The experience of obstetric nursing students in an innovative maternal care programme in Chiapas, Mexico: a qualitative study

Abstract In Mexico, over the last decade, more non-physician medical professionals have been participating in birth care according to recent federal regulations. So far, very few sites have been able to implement birth care models where midwives and obstetric nurses participate. We describe the experience of a group of intern obstetric nurses participating in a model that provides respectful birth care to rural populations, managed by an international NGO in partnership with the Ministry of Health of Chiapas, Mexico. We conducted a case study including individual interviews and focus group discussions with obstetric nurse interns participating in the Compañeros En Salud programme over four years from 2016 to 2019. We applied targeted content analysis to the qualitative data. There were 28 participants from 4 groups of interns. Informants expressed their opinions in four areas: (a) training as a LEO, (b) training experience at CES, (c) LEO role in health care delivery; and (d) LEOs' perspectives about respectful maternity care. Interns identified gaps in their training including a higher load of theoretical content vs practical experience, as well as little supervision of clinical care in public hospitals. Their adaptation to the health services model has increased over time, and recent classes acknowledge the difficulties that earlier ones had to confront, including the challenging interactions with hospital staff. Interns have incorporated the value of respectful birth care and their role to protect this right in rural populations. Findings could be useful to call for the expansion of the model in public birth centres.

[1]  Martha Lilia Bernal Becerril,et al.  Servicio social foráneo: Vivencias de pasantes de enfermería en el cuidado obstétrico , 2020 .

[2]  R. Castro,et al.  Hierarchy systems of the medical field in Mexico: a sociological analysis. , 2020, Ciencia & saude coletiva.

[3]  G. Nigenda,et al.  Interprofessional training for the delivery of community health services in Mexico: the experience of Partners in Health , 2019, Journal of interprofessional care.

[4]  S. Cassiani,et al.  Ampliación del rol de las enfermeras y enfermeros en la atención primaria de salud: el caso de Brasil , 2019 .

[5]  Greg Guest,et al.  Comparing focus groups and individual interviews: findings from a randomized study , 2017 .

[6]  Christine Nadel,et al.  Case Study Research Design And Methods , 2016 .

[7]  D. Devane,et al.  Midwife-led continuity models versus other models of care for childbearing women. , 2016, The Cochrane database of systematic reviews.

[8]  L. Demaria,et al.  Are all skilled birth attendants created equal? A cluster randomised controlled study of non-physician based obstetric care in primary health care clinics in Mexico. , 2013, Midwifery.

[9]  Gustavo Nigenda Servicio social en medicina en México. Una reforma urgente y posible , 2013 .

[10]  G. Nigenda [Social service in medicine in Mexico: an urgent and possible reform]. , 2013, Salud publica de Mexico.

[11]  L. Campero,et al.  Non-physician providers of obstetric care in Mexico: Perspectives of physicians, obstetric nurses and professional midwives , 2012, Human Resources for Health.

[12]  L. Campero,et al.  Educating Skilled Birth Attendants in Mexico: Do the Curricula Meet International Confederation of Midwives Standards? , 2007, Reproductive health matters.

[13]  Hsiu-Fang Hsieh,et al.  Three Approaches to Qualitative Content Analysis , 2005, Qualitative health research.

[14]  Roseni Rosângela de Sena,et al.  El significado de la especialización en enfermería obstétrica desde la perspectiva de algunas egresadas del curso: relato de una experiencia , 2005 .

[15]  W. Kurdi Pregnancy, Childbirth, Postpartul and Newborn Care: A Guide to Essential Practice , 2005, Annals of Saudi Medicine.

[16]  T. Umenai,et al.  Conference agreement on the definition of humanization and humanized care , 2001, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[17]  A. M. Carrillo Nacimiento y muerte de una profesión : las parteras tituladas en México , 1999 .