A humanização do parto e nascimento no Brasil nas trajetórias de suas pesquisadoras

Abstract

Resumo Trata-se de pesquisa qualitativa que analisou as trajetórias de pesquisadoras que produziram teses e/ou dissertações sobre humanização do parto e nascimento em programas de pós-graduação brasileiros. As questões que nortearam a investigação foram: como as pesquisadoras detectam a emersão da concepção de humanização para o parto e nascimento em suas trajetórias profissionais? Como essas trajetórias se relacionam com a história do movimento de humanização do parto e nascimento no Brasil? O referencial teórico foucaultiano contribuiu para identificar as posições ocupadas pelas pesquisadoras no discurso em prol da humanização, seus lugares de enunciação, bem como relações de saber e poder que permeiam a construção do movimento pela humanização do parto e nascimento no Brasil.

Humanized childbirth: the values of health professionals in daily obstetric care

“…Thus, humanization dialogues with vital values while aligned with the well-being of women and babies (24) , with emphasis on the reduction of medicalization, specifically of elective cesarean sections, and the elimination of care techniques that limit and harm the physical freedom of women in labor (2,(7)(8)(9)(10)(11)(12) . Humanization, in the participants' discourse, reinforces the vital value expressed in ensuring the centrality of care for women within the field of physiological birth processes, in which it constitutes a value in itself (24)(25)(26) , ensuring the well-being of the mother-infant binomial.…”

“…These changes are the result of the collective construction of the movement initiated by women, professionals, health administrators, and researchers since the 1980s in favor of maternal and child health. Such changes allowed for a redefinition of the obstetric practices of health professionals, in line with Schelerian values (3)(4)(5)(6) , that is, supported by respect, quality of care, protagonism, autonomy, women's satisfaction, safety, and care anchored in scientific evidence (7)(8)(9)(10)(11) . However, the excess of unnecessary interventions is still part of daily care, including in maternity hospitals in Brazil.…”

“…Women undergo numerous obstetric procedures, such as episiotomy, Kristeller's maneuver, medicalization of oxytocics, trichotomy, enema, in addition to the cesarean epidemic in the country (2,(7)(8)(9)(10)(11)(12)(13)(14) . Studies point to obstacles in the organizational structure of work management and professional attitudes, which are sometimes discriminatory, prejudiced, violent and inconsistent with good practices in childbirth care and with evidence-based practice (8,(12)(13)(14) , going against the biopsychosocial needs of women and their care values (4)(5)(6)(15)(16)(17)(18) .…”

“…Among these interventions is the creation of public policies such as: Programa de Humanização no Pré-natal e Nascimento [Prenatal and Birth Humanization Program] (PBHP) (10) ; Política Nacional de Humanização [National Humanization Policy] (NHP) (19)(20) ; Estratégia Rede Cegonha [Stork Network Strategy] (11,20) ; in addition to the new MH's National Guidelines for Assistance to Normal Childbirth (21) . Such policies promoted accessibility and resoluteness; expansion of obstetric care; construction/renovation of units; training/alteration of professional conduct; reorganization of the work process with an emphasis on the collaborative model of a multidisciplinary team; encouragement of normal/natural/physiological childbirth; and reduction of obstetric interventions (22) , with the valuation of subjectivity, individuality of care and of women's values and expectations (3)(4)(5)(6)(15)(16)(17)(18) .…”

“…In humanization, there is encouragement so that women's values and expectations are respected, such as the life of the woman and the baby in light of the physiology of parturition, with the support of a qualified, safe, and scientific evidence-based professional practice as a way of caring in collaboration with the people involved (1)(2)14,19) . In this sense, based on the humanized model for delivery and birth, health professionals translate into their daily lives values that can be favorable or contrary to the needs of pregnant women (1)(2)11,(19)(20) .…”