State Hospitals Reinforce the Essence of Maternity Through Natural Births
Like most healthy babies, little Aimê Eloá announced her arrival into the world two weeks ago with a strong cry and open arms of a victor. After all, unlike most Brazilian babies born in the private health network, Aimê's mother chose to have her daughter through a natural birth.
With her face pressed against her newborn daughter’s, Paula Batista, 24, sealed the bond that worked. After 8 hours of labor, she was experiencing the emotion of motherhood in its fullness. “When I felt the strong contractions, the nurse made me feel like I was in my mother’s arms. They made me feel comfortable to scream, and when I thought about giving up because of the pain, they wouldn’t let me. I can only thank for all the dedication and care of this wonderful medical team. It’s an experience I will carry for the rest of my life,” said the new mom, emotionally.
During the laborious delivery, Paula heard her baby’s heartbeat, received back massages, warm compresses, and many hugs. All this in a climate-controlled environment while listening to soft music. In the neighboring delivery room, Érika Vieira, 21, was waiting for her first child alongside her husband and a nurse who, while caressing her hands, helped her make movements that would facilitate the baby’s passage. “This should be offered in all hospitals. Despite the pain, I am quite calm. I always wanted to have a natural birth, to feel closer to my child and his father and to have a quicker recovery,” said the future mother.
Reference - This is the reality for mothers in the public health network who decide to give birth at the Gaspar Viana Clinical Hospital, one of the state’s references in humanized childbirth. The encouragement of this type of birth was one of the measures taken by the Ministry of Health to improve the quality of care for pregnant women and humanize childbirth in the country. The ordinance regulates Law 11.108, from April 2005. Since then, pregnant women served by the Unified Health System (SUS) have gained the right to choose someone they trust among friends and relatives to be present in the delivery room and also in the postpartum period.
The Obstetric Center of the Clinical Hospital was inaugurated in 2011, after careful clinical structuring work. The 2005 ordinance from the Ministry of Health highlighted the need to reduce infant mortality rates, part of the Millennium Pact to reduce maternal and infant mortality. At the beginning of the implementation in 2009, the HC received a team from the Ministry of Health, which showed the structural norms for humanized childbirth. They underwent almost a year of infrastructure adaptation, and a multidisciplinary committee was formed, which visited references in humanized childbirth across Brazil, such as the Sofia Feldman maternity hospital in Belo Horizonte. Upon returning, they conducted training for the other members in a one-week course.
R$ 141,000 was invested in the construction of the HC obstetric center, resources from the State Department of Public Health (Sespa) and the State and National Health Funds. The team that works in the four humanized delivery rooms consists of 14 obstetricians, 12 neonatologists, one psychologist, two social workers, anesthetists, seven nurses, and 15 nursing technicians, who also perform other activities in the Obstetric Center.
A Matter of Choice - As soon as the mother enters the hospital, she is not just another number attended by the medical staff. She is a woman who has the right to choose between a normal birth and a cesarean section, and in both cases, she receives all the care given to humanized childbirth. But for the professionals working in the obstetric centers of public hospitals in Pará, the differences go far beyond the procedures. “At the time of a humanized normal birth outcome, the energy is different, the environment changes completely. It’s totally different from the normal births of the past where we only heard screams. Patients look at me crying in pain, sometimes begging to give up, but we encourage them to go all the way. Here, everyone, from the janitor, is trained to answer questions and support mothers in labor,” said Layses Braga, a physician in the Obstetric Clinic and head of the good practices committee for humanized childbirth during its implementation in 2011.
For women with low pain tolerance, methods such as acupuncture and epidural anesthesia are used, but before receiving any medicinal practice, all natural methods are tested.
Humanized childbirth is offered to any woman who wishes to have her child through natural birth, even those with private health insurance. To clarify all doubts about humanized labor and guide future mothers on the care and procedures while waiting for the special day, a team is available for pregnant women and their families at the Clinical Hospital every Tuesday, Wednesday, and Thursday, starting at 2 PM. No appointment is necessary. “Here it’s SUS, everyone is treated equally, just knock on the door and you will have your natural birth, with all the necessary care,” emphasizes the doctor.
It was through these visits that businesswoman Paula Oliveira, 25, fell in love with the structure offered by the Clinical Hospital. She always wanted to have her first child through natural birth and had prenatal care with a private doctor. But as soon as she got to know the HC, she gave up paying for a hospital and decided that this would be the place where little Guilhermina, now 4 months old, would come into the world. During the 17 hours of labor, the mother had unrestricted medical and psychological support. “My mother got very nervous and couldn’t accompany me during the delivery. She stayed in a room next door, with all the support from professionals, while I had my daughter, surrounded by care and affection. It was a wonderful experience that I now pass on in encouraging other mothers to do the same,” said Paula.
According to data from the Ministry of Health, Brazil is one of the countries that perform the most cesarean sections. In the private network, 95% of births occur through surgery, while in the public network, the rate drops to less than half, around 45%. Seeing women opting for state hospitals at the time of delivery makes Sespa confident that it is on the right track. “The change in the model of childbirth assistance is fundamental for the evolution of humanity as a whole. Recent national research shows that one in four women suffer obstetric violence. This change has positively influenced women who have been avoiding cesarean sections without criteria, for other random reasons, such as convenience or the condition of the system itself,” said Ana Guzzo, state coordinator of child health at Sespa.
The Advantages - Doctors emphasize that labor is fundamental for the development of children’s lungs. Contractions release substances that help in the maturation of the baby’s lungs and stimulate sucking movements, improving the quality of breastfeeding.
Since most of the time the date of the cesarean section is set based only on the conveniences of the doctor and the mother, regardless of the onset of labor, many children are born without fully developed lungs. The benefits also extend to the mother. “From recovery time to the risks that the patient faces in natural childbirth, they are much lower than in surgical delivery. Birth is a physiological process; the less intervention that occurs, the greater the recovery of the patient,” highlights Diego Lobão, an on-call doctor in the obstetric sector of the Santa Casa de Misericórdia Foundation of Pará, which is also a reference in humanized childbirth in the state.
Investments - Pará currently has 11 “Child-Friendly” hospitals, with an international proposal to promote breastfeeding and encourage humanized childbirth. With resources from the Ministry of Health invested in the Cegonha Network, in the care of mothers and their newborns, Sespa, through the state coordination of child health, has also been investing in the qualification of its professionals. In 2016 alone, nearly R$ 55,000 was spent on training health professionals for children and women.
This year, there is a forecast for the “Paraense Woman” project, with an investment of R$ 100,000, to act in the qualification of servers in various health regions of the state. The action aims to improve prenatal care, reduce maternal mortality, and assist in reproductive planning.
With investments in structure and qualification, and the engagement of professionals who celebrate each natural birth, public health in Pará is making great strides. This and the upcoming Mother’s Days will be celebrated with the certainty of making motherhood an act of love for humanity.
