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Programas de preparação para o parto e parentalidade : Protocolo de scoping review
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Enquadramento: A prática de exercício físico durante a gravidez é amplamente recomendada pelas principais entidades internacionais, pelos seus benefícios na saúde materno-fetal. No contexto da educação pré-natal, os programas de preparação para o parto e parentalidade (PPPP) constituem uma estratégia central de promoção da saúde, podendo integrar componentes como atividade física, educação e apoio psicossocial. Contudo, verifica-se heterogeneidade na sua implementação e lacunas na sistematização da evidência, particularmente no que respeita à integração do exercício físico e critérios clínicos associados. Igualmente, os estágios realizados contribuíram para o desenvolvimento de conhecimentos teórico-práticos, para obtenção do título de especialista e grau de mestre em Mestrado em Enfermagem de Saúde Materna e Obstétrica, culminando com o desenvolvimento de competências comuns e específicas.
Objetivos: Evidenciar o processo de aquisição, desenvolvimento e consolidação das competências do Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica (EEESMO) e mapear a evidência científica disponível sobre os PPPP, identificando: (i) as tipologias de atividade física incluídas; (ii) as indicações e contraindicações clínicas para a sua implementação; (iii) os profissionais de saúde responsáveis pelo desenho e implementação destes programas.
Metodologia: Este relatório final encontra-se estruturado em duas partes principais. A primeira parte apresenta a contextualização de cada ensino clínico, seguida de uma reflexão crítica sobre as atividades desenvolvidas, articuladas com as competências comuns e específicas do EEESMO, tendo por base o perfil das competências do EEESMO e os padrões de qualidade em Enfermagem de Saúde Materna e Obstétrica, da Ordem dos Enfermeiros. A segunda parte é dedicada à investigação, consistindo numa scoping review, com uma pesquisa realizada em múltiplas bases de dados, sem restrição temporal ou
linguística. A seleção dos estudos foi efetuada por dois revisores independentes, seguindo critérios de inclusão definidos. Foram incluídos 10 estudos com diferentes desenhos metodológicos. Resultados: Os estágios em contexto de Ginecologia, Puerpério, Sala de Partos, Patologia da Gravidez e Vigilância da Gravidez, permitiram o desenvolvimento de competências gerais e especificas, fundamentais à prática profissional especializada, possibilitando não
apenas a aplicação dos conhecimentos teóricos adquiridos, mas também, a assimilação de novas aprendizagens, fomentando uma prestação de cuidados de enfermagem integrada e de qualidade. Deu-se também cumprimento às experiências mínimas legalmente exigidas. A componente de investigação revelou-se igualmente crucial, uma vez que os PPPP apresentaram elevada heterogeneidade em termos de estrutura, conteúdos e modalidades de
implementação. Os programas abordaram múltiplas dimensões da preparação para a parentalidade, incluindo educação para a saúde, preparação para o parto, cuidados ao recém-nascido, amamentação e bem-estar psicológico. Alguns programas integraram atividade física, relaxamento e preparação corporal, evidenciando benefícios como redução da ansiedade, melhoria do autocontrolo no trabalho de parto e melhores desfechos maternos e neonatais. No entanto, a atividade física não surge como componente central na maioria dos programas. As indicações e contraindicações clínicas foram pouco descritas, sendo identificada escassez de critérios de segurança. Os programas são predominantemente implementados por profissionais de saúde, com destaque para os enfermeiros especialistas em saúde materna e obstétrica, frequentemente em articulação multidisciplinar. Conclusões: Os estágios permitiram o desenvolvimento e a consolidação de competências gerais e específicas do EEESMO a, com impacto direto na qualidade e segurança dos
cuidados prestados. Os PPPP apresentam potencial significativo na promoção da saúde materna e neonatal, contribuindo para a literacia em saúde, empowerment e adaptação à parentalidade. No entanto, a ausência de padronização, a limitada integração estruturada da atividade física e a escassez de critérios clínicos de segurança evidenciam a necessidade de desenvolvimento de programas mais sistematizados e baseados na evidência. Destaca-se o papel do EEESMO na conceção e implementação destes programas, reforçando a importância da sua atuação na promoção de intervenções seguras, consistentes e centradas na mulher. Palavras-chave: Programa de Preparação para o parto; Parentalidade; Gravidez; Exercício físico; Educação pré-natal; Scoping review.
Abstract Background: The practice of physical exercise during pregnancy is widely recommended by major international organizations due to its benefits for maternal-fetal health. In the context of prenatal education, childbirth and parenting preparation programs constitute a central health promotion strategy, potentially integrating components such as physical activity, education, and psychosocial support. However, there is heterogeneity in their implementation and gaps in the systematization of evidence, particularly regarding the integration of physical exercise and associated clinical criteria. Likewise, the clinical placements contributed to the development of theoretical and practical knowledge, leading to the attainment of the specialist title and master’s degree in the Master’s Program in Maternal and Obstetric Health Nursing, culminating in the development of both common and specific competencies. Objectives: To demonstrate the process of acquisition, development, and consolidation of competencies of the midwife and to map the available scientific evidence on childbirth and parenting preparation programs, identifying: (i) the types of physical activity included; (ii) the clinical indications and contraindications for their implementation; (iii) the healthcare professionals responsible for the design and implementation of these programs. Methodology: This final report is structured into two main parts. The first part presents the contextualization of each clinical placement, followed by a critical reflection on the activities developed, articulated with the common and specific competencies of the midwife, based on the competency profile of the Specialist Nurse in Maternal and Obstetric Health Nursing and the quality standards in Maternal and Obstetric Health Nursing, from the Order of Nurses. The second part is dedicated to research, consisting of a scoping review, with a search conducted across multiple databases, without time or language restrictions. The selection of studies was carried out by two independent reviewers, following defined inclusion criteria. A total of 10 studies with different methodological designs were included. Results: The clinical placements in the contexts of Gynecology, Puerperium, Delivery Room, Pregnancy Pathology, and Antenatal Care enabled the development of general and specific competencies essential to specialized professional practice, allowing not only the application of acquired theoretical knowledge but also the assimilation of new learning, fostering the provision of integrated and high-quality nursing care. The legally required minimum experiences were also fulfilled. The research component proved equally crucial, as childbirth and parenting preparation programs showed high heterogeneity in terms of structure, content, and implementation modalities. The programs addressed multiple dimensions of preparation for parenthood, including health education, childbirth preparation, newborn care, breastfeeding, and psychological well-being. Some programs incorporated physical activity, relaxation, and body preparation, showing benefits such as reduced anxiety, improved self-control during labor, and better maternal and neonatal outcomes. However, physical activity does not emerge as a central component in most programs. Clinical indications and contraindications were poorly described, with a lack of identified safety criteria. The programs are predominantly implemented by healthcare professionals, particularly midwives, often within a multidisciplinary framework. Conclusions: The clinical placements enabled the development and consolidation of general and specific competencies of the midwife, with a direct impact on the quality and safety of care provided. Childbirth and parenting preparation programs show significant potential in promoting maternal and neonatal health, contributing to health literacy, empowerment, and adaptation to parenthood. However, the lack of standardization, the limited structured integration of physical activity, and the scarcity of clinical safety criteria highlight the need for the development of more systematic and evidence-based programs. The role of the midwife in the design and implementation of these programs is emphasized, reinforcing the importance of their contribution to promoting safe, consistent, and womancentered interventions. Keywords: Childbirth Preparation Program; Parenthood; Pregnancy; Physical exercise; Prenatal education; Scoping review.
Abstract Background: The practice of physical exercise during pregnancy is widely recommended by major international organizations due to its benefits for maternal-fetal health. In the context of prenatal education, childbirth and parenting preparation programs constitute a central health promotion strategy, potentially integrating components such as physical activity, education, and psychosocial support. However, there is heterogeneity in their implementation and gaps in the systematization of evidence, particularly regarding the integration of physical exercise and associated clinical criteria. Likewise, the clinical placements contributed to the development of theoretical and practical knowledge, leading to the attainment of the specialist title and master’s degree in the Master’s Program in Maternal and Obstetric Health Nursing, culminating in the development of both common and specific competencies. Objectives: To demonstrate the process of acquisition, development, and consolidation of competencies of the midwife and to map the available scientific evidence on childbirth and parenting preparation programs, identifying: (i) the types of physical activity included; (ii) the clinical indications and contraindications for their implementation; (iii) the healthcare professionals responsible for the design and implementation of these programs. Methodology: This final report is structured into two main parts. The first part presents the contextualization of each clinical placement, followed by a critical reflection on the activities developed, articulated with the common and specific competencies of the midwife, based on the competency profile of the Specialist Nurse in Maternal and Obstetric Health Nursing and the quality standards in Maternal and Obstetric Health Nursing, from the Order of Nurses. The second part is dedicated to research, consisting of a scoping review, with a search conducted across multiple databases, without time or language restrictions. The selection of studies was carried out by two independent reviewers, following defined inclusion criteria. A total of 10 studies with different methodological designs were included. Results: The clinical placements in the contexts of Gynecology, Puerperium, Delivery Room, Pregnancy Pathology, and Antenatal Care enabled the development of general and specific competencies essential to specialized professional practice, allowing not only the application of acquired theoretical knowledge but also the assimilation of new learning, fostering the provision of integrated and high-quality nursing care. The legally required minimum experiences were also fulfilled. The research component proved equally crucial, as childbirth and parenting preparation programs showed high heterogeneity in terms of structure, content, and implementation modalities. The programs addressed multiple dimensions of preparation for parenthood, including health education, childbirth preparation, newborn care, breastfeeding, and psychological well-being. Some programs incorporated physical activity, relaxation, and body preparation, showing benefits such as reduced anxiety, improved self-control during labor, and better maternal and neonatal outcomes. However, physical activity does not emerge as a central component in most programs. Clinical indications and contraindications were poorly described, with a lack of identified safety criteria. The programs are predominantly implemented by healthcare professionals, particularly midwives, often within a multidisciplinary framework. Conclusions: The clinical placements enabled the development and consolidation of general and specific competencies of the midwife, with a direct impact on the quality and safety of care provided. Childbirth and parenting preparation programs show significant potential in promoting maternal and neonatal health, contributing to health literacy, empowerment, and adaptation to parenthood. However, the lack of standardization, the limited structured integration of physical activity, and the scarcity of clinical safety criteria highlight the need for the development of more systematic and evidence-based programs. The role of the midwife in the design and implementation of these programs is emphasized, reinforcing the importance of their contribution to promoting safe, consistent, and womancentered interventions. Keywords: Childbirth Preparation Program; Parenthood; Pregnancy; Physical exercise; Prenatal education; Scoping review.
Descrição
Palavras-chave
Educação pré-natal Exercício físico Gravidez Responsabilidade parental Revisão scoping Exercise Parenting Pregnancy Prenatal education Scoping review