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

Abstract

Objective To 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. Methods The 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. Results There 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. Conclusion SoB 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.

Changes in perceived knowledge about childbirth among pregnant women participating in the Senses of Birth Intervention in Brazil: A cross-sectional study

“…SoB is an interactive intervention where visitors (women, men, children, adolescents) are invited to walk through the pregnancy and childbirth process, first as a pregnant woman and later as the newborn (60). During the experience, the visitor engages in themes related to normal birth, risks of cesarean, best practices during childbirth, obstetric violence, the Ministry of Health (MS), and World Health Organization (WHO) recommendations, and the Brazilian humanization movement (60).…”

“…First, the visitors see themselves becoming pregnant, where a sensor captures the person's image and projects a pregnancy development. In the sequence, as a pregnant person, the visitor can shop for childbirth products (60)(61)(62). The market is a parody on the contemporary tendency of consumerism and immediacy due to the practicality and commodification of childbirth (60)(61)(62).…”

“…Scheduling a C-section; photographers; beauty salon services; a party in the hospital room after the C-section; and artificial milk (60)(61)(62).…”

“…The next part of the intervention invites visitors to watch the dynamic dialogue between a pregnant woman, a mother with a newborn, a friend, an obstetrician, a doula, and a midwife (60)(61)(62). The dialogue brings to light myths about birth, accurate information, and data to generate questions regarding expectations for the birth (60)(61)(62). Finally, the visitor is invited to end the journey as a baby on the path to being born (60)(61)(62).…”

“…Considering the urgent need to reduce unnecessary cesareans in Brazil and the multi-factorial reasons for the increasing rates, health education and health promotion intervention named Senses of Birth (SoB) was implemented in three different states of Brazil between 2015 and 2017 (60). SoB aimed to contribute to the reduction of unnecessary C-sections and iatrogenic prematurity in Brazil by addressing cultural preferences and behavior, shaped by generations of women who had a negative childbirth experience (60).…”