Humanized birth: the resumption of the pregnant woman's protagonism

Did you know that Brazil is the champion of cesarean sections in the world? Data from the World Health Organization (WHO) show that 52% of births performed in the country are cesarean sections? well above the world average (18%) and the WHO recommendation, which is only 15%.

The point is that although caesarean section can save lives in some cases, it is often performed without medical need, which exposes women and their babies to health risks (short and long term).

According to WHO, caesarean section should only be used when natural childbirth poses a risk to the mother or baby.

It is especially in this context that there has been much talk lately of humanized childbirth. The term is in the mouth of many doctors, nurses, hospitals, pregnant women, etc., but is not always interpreted in the best way.

This is because, first of all, it is necessary to understand that humanized childbirth is not a type of childbirth (as is the cesarean section or the normal delivery). Many people think (wrongly) that humanized childbirth is one defined by external details, such as use of water in the bathtub, light intensity, presence of the partner, etc. However, in fact, there are no rules, the humanization of childbirth is a concept (especially about the restitution of the woman's role at the time of the birth of her baby).

After all, what is humanized childbirth?

For Andrea Amaral de Almeida Prado, a psychologist, mother of three and co-founder of the Amigas do Birthing website, the term humanized childbirth is not always interpreted in the best way. ? In general, as I see it, it refers to a birth that is treated as a normal physiological process? This type of delivery respects the time of the baby is born, respects the woman's ability to give birth (as long as everything is OK with her) and thus offers many benefits to mother and baby?

Andrea points out that, in her opinion, the best birth is "where the woman trusts those around her, feels respected at this time and where interventions are made only as needed".

Yes, sometimes caesarean section is necessary, Andrea adds. ? WHO says 15% to 20% would be ideal. So it wasn't supposed to be more than that. It would be a minority of cases and not the majority? Remember that data show that normal delivery is safer than cesarean section. More unfortunately we live in a country where there is a lot of cesarean section?

Deborah Romanelli Lopes, physiotherapist, doula and mother of three, stresses that humanized childbirth is not a type of childbirth, but a term that defines the return of human practices, from birth to the reception of the baby, and postpartum. "To humanize childbirth is to return the role of women, is to remember that women as human have their instincts and that childbirth is a physiological process and not something that always needs intervention," he says.

Aláya Dullius, acupuncturist, doula and perinatal educator, recalls that the central concept of humanized childbirth revolves around the restitution of women's protagonism. "She must have access to true and quality information, be respected in her individuality as an emotional and cultural subject, and nothing should be done with her body without her full consent," he says.

In humanized childbirth, adds Aláya, the caregiver is a guide to the process. • He works in partnership with the woman and respects her choices and wishes as much as possible, guiding decisions and not simply imposing (often outdated) protocols. This professional understands that childbirth is a physiological and natural event and that most women (about 85%) will be able to give birth without any or almost no intervention, is a professional who believes in the strength and ability of women to give birth to his own son and that does not diminish it in any way or alienate the process and decisions ?, highlights.

Also according to Aláya, in humanized childbirth, women are usually attended by a multidisciplinary team, and these professionals are aligned with the latest and updated in terms of scientific evidence in obstetric care.

How is a humanized birth usually delivered?

Remember that there is no "ready recipe", that humanizing childbirth is not following a set of rules. The premise is that each case is a case, each woman must be respected in their particularities.

But generally, Aláya talks about key points about preparation, timing, and postpartum.

• Prenatal: A good prenatal care is important, so that there is security in decision making and the correct conduct of care can be determined.? The woman who seeks humanized care knows the importance of good monitoring of pregnancy ?, highlights the doula.
• Examinations and consultations: A humanized professional does not usually ask for unnecessary tests (too many unnecessary tests, which only increase women's anxiety, has been a common practice in Brazil), but can assess when a case needs further investigation.
• Preparation of the pregnant woman: Many women feel that they are preparing for a humanized birth by doing yoga or some kind of activity (which is great for pregnancy), but this is not enough to ensure a respectful normal birth. "The main preparation is in finding information, support groups, doulas and choosing an evidence-aligned professional," adds Aláya.
• Post childbirth: The postpartum of those who had a humanized birth is not necessarily different from another postpartum, but it is more common that these women, because they are already in a questioning movement and seeking differentiated information, are more engaged in breastfeeding and often do so. choices that escape common sense when it comes to raising babies.

The advantages of a humanized birth

Andrea explains that in a birth that is done as naturally as possible, without or with minimal intervention, the woman ends up feeling part of the process. Are you more present, participate in the baby's birth? which is a very important moment for her. This favors the mother and baby bond. Is this a good start to the mother-child relationship?

For Aláya, the advantages of humanized childbirth are:

1. It is to take for the rest of your life, on each birthday of your child, the memory of a day that was special, without suffering, surrounded by love and respect.
2. It is giving your best, and seeking the best for your baby; It is subjecting yourself to less risk and having more benefits.
3. It is more likely to have a healthy birth, a respected baby brought to the world surrounded by affection.
4. It is not having your body go through unnecessary pain and invasive procedures, and the confidence that you have offered the best (and most assured of health) to your child and to yourself.

What would be the benefit of an unhumanized birth? None! Every childbirth should be humanized, we should not have to deal with violence at such a special and delicate moment. All childbirth should be updated, with health professionals, and are well grounded in their practices. Should every birth be celebrated with love and respect for the autonomy and individuality of each woman ?, adds Aláya.

Reports of who had a humanized birth

Deborah Romanelli Lopes says that, as much as she was born from a caesarean section, she always knew instinctively that women were capable of giving birth to their own children. ? During my first pregnancy I sought a lot of information about childbirth, and I was faced with the harsh Brazilian reality, that doctors could no longer attend a natural birth. Researching a lot I saw that there were few obstetricians who knew what it was to watch a woman giving birth and I went after, after going through 8 doctors, I decided that would really be empowering me and having a doula, which was essential in my choice ?, highlights.

Deborah, who is a mother of three, talks about the differences in childbirth. She says that during her pregnancy, she participated in meetings with her doula. "She instructed both my husband and I as to what might or might not happen, what were my rights in the delivery room and hospital that I could talk about? No?" to the routine procedures, that the birth was MY, and no one else's, that nothing without my consent could be done. At 35 weeks of gestation my first daughter was born, in a natural hospital delivery very fast, after much struggle to get what we wanted ?, says.

She reports that as soon as she arrived at the hospital, after advising the on-duty doctor that she would not be lying on the stretcher and that he would not make any anesthesia and any cuts, he heard that he could not deliver in this way. “It was a struggle, I heard that my daughter would fall to the floor if I didn't sit down, I was prevented from drinking water when I requested it and heard shouts from the nurse. My daughter was born, stayed with me a little, but was taken to be attended by the neonatologist for being born prematurely (nothing that could not be done on my lap) ?, says.

The next day, says Deborah, the nurse took the baby to the pediatrician. “I warned her that she had not breastfed at that time, I was informed that they would bring her back soon, but after a few hours they called me that they had measured blood glucose and that she was hypoglycemic, ready! Soon they put it in the glycated serum and even with full breasts, I heard from the pediatrician that no mother has milk when the baby is born ?, reports.

A year and a half later, Deborah had her second birth and decided to change hospitals and staff, to try a better care. “I had my second child standing in the bathtub with my husband only because there was no time for the doctor who was in surgery next door to arrive.With the reception of the baby, I questioned what was the routine care of the babies and after noticing that the pediatrician on duty aspires all babies (even with my already breastfeeding) decided to call the humanized neonatologist who soon arrived and attended with all the possible affection? Skin-to-skin contact on all exams, blanket-covered weighing, bucket bath? All but stressful for the baby, other than not removing the mother from the room while nursing the baby. Was his presence essential?

After two years, Deborah had her third child. “I decided I wouldn't set foot in a hospital anymore. We hired a team of obstetric nurses and planned our home birth. She would be born at home, with siblings and family. And it went like this: We called the team, they arrived, I already in the shower relieving the contractions while they assembled all the equipment, if needed? After a few minutes, our youngest little girl was born at home, in the shower, with the presence of her brothers, supported by her father ?, he says.

"She was breastfed, was not separated from her mother, was cherished by everyone, was heavy after being comfortable, was not aspirated?" And I knew that any intervention that was made, I knew it would take, I trusted my team, I knew they fought for the same as me ?, says Deborah.

Humanized video birth

In the videos below you can see examples of humanized births. It is noteworthy that the scenes show intimate moments of women and the whole family. There is bloodshed, so they are not recommended videos for people who consider themselves sensitive to it.

Valentina's birth

Eduardo's birth at home birth

Gabriel's birth in waterbirth

Top questions about humanized childbirth

Although it has been gaining more and more attention lately, there is still much doubt surrounding the so-called humanized birth, especially since the term does not concern a type of birth but a concept? which of course can generate different interpretations.

Thinking about it, below the professionals try to clarify the main doubts around the subject:

1. Can a humanized birth be done both at home and in hospital?

Aláya Dullius: What determines the humanization of a birth is its delivery, not its location, so it can occur both at home and in the hospital. If there is respect for women's autonomy, warm and non-violent treatment, and up-to-date care by the professional, it can usually be said that childbirth has been humanized. A humanized birth doesn't have to be at home, it doesn't have to be in the bathtub or it has music and candlelight, it mainly concerns allowing the woman to give her best birth and no intervention to be done on her body without there is real need and without it understanding and accepting. In humanized childbirth there is trust and dialogue between the pregnant woman and the caregiver.

2. Is every normal birth humanized?

Aláya Dullius: Unfortunately, in Brazil, most normal births are surrounded by obstetric violence, that is, verbal and emotional aggressions (angry faces for women, reprimands of her behavior, treating her as if she were an object, ignoring her desires, fears and doubts, isolating her, not allowing a companion) and also physical aggression in order to prevent the woman from having freedom of movement: forcing her to be in a position that is not the most comfortable for her, and performing actions on her body invasive and painful, these being obsolete and inadequate in terms of best practice according to scientific evidence, such as pushing your belly or cutting your perineum. A normal birth can be humanized or extremely violent. The humanized childbirth movement seeks women to be respected at one of the most important moments of their lives, not normal childbirth anyway.

3. Can a cesarean section be humanized?

Aláya Dullius: Humanization of childbirth presupposes women's protagonism, presupposes that she has an active voice in the actions and choices about herself and her body; and it also presupposes respect for science. Thus, a woman can, even with access to all information, choose for herself a cesarean section, but a cesarean section made without real medical need, with all the risks inherent in this action, cannot be considered a humanized action. In a cesarean section, the woman is passive in actions, she is not involved in events, she is subjected to procedures over which she has no control. A caesarean section can be respectful when done with indication, it can be necessary, it can be loving and humane. There are procedures the provider can do to minimize cesarean section damage, such as allowing the mother to have immediate contact with the baby, or turning down lights at birth, but a cesarean section is not a humanized birth.A scheduled cesarean out of labor is not humanized, it is against science and puts the mother and baby at greater risk. It is important to remember that humanization has nothing to do with being merely affectionate with the pregnant woman, but respecting the indications based on an updated and scientific medicine. When needed (about 15% of the time) and well-indicated, she can be respectful and save a life.

4. In humanized childbirth, which professionals participate / can participate in the process?

Aláya Dullius: In the case of low-risk (or usual-risk) pregnancies, delivery may be accompanied by obstetric or midwife nurses. This is the assistance model in Australia and in several European countries. When pregnancy becomes risky or childbirth calls for more invasive interventions, it is important to have an obstetrician. In natural births, both obstetricians and obstetric nurses and midwives are trained to provide care. In addition, the presence of a doula greatly assists in reducing pain and satisfying the woman with her childbirth.

5. Is humanized delivery cut in the perineum?

Andrea Amaral de Almeida Prado: There is evidence that this cut should only be done in rare specific cases. So, of course, a humanized birth will be done rarely. Scientific evidence shows that this procedure should not be routine. In a birth seen as a natural, physiological process, the woman can assume different positions at the time of birth, thus helping to prevent any damage to the perineum.

6. Is humanized childbirth less painful?

Andrea Amaral de Almeida Prado: The pain is very relative and depends on several factors. Pain is not the same as suffering and there are several resources to deal with the pain of contractions during a natural birth. The contractions of labor are not continuous, so the woman can rest at intervals. Feeling supported, unrestricted movement, using the shower and bathtub are some simple features that can be used. On the other hand, normal delivery in some hospitals can be experienced as extremely painful due to movement restrictions and routine use of serum that speeds up labor.

I think the pain of contractions, the intensity of which can vary greatly depending on the woman, can be endured if the environment is warm, with supportive people, if the woman relies on the process.

7. Is anesthesia applied to humanized birth?

Andrea Amaral de Almeida Prado: Remember that humanized birth is not a type of birth. In some longer births anesthesia may be welcome, as well as other interventions when needed. When childbirth is believed to be a normal physiological process, however, it is not assumed that anesthesia is necessary because for many women being able to live the whole process of childbirth intensely is a great gift and there are other resources for alleviate pain during labor.

Support Groups and Discussion on Humanized Childbirth

Interested in the subject and would like to talk to more people about humanized childbirth? Facebook discussion / support groups may be a good option. Check out some suggestions below:

• Humanized childbirth Brazil
• Humanized childbirth and mothering? Caldas Wells
• Humanized Birth Campinas and Region
• Humanized birth in Ceará
• Humanized childbirth Japan
• Humanized childbirth Cuiabá
• Humanized birth
• Support for Humanized Childbirth? savior

Now you have probably clarified your main questions about humanized childbirth. It generally provides for a woman to be free to give birth to her baby in whatever way she thinks is best (as long as her and her baby's health are okay) and, above all, to participate and be respected. as? main character? at birth.

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