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Objective: analyze the insertion of the nurse midwife in a teaching hospital in Rio de Janeiro State. Method: descriptive, exploratory study of qualitative nature, study case type, carried out in a maternity in the mountain region, with nine healthcare professionals and six managers. The data collection occurred from December 2016 to March 2017, by semi-structured interviews that subsequently transcribed and submitted to content analysis in the thematic modality. Results: difficulties were observed for the insertion of the nurse midwife such as: lack of specialist nurses in the delivery room; absence of space for the professional autonomy; political partisans influence in the health management; acting conflict with the obstetricians; no team support, mainly with regard to workers qualification. Conclusion: this study shows the need for direct insertion of the nurse midwife in delivery and birth, especially valuing humanized care and autonomy for professional practice.

The insertion of the nurse midwife in delivery and birth: obstacles in a teaching hospital in the Rio de Janeiro state