Childbirth In Brazil Research Articles

How humanized birth practice became an experience connected to neoliberal philosophy

Humanized childbirth is a practice that began to be disseminated in Brazil about 20 years ago, seeking to promote natural birth, reduce unnecessary clinical interventions, and establish a more human model of childbirth. Although humanized childbirth in Brazil is an act of rescuing women’s autonomy and an act of resistance against the technological and capitalist perspective of birth, this philosophy harbors tensions and contradictions involving women as consumers, showing connections to a neoliberal idea of consumer empowerment. Considering this scenario, the present research intends to explore how the diffusion of the humanized birth practice was co-opted by the neoliberal philosophy. Conducting a 2-year netnographic study, we observe and analyze online traits on Instagram and YouTube about humanized childbirth. We shed light on social media as an important mechanism in facilitating practice engagement and practice reproduction, by presenting a framework about the practice diffusion process.

Humanized Childbirth: An Experience Report of the Assistance Offered by the Unified Health System in a City in the SouthEast of Brazil

Background: Childbirth is a crucial event in a woman’s life and her baby’s, with significant implications for the health and well-being of both. In Brazil, the predominant approach has been medicalized childbirth, with frequent medical interventions during the birthing process. However, growing evidence highlights the benefits of humanized childbirth for the physical and emotional health of the mother and baby. In this context, this study analyzes the transition towards more humanized childbirth practices in Brazil, its impacts, and associated challenges. Objectives: This study aims to analyze the implementation of humanized childbirth practices in Brazil, focusing on the stages of pregnant women reception, preparing the environment for the child’s arrival, and the symbolism of childbirth through Placenta Printing. Specific objectives include evaluating pregnant women’s satisfaction with the childbirth experience, analyzing the reduction of unnecessary medical interventions, and assessing neonatal outcomes associated with these practices. Methods: The study is an experience report that occurred in a municipal hospital in Minas Gerais, Brazil, during the year 2024. Humanized childbirths were followed through the Brazilian public healthcare system, which offers free and universal assistance to pregnant women during childbirth. The stages of pregnant women reception, preparing the environment for the child’s arrival, and the symbolism of childbirth through Placenta Printing were detailed and implemented according to established protocols. Pregnant women’s satisfaction was assessed through postpartum interviews, while data related to the rate of medical interventions and neonatal outcomes were collected and analyzed. Results: The results demonstrated high satisfaction among pregnant women with the humanized childbirth experience, highlighting empathetic reception, clear and respectful communication, and consideration of their preferences in preparing the environment and practicing Placenta Printing. Additionally, there was a significant reduction in unnecessary medical interventions, reflected in a decrease in the cesarean section rate, episiotomies, and other medical procedures during childbirth. Neonatal outcomes were also positive, with favorable neonatal adaptation indicators. Conclusion: The experience of humanized childbirth in Brazil represents a significant advancement in promoting maternal and neonatal health. Despite the challenges faced, the benefits associated with this comprehensive approach to childbirth are undeniable. It is crucial for health authorities, healthcare professionals, and society to continue supporting and promoting humanized childbirth practices as part of a broader effort to improve maternal and neonatal health outcomes in Brazil

Influence of diagnosis of gestational diabetes mellitus on fear of childbirth

IntroductionConsidering the relationship between Gestational Diabetes Mellitus and maternal and perinatal adverse outcomes, it's pertinent to investigate whether this diagnosis is a predictor of fear of childbirth. As there is little data about the fear of childbirth in Brazil, it´s necessary to understand better the population, and this way the authors can identify factors that influence this fear as well as propose public health policies to treat it. ObjectiveThe main goal was to compare the prevalence of fear of childbirth between the groups of low-risk pregnancy and gestational diabetes mellitus. Material and methodsIn this cohort study, the sample consisted of 319 patients divided into low-risk pregnancy group (n = 152) and gestational diabetes mellitus group (n = 167). Patients have undergone a semi-structured interview with epidemiological, obstetric, and anthropometric data and the main cause of fear of childbirth. In addition, the patients have marked an “X” on the scale into the Fear of Birth Scale to describe their fear. After delivery, data have been collected through electronic medical records. ResultsThe prevalence of fear of childbirth found was higher for the gestational diabetes mellitus group (46.05%) compared to the low-risk pregnancy group (34.73%) with a cutoff score ≥ 54. In the whole sample, the main cause of fear of childbirth (score ≥ 60) was the pain of labor and delivery (31.58%). ConclusionsThe prevalence of fear of childbirth in the present study was greater than 30%, highlighting the relevance of implementing this assessment during prenatal care.

Misinformation in childbirth and online exchanges: support among generational peers

The objective of this study was to investigate the role of online exchanges and the support of generational peers in childbirth. Researchers conducted a qualitative study by way of a collective case study (Stake, 2016), in which researchers analyzed 30 childbirth accounts published on personal blogs about pregnancy, childbirth, and parenthood experiences, 15 of which were written by women and 15 by men. The results pointed to a scenario of misinformation about childbirth in Brazil and the power of online sharing among generational peers in terms of a support network during the transition to parenthood and the mobilization of civil society to change the childbirth assistance situation in Brazil. Share childbirth experiences is a powerful resource of psychological support for those who are about to give birth. Researchers highlight the importance of the appropriate health agencies promoting encounters at health centers that foster sharing between pregnant persons. Researchers emphasize that there were changes in support networks during the transition to parenthood, currently leading to a search for identity references predominantly in generational peers.

PERSPECTIVAS SOBRE A HUMANIZAÇÃO DO ATENDIMENTO DE ENFERMAGEM A PARTURIENTE

The evolution of knowledge about pregnancy, associated with structural changes in social organization, caused important changes in the vision and conduct offered to parturients. The metaphysical character, postulated by the medieval Church in relation to childbirth, restricted the intervention in the parturient, especially by men, considering the process of divine character. This model lasted for centuries, but later the idea of ​​humanization became more widespread among doctors. In the twentieth century, the thinking spread by health professionals assumed that the use of forceps and narcosis humanized the process by minimizing pain and dilation-related complications. The concept of humanization of childbirth has been resignified. Currently, complete sedation and cesarean sections are no longer considered first-choice methods, being restricted only to cases that justify their use. Humanization consists in assisting the parturient in an empathic way, understanding childbirth as a human experience, subject to professional interventions that seek to act in the face of the other's suffering, without necessarily expiating it pharmacologically or promoting physical trauma in the parturient's body. Thus, this study sought to evaluate the evolution of the perception of childbirth in Brazil, as well as discuss the role of the nursing team in monitoring the pregnant woman.

Cesarean childbirth: an institutional socio-clinical study of the professional practices and discourses.

Objective:to analyze how the social, historical, economic and professional elements influence the institutionalization process of cesarean childbirth in Brazil and France.Method:a qualitative study grounded on the theoretical framework of the institutional socioclinic. The data were produced through focus groups and individual interviews, supported by semi-structured scripts, with health professionals, mothers and fathers and a research diary. The study had 83 participants. The analysis was based on the theoretical framework and thematic analysis. Cross analysis was developed between the different types of data, services and groups, as well as between countries.Results:the participants were characterized in terms of schooling, employment, level of training and workplace. The countries researched have their own peculiar health and educational structure and are marked by a social-historical-economic construction outlined by patriarchy. The New Public Management influences both contexts and makes health care precarious. The technical and organizational dimensions reinforce an intellectual and social division of work and knowledge in health.Conclusion:the institutionalization process of childbirth in the countries is marked by social, economic and professional aspects. Practices and speeches of the professionals in their work process influence the occurrence, or not, of cesarean sections.

Implementation of national childbirth guidelines in Brazil: barriers and strategies.

ABSTRACTThe present report describes the process and results obtained with a knowledge translation project developed in three stages to identify barriers to the Implementation of the National Guidelines for Normal Childbirth in Brazil, as well strategies for effective implementation. The Improving Programme Implementation through Embedded Research (iPIER) model and the Supporting Policy Relevant Reviews and Trials (SUPPORT) tools provided the methodological framework for the project. In the first stage, the quality of the Guidelines was evaluated and the barriers preventing implementation of the recommendations were identified through review of the global evidence and analysis of contributions obtained in a public consultation process. In the second stage, an evidence synthesis was used as the basis for a deliberative dialogue aimed at prioritizing the barriers identified. Finally, a second evidence synthesis was presented in a new deliberative dialogue to discuss six options to address the prioritized barriers: 1) promote the use of multifaceted interventions; 2) promote educational interventions for the adoption of guidelines; 3) perform audits and provide feedback to adjust professional practice; 4) use reminders to mediate the interaction between workers and service users; 5) enable patient-mediated interventions; and 6) engage opinion leaders to promote use of the Guidelines. The processes and results associated with each stage were documented and formulated to inform a review and update of the Guidelines and the development of an implementation plan for the recommendations. Effective implementation of the Guidelines is important for improving the care provided during labor and childbirth in Brazil.

The humanization of childbirth in Brazil as seen in the trajectories of its researchers

This qualitative research analyzes the trajectories of researchers who have produced master's and doctoral dissertations and theses on the humanization of childbirth in Brazil. The questions guiding the investigation are: How did the researchers detect the emergence of the conception of humanization of childbirth in their professional trajectories? How do these trajectories interrelate with the movement for the humanization of childbirth in Brazil? The Foucauldian theoretical framework adopted helps identify the positions occupied by the researchers in the discourse in favor of humanization, their places of utterance, and relations of knowledge and power that permeated the construction of the movement for the humanization of childbirth in Brazil.

The Senses of Birth intervention to decrease cesarean and prematurity rates in Brazil.

ObjectiveTo increase knowledge and promote cultural change toward valuing normal birth, and to lower rates of cesarean and unnecessary interventions during childbirth in Brazil via the Senses of Birth (SoB) exhibition.MethodsThe SoB intervention targeted 22 621 participants in three Brazilian cities in 2015. The effects of the exhibition in knowledge, perceptions, and preferences regarding childbirth were analyzed in a multi-method study. Pre- and post-exhibition survey responses of 17 501 (77.0%) visitors, 1947 (8.6%) non-pregnant women, and all pregnant women (n=1287) were collected at the exhibition. A follow-up survey was completed by 555 (43.0%) postpartum women who had participated at SoB while pregnant. Univariate analyses were used to compare before and after changes.ResultsThere was a significant increase in knowledge about normal birth, varying from 10.0% to 25.0% among general visitors (P<0.001) and 27.3% to 42.0% among pregnant women (P<0.001). Perceptions and preferences for normal birth also changed, reaching 83.0% of general visitors and 87.4% of pregnant women.ConclusionSoB was found to effectively improve knowledge about and preference for normal birth. Scaling-up the intervention might contribute to cultural change toward valuing normal birth, and might decrease the rate of unnecessary cesarean and premature birth in Brazil.

Annotated bibliography on the medicalization of childbirth in Brazil, 2001-2017

An annotated bibliography on the medicalization of childbirth in Brazil from 2001 to 2017. It includes articles published in Brazilian periodicals retrieved from the Scielo, Hisa, and Lilacs databases. The references from the articles are presented, followed by the authors' abstracts. The aim is to map out what was written about the medicalization of childbirth in Brazil in the period in question in order to make this scholarly output more accessible to students and researchers interested in the subject.

The transnationalization of normal childbirth in Brazil: a study of the last five decades

In recent years, changes have taken place in Brazilian obstetrics in response to the distance between the national scenario and World Health Organization recommendations and the work of organized civil society. This indicates the need for the national and international contexts to be considered. As such, the aim here is to understand the influence of transnationalism on normal childbirth in Brazil. Documental research was conducted to trace out the development of obstetrics in the country. It was found that the historical trajectory of normal childbirth in Brazil has not necessarily been restricted to national borders, but has been influenced by transnational recommendations and standards, orienting the creation of new regulations.

Medicalization of pregnancy and childbirth in the pages of Claudia, 1961-1990.

The role of the women's magazine Claudia as a pedagogic device in the medicalization of pregnancy and childbirth in Brazil is discussed. The analysis of issues from the magazine's first three decades shows how information in this field was presented and taught, articulating elements of biomedicine, technology, and consumption. Under the aegis of the supremacy of scientific rationality and politics of risk, pregnancy and childbirth were resignified and incorporated into new medical and technological regimes, which included the need for women to internalize the desire and obligation to be healthy during pregnancy and produce healthy children. Claudia translated new scientific and medical knowledge for its readers, along with new norms of motherhood, reflecting the complexity and multiple agency of medicalization.

The medicalization of childbirth in Brazil through the study of obstetrics handbooks

In this research note, I present a preliminary account of doctoral research in women's and children's health at the Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz. The aim is to study the spread of knowledge and practices relating to childbirth by analyzing obstetrics handbooks published in Brazil between 1980 and 2011, contributing to the development of childbirth care in which the woman and her needs are at the center of the decision-making process about which care, interventions, and procedures are to be dispensed during labor and childbirth.

Episiotomy from the perspective of humanized obstetrics: reflections based on social studies of science and technology

An initial analysis is made of the way obstetricians that defend the humanization of childbirth in Brazil understand and analyze the practice of episiotomy, a conventional technique included in protocols in obstetrics that they had learned in medical training and subsequently abandoned. We present an initial analytical construct through the prism of the social studies of science and technology and raise questions about the neutrality of science and technology and the impartiality of the specialist/scientist. We further point out the relationships that seem to exist between political activity, the production of scientific knowledge, and technical activities in the professional work of the aforementioned obstetricians.

Sources for the history of gynecology and obstetrics in Brazil

This article contributes to the debate about the medicalization of childbirth in Brazil through a literature review of databases of Brazilian libraries. Its main goal is to enable the systematized availability of specialized scientific publications in gynecology and obstetrics in the twentieth century, especially 1900 to 1950. In view of the importance of the analysis of journals in the development of scientific knowledge in Brazil and the importance of specialized journals in constituting and developing medical specializations, details of these archives are presented, including their location, when they were published, and where they were produced, paying particular attention to the archive in the library of the Teaching Maternity Hospital (Maternidade-Escola) of the Universidade Federal do Rio de Janeiro.

The satisfaction of the normal delivery: finding oneself.

To understand the satisfaction women experience during the normal delivery. Qualitative, exploratory and descriptive study, developed during January and February of 2017, from interviewing twenty women that were satisfied with their natural delivery, residing on the countryside of Sao Paulo. The Symbolic Interactionism and the Thematic Content Analysis support this study. The main theme "Normal delivery as a means to find oneself" developed through three thematic units that report the satisfaction in the normal delivery: "Decision for normal delivery", "Childbirth with welcoming support", "Violence: it is not all roses". The satisfaction has been correlated to the accomplishment of the dream of giving birth, welcoming support of Doulas/health professionals and the presence of a companion/family members during the process, but it also reveals labors marked by invasive, imposing and unwelcoming experiences. The empowerment granted and felt by the woman during the normal delivery experience reinforces the urgency of investments to promote sociocultural transformations that concern childbirth in Brazil.

The Language of Risk, Public Policies, and Childbirth in the Municipality of São Paulo: A Reading of Data From the Live Birth System 2010–2016

The main factor for the hospitalization of childbirth was the expansion of power-knowledge in 18th century medicine. In Brazil, throughout the 20th century, public policies for women’s health focused care on biological and reproductive dimensions, and birth control technologies. Technoscience advances in producing knowledge and interventions regarding women’s bodies led to a medicalization of labor and birth, consolidating the hospital as an ideal space. This article aims to examine numbers of surgical-cesarean births in the municipality of Sao Paulo, and to discuss how racial, cultural, social, and economic inequalities influence forms of birth. The statistics have been problematized in their connections with the language of risk, actors, and materialities involved in producing surgical births: public policies for pregnancy, labor, and post-natal care; hospitals. Research was carried out in the repository of public data on births in the municipality of Sao Paulo, in the period between 2010 and 2016, focusing on types of birth, in relation to place of birth, and women’s race/color and levels of education. The analysis indicated that the majority of births are surgical-cesarean, at a number five times higher than that recommended by the World Health Organization; the number is even higher at private hospitals and among women who declared themselves as White or Asian. Higher levels of education are also linked to this elevated number of births. Vaginal birth numbers were greater in public hospitals for women who declared themselves as Black, Mixed Race, and Native Brazilian. The language of risk guides public policies, delivery practices, and childbirth in Brazil. The lack of investment in birth centers in the country encourages hospitalization. Health professionals attending births have a central role in maintaining the culture of surgical delivery. Surgical-cesarean birth as a woman’s choice is an argument based on childbirth myths, on incorrect information about physiological and psychological processes, and lack of support from health professionals and families faced with the desire for vaginal birth. The complexity of the situation demands recognition that these realities are built on several factors, interconnected in the day-to-day of health services.

Factors associated to the type of childbirth in public and private hospitals in Brazil

Abstract Objectives: to estimate the prevalence of cesarean sections and factors associated to the type of childbirth in Brazil. Methods: data on childbirths were collected in Brazil in 2014. Demographic characteristics, related to pregnancy and birth hospital regime (public or private) were evaluation. For each hypothesis raised, the variables were modeled by the binary logistic regression, which the outcome was considered in the type of childbirth. Results: the prevalence of the cesarean sections in Brazil in 2014 was 52.8%; that is 38.1% at public hospitals and 92.8% at private ones. The association between cesarean section and the legal regime at the hospital was highlighted in the logistic model which presented a positive association and interaction between age groups (OR = 23.26; 95% CI= 13.39 - 41.79 for women between 20 and 24 years old and OR = 51.04; 95% CI 31.06 - 84.23 for women aged 35 and over). Conclusions: the performance of childbirth in Brazil meets the routines and recommendations regarding women's health and humanized childbirth established by the Brazilian National Health System policies.

"Daí você nasceu minha filha": análise discursiva crítica de uma carta ao obstetra

Neste artigo, parte de uma pesquisa mais ampla sobre a representação discursiva do parto, realizamos análise discursiva crítica de uma carta ao obstetra que tematiza a violência obstétrica. A justificativa para a escolha desse tema é a hospitalização do parto no Brasil, onde se observa um índice de 82% de cesarianas na rede privada, o mais alto do mundo. E a escolha do objeto justifica-se por se tratar de gênero discursivo inovador e relacionado ao movimento pró parto natural no Brasil. Partindo de categorias analíticas como avaliação, coesão, modalidade, pressuposição, intensificação, investigamos estilos no texto, considerando a construção discursiva de identidade e identificação. Nossa análise aponta alto teor de intensificação e negação, além da expressão recorrente de afetos, julgamentos e apreciações. Considerado o documento como registro de uma conjuntura, interpretamos a avaliação do comportamento da médica como parte de uma crítica mais ampla ao modelo de assistência vigente no Brasil, o que materializa aspectos da luta hegemônica travada no discurso.

Childbirth in Brazil: challenging an interventionist paradigm.

Childbirth in Brazil: challenging an interventionist paradigm.