Determining factors of nursing care in the parturition process

Adriana Aparecida Piler, Marilene Loewen Wall, Juliane Dias Aldrighi, Silvana Regina Rossi Kissula Souza, Tatiane Herreira Trigueiro, Larissa de Oliveira Peripolli



Objective: to analyze the scientific evidence about the factors that determine Nursing care for women in the process of parturition. Method: this is a bibliographical study, type integrative, carried out in the databases CINAHL, LILACS, MEDLINE, in publications from the year 2000 to 2018. The studies were analyzed in six phases and presented in figure form and syntheses. Results: 24 studies were selected and analyzed. The common themes were organized and classified after the analysis in the categories "Professional / parturient relation: determinant factor for the care"; "Valuation / Inclusion of the companion as a determinant factor for care"; "Environmental conditions as a resource for the caring process" and "Factors based on care techniques". Conclusion: it was evidenced that other factors, besides the assistance techniques, are determinant for the Nursing care dispensed to the women in the process of birth and birth, which leads to the need of sensitization of the professionals for the involvement of these factors in the care guided in the good practices. Descriptors: Nursing Care; Obstetric Nursing; Childbirth; Humanized Birth; Labor; Review.


Objetivo: analisar as evidências científicas acerca dos fatores que determinam os cuidados de Enfermagem à mulher em processo de parturição. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa, realizada nas bases de dados CINAHL, LILACS, MEDLINE, em publicações a partir do ano 2000 até 2018. Analisaram-se os estudos em seis fases e apresentados em forma de figura e sínteses. Resultados: selecionaram-se e analisaram-se 24 estudos. Organizaram-se e classificaram-se os temas comuns após a análise nas categorias “Relação profissional/parturiente: fator determinante para o cuidar”; “Valorização/Inclusão do acompanhante como fator determinante para o cuidado”; “Condições do ambiente como recurso para o processo de cuidar” e “Fatores pautados em técnicas assistenciais”. Conclusão: evidenciou-se que outros fatores, além das técnicas assistenciais, são determinantes para o cuidado de Enfermagem dispensado às mulheres no processo de parto e nascimento, o que leva à necessidade de sensibilização dos profissionais para o envolvimento desses fatores no cuidado pautado nas boas práticas. Descritores: Cuidados de Enfermagem; Enfermagem Obstétrica; Parto; Parto Humanizado; Trabalho de Parto; Revisão.


Objetivo: analizar las evidencias científicas acerca de los factores que determinan los cuidados de Enfermería a la mujer en proceso de parto. Método: se trata de un estudio bibliográfico, tipo revisión integrativa, realizada en las bases de datos CINAHL, LILACS, MEDLINE, en publicaciones a partir del año 2000 hasta 2018. Se analizaron los estudios en seis fases y presentados en forma de figura y síntesis. Resultados: se seleccionaron y se analizaron 24 estudios. Se organizaron y clasificaron los temas comunes después del análisis en las categorías "Relación profesional / parturienta: factor determinante para el cuidar"; "Valorización / Inclusión del acompañante como factor determinante para el cuidado"; "Condiciones del ambiente como recurso para el proceso de cuidar" y "Factores pautados en técnicas asistenciales". Conclusión: se evidenció que otros factores, además de las técnicas asistenciales, son determinantes para el cuidado de Enfermería dispensado a las mujeres en el proceso de parto y nacimiento, lo que lleva a la necesidad de sensibilización de los profesionales para la implicación de esos factores en el cuidado pautado en las buenas prácticas. Descritores: Atención de Enfermería; Enfermería Obstétrica; Parto; Parto Humanizado; Trabajo de Parto; Revisíon.


Cuidados de Enfermagem; Enfermagem Obstétrica; Parto; Parto Humanizado; Trabalho de Parto; Revisão.


World Health Organization. Sexual and reproductive health. WHO recommendations: intrapartum care for a positive childbirth experience [Internet]. Geneva: WHO; 2018 [cited 2018 May 20]. Available from:

Organização Mundial de Saúde. Maternidade segura: assistência ao parto normal: um guia prático. Genebra: WHO; 1996.

Leal MC, Pereira APE, Domingues RMSM, Theme Filha MM, Dias MAB, Nakamura-Pereira M, et al. Obstetric interventions during labor and childbirth in Brazilian low-risk women. Cad Saúde Pública. 2014; 30(Suppl. 1):S1-S16. Doi:

Dahlen HG, Tracy S, Tracy M, Bisits A, Brown C, Thornton C. Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000–2008): a linked data population-based cohort study. BMJ Open. 2014 May; 4(5):e004551. Doi: 10.1136/bmjopen-2013-004551

Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2016 Apr; 4: CD004667 Doi: 10.1002/14651858.CD004667.pub5

Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it? Einstein. 2010 Jan/Mar; 8(1 Pt 1):102-6. Doi:

Ministério da Saúde (BR), Secretaria Executiva. Humanização do parto: humanização no pré-natal e nascimento [Internet]. Brasília: Ministério da Saúde; 2002 [cited 2018 Mar 17]. Available from:

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 July; 6(7):e1000097. Doi: 10.1371/journal.pmed.1000097

Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM. Evidence-based practice, step by step: Searching for the evidence. Am J Nurs. 2010 May; 110(5):41-7. Doi: 10.1097/01.NAJ.0000372071.24134.7e

Manogin TW, Bechtel GA, Rami JS. Caring behaviors by nurses: women's perceptions during childbirth. J Obstet Gynecol Neonatal Nurs. 2000 Mar/Apr; 29(2):153-7. Doi: PMID: 10750681

Chen CH, Wang SY, Chang MY. Women's perceptions of helpful and unhelpful nursing behaviors during labor: a study in Taiwan. Birth. 2001 Sept; 28(3):180-5. Doi: PMID: 11552966

Figueiredo NMA, Tyrrell MAR, Carvalho V, Leite JL. Care indicators for the body that procreates: nursing actions before, during and after delivery - a contribution to obstetrical nursing practice. Rev Latino-Am Enfermagem. 2004 Nov/Dec; 12(6):905-12. Doi:

Matthews R, Callister LC. Childbearing women's perceptions of nursing care that promotes dignity. J Obstet Gynecol Neonatal Nurs. 2004 July/Aug; 33(4):498-507. Doi: PMID: 15346675

MacKinnon K, McIntyre M, Quance M. The meaning of nurse's presence during childbirth. J Obstet Gynecol Neonatal Nurs. 2005 Jan/Feb; 34(1):28-36. Doi: 10.1177/0884217504272808

Castro JC, Clapis MJ. Humanized birth according to obstetric nurses involved in birth care. Rev Latino-Am Enfermagem. 2005 Nov/Dec; 13(6):960-7. Doi:

Rodrigues DP, Silva RM, Fernandes AFC. Interactive action nurse-client in the obstetric attendance. Rev Enferm UERJ [Internet]. 2006 Apr/June [cited 2018 Jan 31]; 14(2):232-38. Available from:

Silveira IP, Fernandes AFC. The nurse and the humaninzing approach in nursing care during labor. Rev Rene. 2006 May/Aug; 7(2):48-56. Doi:

Carraro TE, Knobel R, Radünz V, Meincke SMK, Fiewski MFC, Frello AT, et al. Care and comfort during labour and delivery: searching for women´s opinions. Texto contexto-enferm. 2006; 15(Spe):97-104. Doi:

Narchi NZ. Labor care delivered by nurses in the East Zone of the municipality of São Paulo, SP, Brazil. Rev Bras Enferm. 2009 July/Aug; 62(4):546-51. Doi:

Frello AT, Carraro TE. Nursing care components in the childbirth process. Rev eletrônica enferm [Internet]. 2010 [cited 2018 Jan 31]; 12(4):660-8. Available from:

Lobo SF, Oliveira SMJV, Schneck CA, Silva FMB, Bonadio IC, Riesco MLG. Maternal and perinatal outcomes of an alongside hospital birth center in the city of Sao Paulo, Brazil. Rev Esc Enferm USP. 2010 Sept; 44(3):800-6. Doi:

Pereira ALF, Bento AD. Autonomy in normal delivery from the perspective of women assisted in birthing center. Rev Rene. 2011 July/Sept; 12(3):471-7. Doi:

Oliveira ASS, Rodrigues DP, Guedes MVC. Perceptions of women in labor about nursing care during labor and delivery. Rev Enferm UERJ [Internet]. 2011 Apr/June [cited 2018 Jan 31];19(2):249-54. Available from:

Camacho KG, Progianti JM. The transformation of nurses’ obstetrical practice in humanized birth care. Rev eletrônica enferm. 2013 July/Sept; 15(3):648-55. Doi:

Silva ALS, Nascimento ERD, Coelho EDAC. Nurses practices to promote dignity, participation and empowerment of women in natural childbirth. Esc Anna Nery Rev Enferm. 2015 July/Sept; 19(3):424-31. Doi:

Zveiter M, Souza IEO. Solicitude constituting the care of obstetric nurses for women-giving-birth-at-the-birth-house. Esc Anna Nery Rev Enferm. 2015 Jan/Mar; 19(1):86-92. Doi:

Lucas MTB, Rocha MJF, Costa KMM, Oliveira GG, Melo JO. Nursing care during labor in a model maternity unit: cross-sectional study. Online Braz J Nurs [Internet]. 2015 Mar [cited 2018 Jan 31]; 14(1):32-40. Available from:

Reis TR, Zamberlan C, Quadros JS, Grasel JT, Moro ASS. Obstetric Nurses: contributions to the objectives of the Millennium Development Goals. Rev Gaúcha Enferm. 2015; 36(Spe):94-101. Doi:

Medeiros RMK, Teixeira RC, Nicolini AB, Alvares AS, Corrêa ACP, Martins DP. Humanized Care: insertion of obstetric nurses in a teaching hospital. Rev Bras Enferm. 2016 Nov/Dec;69(6):1091-8. Doi:

Silva U, Fernandes BM, Paes MSL, Souza MD, Duque DAA. Nursing care experienced by women during the child-birth in the humanization perspective. J Nurs UFPE Online. 2016 Apr; 10(4):1273-9. Doi:

Guida NFB, Pereira ALF, Lima GPV, Zveiter M, Araújo CLF, Moura MAV. Compliance of nursing care practices with technical recommendations for normal birth. Rev Rene. 2017 July/Aug; 18(4):543-50. Doi:

Soares YKC, Melo SSS, Guimarães TMM, Feitosa VC, Gouveia TMM. Satisfaction of puerperal women attended in a normal birth center. J Nurs UFPE Online. 2017 Nov; 11(11):4563-73. Doi:

Giantaglia FN, Garcia ESGF, Rocha LCT, Godinho MSC, Leite EPRC, Calheiros CAP. The care of nurses of an obstetric residence program under the scope of humanization. J Nurs UFPE Online. 2017 May; 11(5):1882-91. Doi:

Bohren MA, Hofmeyr G, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017 July; 7: CD003766. Doi: 10.1002/14651858.CD003766.pub6

Palinski JR, Souza SRRK, Silveira JTP, Salim NR, Gualda DMR. Women's perception of the process of labor coaching: a descriptive. Online Braz J Nurs [Internet]. 2012 [cited 2018 Mar 22];11(2):274-88. Available from:

Caus ECM, Santos EKA, Nassif AA, Monticelli M. The process of giving birth assisted by obstetrician nurse in a hospital context: mean for the parturientes. Esc Anna Nery Rev Enferm. 2012 Mar; 16(1):34-40. Doi:

Sousa AMM, Souza KV, Rezende EM, Martins EF, Campos D, Lansky S. Practices in childbirth care in maternity with inclusion of obstetric nurses in Belo Horizonte, Minas Gerais. Esc Anna Nery Rev Enferm. 2016 Apr/June; 20(2):324-31. Doi:

Ferreira LMS, Santos ADF, Ramalho RCF, Alves DA, Damasceno SS, Figueiredo MFER, et al. Nursing care during labor and delivery: the women's perception. Rev Cubana Enferm [Internet]. 2017 [cited 2018 Mar 17];33(2). Available from:

Rocha FAA, Fontenele FMC, Carvalho IR, Rodrigues IDCV, Sousa RA, Ferreira Junior AR. Care during labor and birth: mothers’ perception. Rev Rene. 2015; 16(6):782-9. Doi: 10.15253/2175-6783.2015000600003

Lei n. 11.108, de 7 de abril de 2005 (BR). Altera a Lei n. 8.080, de 19 de setembro de 1990, para garantir às parturientes o direito à presença de acompanhante durante o trabalho de parto, parto e pós-parto imediato, no âmbito do Sistema Único de Saúde – SUS. Diário Oficial da União [Internet]. 1990 Sept 19 [cited 2018 Mar 17]. Available from:

Diniz CS, d’Orsi E, Domingues RM, Torres JA, Dias MA, Schneck CA, et al. Implementation of the presence of companions during hospital admission for childbirth: data from the Birth in Brazil national survey. Cad Saúde Pública. 2014 Aug; 30(Suppl 1):S1-S14. PMID: 25167174

Ferreira AGN, Ribeiro MM, Dias LKS, Ferreira JGN, Ribeiro MA, Ximenes Neto FRG. Delivery and birth humanization: embracing the parturient from Paulo Freire’s dialogic perspective. Rev enferm UFPE on line. 2013 May; 7(5):1398-405. Doi:


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.




bvs elsevier nlm diadorim periodicaabec


cinahl citefactor cuidenplusb socolar ulrichs sumarios