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Meaning of the labor process: Significado del trabajo de parto: Education and training of nurses on all aspects of the labor process promote quality care to women in labor.
Symbolic Interactionism served as the theoretical framework for this qualitative study. Data collection consisted of participant observation and unstructured interviews. Labor was perceived as a symbol of pain, anguish, fear, and anxiety. The meaning of the labor process was to witness the physical and emotional suffering of women in labor. Nursing student experience in providing care during the labor process made the teaching-learning plan broader and suggested new perspectives to attend women in labor needs.
Obstetrical nursing; Labor, Obstetric; Students, nursing; Teaching. The millenary practice of supporting women during pregnancy, labor and their newborns until the end of the 18th century was performed basically by women, with the exception of some indigenous communities where husbands also helped 1.
This practice passed from mothers to daughters and gave origin to midwives. With the coming of Obstetrics formally in the academy, in the middle of the 19th century, empirical care provided by women lost its space 2. In the 20 th century, after the World War II, deliveries started to be carried out in hospitals to reduce maternal-children mortality. In the 60’s in Brazil retirement and pension institutes were united and the fund for Social Welfare was created by the federal government, which allowed the construction and expansion of the public and private hospital network 3.
The national health policy started to increasingly support hospital birth. Inthe Program for Total Women Health Care encompassed women’s health in the pregnancy and postpartum period, high risk pregnancy prevention and also offered greater safety in hospital birth. This proposal aimed at integral health care establishing levels for referral and counter-referral 4.
However, there were expressive advances in health, especially inwith the movement of the Sanitary Reform and inwith the creation of the Constitutional Letter.
One of the main advances was the institution of the prenatal care ensuring essential obstetric care to reduce the rate of maternal and perinatal morbidity and mortality 6. According to the recommendations of the World Health Organization 7in normal birth there must be a valid reason to intervene in the natural process.
Care objective is for mothers and infants to be healthy, ensuring safety with the lowest level of intervention 7. Childbirth can be seen as distressful by women since from the time they are admitted to the maternity they no longer have control of the situation, everything is unpredictable and unfamiliar. Women need health professionals to be close and understanding, especially nurses 8. Based on this aspect, the authors are concerned with the education of new nurses that can assist women during labor and birth.
The teaching-learning process goes through understanding of what it is, how to, and what to do to offer the best care for women in labor. Qualitative research, based on the perspective of Symbolic Interactionism, was chosen to understand the meaning of labor and birth for nursing students; this was done because we believed it is a guiding axis to understand the meaning of the study object. The origin of Symbolic Interactionism is derived from Pragmatism, it started in the United States and England in the end of the 19th century.
Several thinkers have contributed to its formation, the following are among them: In the theoretical-methodological design, Herbert Blumer coined the expression Symbolic Interactionism and described its perspective and method supported by the six interacvionismo images and three basic premises 9. For the present study, the premises from Symbolic Interactionism were adjusted according to the study objective. Thus, we have considered that: Data collection was carried out in two stages: Participative observation occurred through the direct participation of one of the researchers with the ibteraccionismo observed, to obtain information on the reality of students involved in the context of pre-labor and birth The importance of this technique is in the fact that it can capture several situations or phenomena that cannot be obtained with questions and answers.
The student directly observed through the reality talked about what was most unpredictable and evasive in real life The second stage was an open interview with 20 students taking part in the study based on the following guiding question: Furthermore, interviews were used to complement the understanding of the data obtained through observation.
The interview is not only a data collection technique, but rather a social interaction between two people, the interviewer and the interviewee, to obtain information Therefore, it is important to have a harmonic contact with informants Data have been examined interacionismo to content analysis 11more specifically, according to thematic analysis.
This was carried out in three phases: To ensure informants’ anonymity, we have used fictitious names. Interaccionisom nursing students with ages ranging from 21 to 26 years old took part in the study, 18 were females.
George Mead – definition of George Mead by The Free Dictionary
Among women, two were mothers, one had a normal delivery and the other had undergone a Cesarean section. Before they took the discipline, most these blumet 18 had already heard of labor and child birth, especially on TV documentaries and filmsthrough stories of mothers and friends that had undergone labor which were the most important source to know about the issue. Therefore, students’ previous experiences were essential to consider labor significant or not to for their teaching-learning process.
Thus, in their statements, students expressed surprise about the physiologic condition of laboring women, because they did not know how labor developed. When they were near women in labor, nursing students act according to the meaning labor has to them and this meaning is made from the interactions each student has with their world thorough their lives, that is, what they have heard from their mothers, relatives, and the media, among others.
Thus, when they see women in labor, students always refer to the painful process that makes women suffer as we can see by the following statements. Labor for some women takes long, making them suffer even more. Also because they want to see the baby’s face, to see who it looks like. It is all the suffering, the pain, the contractions DUDA. It is very painful, very distressful for patients; they cry a lot, sweat, get restless and cannot relax SUZY.
Interaccioniamo meanings are formed by feelings, behaviors, and attitudes so that for the individuals of the study, the meaning of labor is directly connected with the painful process when laboring women express feelings of anguish, fear, pain, anxiety, incapacity, and even happiness.
George Herbert Mead
Supporting women in labor, in nursing students’ point of view means physical pain characterized by uterine activity to dilate cervix. Students that support laboring women describe pain as a complex and subjective phenomenon. It is filled with sensations and emotions resulting from their interactions with reality so that the meaning students give to labor is a dynamic and progressive phenomenon resulting from learning and from the context experienced.
That pain, everybody talks about that pain. I believe that women should not have to undergo all this suffering I believe many women, even ourselves, we have too many fantasies, we are apprehensive about labor. A difficult and painful time that will make women cry, feel pain, and we may have different reactions NICE.
Triggering labor does not concern only one factor, but rather it is a multi-causal event.
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Students start to recognize physical suffering related to it because of dilation which is considered as a natural process, however, students fear complications that can occur during labor. I understand that it is a normal, physiological process and that it will happen if there are one thousand people or not. It has to happen, it will evolve and if there is any problem, a solution will be looked for. For me it is a very special moment because there are doubts and questions to mothers.
The phenomenon of child birth involves concerns related to birth. Characterized by unpredictability, labor and child birth can be experienced with pain and possibility of risks and worsening of the physical state of mother and babies. This can be corroborated by statements nlumer students from the present study, because they believe both laboring women and themselves suffer emotionally when there is a threat to biological integrity, characterized by the irreversible state of women in a vulnerable position interaccioismo to child birth.
When they face an unknown and threatening situation, although they have theoretical knowledge, students demonstrate fear and anxiety because they are uncertain about what may happen normal child birth, forceps or Cesarean section. Laboring women, either primiparous or multiparous, fear labor when it occurs, bulmer demonstrated by the following statements. Labor causes a lot of anxiety, especially when it is the first child, because you know Women are very fragile, they need attention, they feel anxious, they are in pain, it is a unique moment for them REGINA.
Labor is a natural process, but, at the same time, it is not seen this way. Almost all women get scared, it was a very beautiful experience, I was very anxious ANE. Based on the statements of informants, we learned about the meaning of labor and child birth to students, and we realized their concern is directly related to child birth even though they have to support labor.
During care for women in labor, even though they considered supporting laboring women important, many times they were taken aback and scarred because they did not feel confident to perform any procedure. They had an elusive, apprehensive, and quiet behavior. Through intraccionismo convergence of symbols of labor and simbolici birth for nursing students, it is clear that feelings, behaviors, and attitudes regarding labor and child birth have to do with pain, anguish, fear and anxiety, so that the meaning built by students is that supporting women in labor and child birth is to witness the physical and emotional pain experienced by laboring women.
Data presented here show that informants were mostly young females which characterizes the nursing undergraduate students whose knowledge on labor and child birth before taking the discipline Women’s Health was limited to television documentaries and moviesand to the stories of close people such as mothers and friends that had delivered a baby.
As researchers, we were able to live with students at the Centro de Parto Normal Normal Child Birth Centerinteracting with them during obstetric practice to understand better the meaning they give to labor and child birth. Before child birth, women have to experience labor which is characterized by three stages early, active and transitionstarting with uterine activity and progressively continuing with cervix dilation and effacement, allowing for proper development of labor.
Labor is the most significant and dramatic stage for women and their families. It represents a set of physiological phenomenon occurring in a certain period with the purpose of dilating the cervix to prepare the birth canal for the passage of the fetus.
These physiological phenomena are characterized by the presence of contractions with growing intensity that leads to cervical effacement, its progressive dilation, fetal presentation, and fetal expulsion Therefore, nursing students need to understand the clinical study of labor to be closer to this moment that is as important as child birth interraccionismo.
Students, however, experience a paradox regarding their interest to know. At the same time they want to witness child birth, which is the miracle of life, they are not interested in observing the phenomenon that occurs to women during labor, which is a unique moment that is as significant as delivery.
Based on these premises intfraccionismoit is clear that nursing students act according to the meaning labor has to them 9and this meaning was created based on students’ interactions with their world of objects.
Thus, everything they have heard from their mothers, relatives, communication media, etc was important to form this meaning. So the meaning of labor refers to a painful process that makes women suffer.
Because meanings are formed by feelings, behaviors, and attitudes, students assimilate the feelings expressed by laboring women that go from anguish, fear, pain, anxiety, incapacity, and even happiness. As the painful phenomenon of labor is complex, its interpretation should not be simplified. Pain in child birth resulted from several interactions with exciting and inhibiting features, and although they are similar to the mechanism of acute bpumer, there are other specific factors with an obstetric, neurophysiologic, psychological and sociological nature All human beings have a subjective idea of what the labor and child birth pain is.
This is many times directly related to pain, suffering, and anguish. Labor pain is expected by women since childhood; labor is considered as something painful and dangerous, thus creating a type of conditioned reflex between the onset of labor and the beginning of pain Labor is a natural and physiologic process although it is frequently associated with a time of deep concern dimbolico those experiencing it, and for those around them, as it is considered a difficult and painful time.
Regardless of the physiologic process, the way women and relatives face labor is related with the way they were socialized with the labor process