Nascer no Brasil

Abstract

Childbirth in Brazil has not always been a natural experience for either rich or poor. Vaginal birth is more frequent in the public health system and occurs almost always with great pain and with excessive use of interventions. In private sector establishments, caesarean section is often unnecessary and almost always pre-scheduled, becoming an option to minimize suffering. Given this peculiar scenario, the Ministry of Health decided to open a call for action via a grant from the National Council for Scientific and Technological Development (CNPq) for conducting a large national study designed to examine labor and birth in the country. The INOVA-ENSP project and Foundation for Supporting Research in the State of Rio de Janeiro (Faperj) also gave important support for this research. This study was coordinated by Oswaldo Cruz Foundation (Fiocruz), and covered 266 hospitals that reported 500 or more deliveries per year, representative of hospital births in this universe, where 83% of all births occur in the country. 191 municipalities were visited and 23,940 women were interviewed between February 2011 and October 2012. The results are presented in 14 original articles in this thematic issue, addressing methodological aspects of the sample, creating an algorithm for calculation of gestational age and estimation of maternal mortality; antenatal care outcomes; decision on the mode of delivery; interventions on low-risk mothers and newborns; mode of delivery in adolescents; satisfaction with care and the presence of a companion during hospitalization; maternal and neonatal near miss and mortality, an analysis of the structure of maternity care and a description of a successful experience for reducting caesareans in the private sector. Conducting this research required the participation of a large number of universities and researchers who gathered to form a CNPq Research Group. Without this team, this research would have been more difficult and, above all, less significant. Likewise, the study enabled research training for a large number of young professionals, many of whom developed their masters dissertations and doctoral theses with these results. The work of the technical team and IT support, was equally significant, given the complexity of the logistics in the fieldwork for a research of this size. Hospitals that participated in this study deserve recognition for their trust and generosity in allowing their facilities to be visited and their documents handled. In this final stage of publication, the participation of the editorial team of the Cadernos de Saúde Publica and the entire staff of the journal was of fundamental importance, resulting in publication in record time without sacrificing scientific rigor, as well as the tireless work of reviewing manuscripts. We would particularly like to thank the women who responded to our invitation to join the research, because without them this study would not have happened. Statements were video-recorded and organized in the form of videos. We hope that the information pr...

Using the Bologna Score to assess normal delivery healthcare

“…Regarding birth in Brazil, it should be emphasized that the current obstetrical model has not allowed this event to occur naturally, regardless of the economy status of laboring women. In the public healthcare service, vaginal delivery is usually marked by pain and an excess of interventions; on the other hand, the routine caesarean culture in the private healthcare service prevails based on the justification of reducing womens' suffering (13) . This reality leads to questions about care quality.…”

Metodologia para articular processos de formação-intervenção-avaliação na educação profissional em enfermagem

“…This challenge is in line with one of the principles of the Unified Health System (SUS) -of teaching-service integration -being the legitimate originator of vocational training. It is worth remembering the current scenario of delivery-birth care in Brazil, with disturbing indicators of morbidity and mortality, caesarean sections, inadequate care practices 4 and difficulties to insert the ON into the interprofessional practice 5,6 .…”

<b>Violência Obstétrica: experiências de puérperas primíparas em uma maternidade pública / Obstetric Violence: experiences of puerperal primiparae in a public maternity<b>

“…Os achados deste estudo estão em consonância com os da pesquisa "Nascer no Brasil", quanto à realização de intervenções desnecessárias durante o parto, que mostrou que apenas 5% das entrevistadas tiveram partos sem nenhuma intervenção, 91,7% estavam em posição de litotomia, 53,5% foram submetidas à episiotomia, 36,4% receberam ocitocina, 39,1% sofreram a amniotomia, 36,1% receberam a manobra de Kristeller e apenas 18,7% contaram com a presença do acompanhante (14) . Nesta pesquisa, a região Centro-Oeste foi apontada como a região onde acontecem com mais frequência a manobra de Kristeller, a posição de litotomia e a prática da episiotomia (15) .…”

A Difícil Tarefa De Escolher O Parto Natural

“…Quando se pensa no parto normal no Brasil, imagina-se um momento perigoso, dolorido, angustiante e sofrido, tal como relatado na dramaturgia, além de abarrotado por diversas intervenções, tanto para o recém-nascido (RN), quanto para a parturiente (cesárea, episiotomia, ocitocina, aspiração naso-faríngea, entre outros), tecnologias próprias do ambiente hospitalar, que objetivariam tornar um ambiente seguro para o binômio mãe-filho (5) . Vale ressaltar que os avanços na obstetrícia contribuíram para a melhoria dos indicadores de morbimortalidade materna e perinatais mundialmente, porém, essas intervenções, ao longo do tempo foram sendo utilizadas demasiadamente refletindo em altos índices de partos obstétricos (cesárea) como no Brasil, onde chegou 55,5% em 2015, podendo alcançar taxas ainda maiores na rede privada, quando o recomendado pela OMS é 15%, a fim de reduzir a mortalidade materno-infantil (3,6,7) e refletindo a complexidade deste fenômeno, grande influência das intervenções tecnológicas e médicas ao parto ao longo do tempo (8) , sendo perpetuado pela mulher e seu entorno. A escolha pelo parto natural/ normal/ vaginal não é uma decisão fácil.…”

O cuidado ao parto e nascimento: implicações sob a ótica fenomenológica de Husserl

“…O parto vaginal, mais frequente nos estabelecimentos públicos, quase sempre ocorre com muita dor e excesso de intervenções". 1 Refletir a respeito é ir ao encontro das seguintes indagações de Husserl: qual o sentido desta matematização da natureza? Como reconstruímos o curso do pensamento que a motiva?…”