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Normal Birth: Ministry of Health announces slew of new guidelines


Normal Birth: Ministry of Health announces slew of new guidelines

Dr Norbert D"cruz January 8, 2018

Notice -The Government took advantage of Women’s Day to launch guidelines aimed at reducing the number of cesareans.

On March 8, when thousands of women took to the streets to fight for equal rights and justice, who includes public and health policies, the Federal Government launched guidelines to assist normal childbirth. The idea is that women can draw up their own birth plan, choosing how, where and how they wish to experience this experience. For the obstetrician and obstetrician Alberto Guimarães, a humanized delivery advocate, the birth plan is an interesting tool for the woman to express her wish about what she wants to happen and an opportunity for the doctor to accompany her and give the dimension of what is doable. “It is the ideal time to have this conversation, preferably accompanied by a multidisciplinary team. But it is important to do some work to clarify what the birth plan is for both women and the lay public as well as for health professionals. They think it’s the woman trying to get over the doctor, “he says.

The government-issued document also recognizes Normal Birth Centers, such as Casa Angela (SP), as safe places to perform low-risk births, which may be done by an obstetric nurse or obstetrician, as is already the case in other countries, such as England. Women should also have the guaranteed right to choose the best position for delivery, free diet (with no mandatory fasting), follow-up of doulas and access to alternatives to relieve pain, such as massages and immersion in water. Pregnant women already have the right to enjoy an accompanying person at all times. Although there is no great news, Guimarães sees the initiative with good eyes. “Maybe with this we cannot show, for example, a birth experience with vaginal delivery attempt is in favor of the baby and the woman. There is poverty. There is still that stigma that the rich do cesarean section and poor childbirth, normal childbirth, giving birth by SUS is not a punishment, it is a positive possibility for both mother and baby, “he says.

The Minister of Health, Ricardo Barros, stated that “the guidelines are an advance that guarantees the autonomy of women and reduce unnecessary cesareans. She will have to be informed of the entire delivery plan during prenatal care. They guarantee more information, more access and more respect, “he said. Although the Government also announced that the Kris teller maneuver is now considered to be contraindicated, the practice was already considered to be obstetric violence and considered inadequate because it posed risks to the mother and the baby.

A cooperation agreement was also announced between the Ministry of Health and the Federal University of Minas Gerais to train health professionals in 86 teaching hospitals distributed in all the states, which together perform over one thousand births per year. This is a project to qualify obstetric and neonatal hospital care, in which R $ 13.6 million will be invested over the next four years.

This set of measures is not the first attempt to reduce the unnecessary completion of cesarean sections. In 2015, during the Dilma administration, the Ministry of Health, in partnership with the National Health Agency, created new rules to encourage normal birth in the private network, where the cesarean rate reaches 84%. And in 2016, it launched a document to encourage normal childbirth, entitled “Clinical Protocol of Therapeutic Guidelines for C-section “, which was published in the Official Gazette.

It is worth mentioning that, although the Government is commemorating the stabilization of the number of cesareans in the country, which has been growing at 1.5 percentage points per year, according to the latest data from 2015, we are still among the world record in carrying out the procedure. While the World Health Organization recommends that the cesarean rate reach a maximum of 15%, it represents 54.7%, according to the latest data released by the IBGE.

Family planning

The Government also announced the expansion of access to the Intrauterine Copper Device, known as the IUD. It can be placed in maternity hospitals, both after delivery and post-abortion. “It is an excellent contraceptive method, safe, with low side effects and reversible, Postpartum or after an abortion is a propitious moment to do this type of intervention,” says Guimarães. Later this month, a hands-on guide for health professionals with guidance on device management, which is already distributed in basic health units for women, will be published. The maternity wards will have up to 180 days to adapt to the measures.

Dr Norbert D"cruz

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