Planned home birth assistance: challenges during the COVID-19 pandemic.

Natália Webler,Luana Moura Campos,Tanila Amorim Glaeser,Telmara Menezes Couto,Lilian Conceição Guimarães De Almeida,Jordana Brock Carneiro,Margarete Costa Santos

doi:10.1590/0034-7167-2021-0083

Natália Webler, Luana Moura Campos + Show 5 more

Open Access

https://doi.org/10.1590/0034-7167-2021-0083

Copy DOI

Abstract

To understand the challenges faced by urban midwives in assisting planned home births during the COVID-19 pandemic. Qualitative study, based on the Collective Subject Discourse methodological framework, carried out with eight professionals, members of a birth care collective from the northeast region of Brazil. Data was collected between September and October of 2020 using the focus group technique. The collective discourses revealed five central ideas: Changing assistance strategy; Dealing with frustration; Facing the fear of contamination; Avoiding exposure to the virus; and Keeping distance during the care process. The challenging condition the pandemic brings to the care of planned home births is made evident, being marked by the need for collective protection and the pressure of following health recommendations. The study also points out the need for official protocols and good quality information based on scientific evidence and humanizing principles to guide health care.

Highlights

Specialized care for planned home births (PHB), despite being a viable possibility and a growing trend for childbirths in Brazil, is still an alternative available only to a few women in the country
There is a need to use full-body protective equipment during the expulsive phase, and prenatal care is alternated between face-to-face visits and online appointments
I sometimes take off my mask to eat and sleep, as I would at the hospital, at home, we have a separate space just for us, which is better than the condition in health care institutions, where there is increased risk due to the high transit of people

Summary

Introduction

Specialized care for planned home births (PHB), despite being a viable possibility and a growing trend for childbirths in Brazil, is still an alternative available only to a few women in the country This possibility is restricted to families with greater income, who can afford a private care team[1]. In the context of Brazilian public health care, only one maternity hospital has implemented this type of care (in 2013), revealing that public administration’s interest in developing policies to make this option accessible through SUS (Sistema Único de Saúde) - The Brazillian unified health care system -, is still incipient[2] This situation contrasts with the scenario found in the Netherlands and the United Kingdom, places with high rates of home births and considered worldwide as a role model for obstetrical care[3,4]. The documents mention the roles of doctors, nurses, and midwives in this care context and advises that women who choose this type of childbirth should not be discouraged, without bringing up the benefits and the importance of standardizing this modality of out-of-hospital care[5]

Methods

Results

Conclusion