Table 1 Thematic coding tree
Incorporation of care practices | Adaptation of the care practices | Rejection of care practices |
|---|---|---|
Information, communication and education | Cesarean | Kristeller Maneuver |
Women empowerment information | Elective cesareans over 39 weeks | Practice abolished |
Information received by the prenatalist | Clinical justification for the indication of elective cesarean sections | Performed when “necessary” |
Information during the maternity tour | Informed Consent Form for cesarean section | Performed, consented to and/or when requested by the woman |
Information through the construction of the birth plan | Cesarean at maternal request/desire | |
Information received through social media | Indication of cesarean section due to maternal or fetal risk | |
Information during labor and delivery | Specific medical teams to perform cesarean/vaginal delivery | |
Professional approach to providing information | Absolute indications for cesarean section | |
Use of non-pharmacological pain relief methods | There were no changes in the criteria for cesarean section indications | |
Squat | Induction of labor | |
Therapy bath | Induction of labor, rather than indicating cesarean section | |
Swiss ball | Use of Bishop’s index, misoprostol, oxytocin and amniotomy | |
Birth stool | Oxytocin | |
Walk | Used with discretion | |
“Cavalinho” in childbirth | Used by most women | |
Professional interaction with the woman during the use of the methods | Used to induce labor | |
Skin-to-skin contact and breastfeeding | Used to treat postpartum hemorrhage | |
Skin-to-skin contact during cesarean section | There was no change in the indication of oxytocin | |
Immediate postpartum breastfeeding | Episiotomy | |
Partogram | Practice not performed | |
Influence of the partogram on care practice | Perform episiotomy, but selectively | |
Partogram update/adaptation needed | Modified episiotomy amount but not because of PPA | |
Courses for pregnant women with guided visits to maternity hospitals | There is still resistance to changing practice | |
Environment to acquire information | ||
PPA dissemination environment | ||
Integration with prenatal care | ||
Visit and course conducted by the professional nurse | ||
Number and duration of courses and visits | ||
Birth plan | ||
Instrument for providing information | ||
Instrument that favors previously constructed choices | ||
Professional approach and respect for the birth plan | ||
Diet during labor | ||
Bland diet release | ||
Insertion of doulas | ||
Unknown of the concept “doulas” | ||
The doula hired by the woman (no link with the health institution) | ||
Presence of companion | ||
The woman is more comfortable | ||
Analgesia for vaginal delivery | ||
Decision on the use of analgesia | ||
Anesthetist availability | ||
Indication of analgesia based on cervical dilation | ||
Creation of a protocol for labor analgesia | ||
Limitations in the evolution of labor after the use of analgesia for vaginal delivery |