Expressões da autonomia relacional das mulheres frente ao agir de enfermeiras obstétricas na parturição

Abstract

The present dissertation had the following objectives: to describe women's perceptions about the action of obstetric nurses in the parturition process; to know the expressions of women's autonomy in relation to the action of obstetric nurses in the parturition process; to identify the interfaces between the actions of obstetrical nurses and women's satisfaction with the childbirth experience. This is a qualitative, descriptive and exploratory research carried out with 15 women, who were assisted by midwives during parturition in institutions of public services in the State of Rio de Janeiro. Data were collected from May to July 2022, through semi-structured interviews, submitted to inductive thematic analysis and discussed in the light of theoretical concepts of feminist bioethics and literature on the subject. The participants' perceptions reveal that the actions of obstetric nurses constitute a process of dignified, empowering and respectful care, fostered by relational skills, expressed in welcoming and close attitudes and demonstrations of availability, love and sensitivity, associated with actions that: transmit support , trust, affection, tranquility and security; they favor acceptance and bond building; provide a comfortable and welcoming environment; respect the privacy and participation of companions; promote women's self-confidence; ensure access to evidence-based information and practices; and provide opportunities for shared decisions, with respect to their choices. Furthermore, it was found that this action allowed the exercise of freedom and free choice by the participants, guaranteeing them the right: to the companion to be the protagonist; consent, free and informed; respect for the physiology of childbirth and bodily integrity; participation in decision-making processes; and the freedom to eat and drink fluids, move and adopt positions, express emotions and religious beliefs, and decide on the care offered, without coercion. As a result, all participants reported satisfaction with the parturition experience, although two of them experienced specific situations of disrespect in care, which seem to be related to obstetric complications that required the joint action of the nurse with the medical professional. It is concluded that the actions of the obstetrical nurses with an ethical attitude in the care relationship provided the participants' relational autonomy. By positioning themselves in this way, these specialists expressed values, affections and behaviors consistent with the feminist approach to relational autonomy, developing actions that valued the stories and life experiences of women and enabled their place of speech through symmetrical relationships and emancipatory dialogues that instrumentalized them to recognize their capacity for self-determination, understanding the contextual and interactional nature of their sense of identity and their ability to choose and act autonomously. Considering that the skills and actions manifested in this act correspond to non-invasive nursing care technologies, it is possible to infer that these technologies add a feminist-inspired bioethical dimension.