Aleitamento materno: percepção de enfermeiras sobre a vivência da assistência oferecida no puerpério imediato

Abstract

Breastfeeding brings many benefits to the mother and child binomial and its success may be related to the experiences lived in the immediate puerperium. It is in this period that some obstacles arise and interfere with the correct practice of breastfeeding, which makes it a favorable time to provide nursing care that seeks to implement actions to promote, protect and encourage the practice of breastfeeding. The aim of this study was to understand the nurses' perception of the experience of assistance offered to breastfeeding in the immediate puerperium; and, to describe this experience through these professionals’ speeches. This is a research with a qualitative approach, supported by Ethnography. The method of choice was Ethnonursing, presented by the Theory of Diversity and Universality of Cultural Care by Madeleine Leininger and the Medical Anthropology referential was used. The following inclusion criteria were adopted: being a nurse who develops care practices related to women in the immediate puerperium, working in the maternity ward of a hospital located in the south of Minas Gerais. This study was approved with the number 3,398,381 and took into account ethical principles, guaranteeing the anonymity of the collaborators, by signing the Informed Consent Form. Data collection started in September 2019 and ended in January 2020. It was carried out through participant observation, field notebook, workshops and semi-structured interviews, with the following guiding questions: Tell me how do you see breastfeeding in the immediate puerperium? Tell me about your practice in relation to breastfeeding? The Participant Observation lasted two months along with the elaboration of the field notebook, where Observation Notes; Theoretical Notes; Methodological Notes and Personal Notes were grouped. The workshops were held during the months of November and December 2019, for a total of two months. Three 50-minute meetings were held with the nurses, with each meeting having a specific workshop. Seven nurses participated in the research and formed the cultural group called “Belas Flores”. The narratives transcribed from the interviews were categorized in a process that required systematization of the data. Reading the narratives showed the movement of the speeches that intertwined vital tones, concepts and attitudes of the collaborators. Thematic analysis of the data resulted in eight categories: Breastfeeding and benefits; Normal childbirth helps! Cesarean delivery gets in the way! The latter category was divided into two subcategories: Cesarean section and breastfeeding: difficulties with surgery; Normal delivery and breastfeeding; Practice in breastfeeding assistance, which was divided into three subcategories: Lack of practice and incentives make assistance difficult; Nurse and also mother: personal experience in breastfeeding; and, Professional practice in breastfeeding assistance; Prenatal care and hospital care; Guidelines; Breastfeeding in the immediate puerperium; Difficulties faced during breastfeeding and Perception of the importance of the role of nursing. Nursing care is part of the experience of the collaborators in this study and involves all perceptions about the practice of breastfeeding. In view of the context found, this study points out that nurses, despite having practice and knowledge, realize that nursing care is still deficient, pointing out many barriers that hinder the practice of breastfeeding. As a result, changes are necessary in order to strengthen and enhance this practice.