is increased in favor of the group that used only TNICEO.