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The humanization of childbirth should be understood as a set of
practices and attitudes that perceives childbirth as a natural
event in the life of a woman, child and her family, and not a
medical act. These practices are based on dialogue, empathy,
and embracement, and they are in line with the latest and best
scientific evidence available, so it is the safest way to
bring a baby into the world.
Today the humanization of
birth is still a challenge in professional practice around the
world, and the role of women and respect for their rights and
anatomy is not always in tune with the best medical
procedures. This happens because there is the need to make a
new approach that understands that childbirth is truly a human
experience, so the way we receive, listen, and provide
informed guidance to a woman is really essential, and
beneficial to maternal and child health.
At the end of the 20th century, women used to give birth with
the help of midwives at home. The presence of physicians was only
requested when there was a complication during labor. But this
setting has changed with technical and scientific progress and the
evolution of medicine. Childbirth became a hospital event in which
technological and surgical means are used. Of course, medicine is
there to save lives, there is no question about it, but after
these changes, the increase of interventions during pregnancy,
labor and the post-partum period became excessive and a lot of
times unnecessary because they became a routine taught to health
care professionals. Even when the finest evidence based research
is out there, it is taking decades to change the installed system,
contributing to a parturition setting in which women are submitted
to unnecessary interventions.
Moreover, women began to be
hospitalized earlier, sometimes with little privacy and deprived
of their family support team. Even without any medical reason,
labors started to be scheduled in a certain day and time to meet
the mother’s or the doctors request, artificial hormones are
administrated to women with pour knowledge regarding the outcomes
for both mother and baby, and not taking in consideration the
physical and emotional development and well-being of the baby.
It is now known that these interventions and conducts may
worsen the care provided to women during childbirth and this is
why it is so important for women or a couple to understand their
needs, their baby’s needs, research for evidence based information
to be able to make informed decisions about their pregnancy, birth
and the post-partum period.
Taking these facts into
consideration, the World Health Organization (WHO) has proposed
some changes, focused on care provided to women, including the
return of natural childbirth, and encouraging the participation of
nurse-midwives and teams qualified in the assistance of pregnancy
and childbirth, in addition to incentive initiatives so that
childbirth can be regarded as a physiological process conducted
from a humanizing approach. And this is where the humanized care
of childbirth comes from!
So
let’s clarify a few misconceptions that some people have about
humanized care of childbirth:
1. Natural/normal
childbirth has nothing to do with humanized childbirth. Natural
childbirth means that the mother had a vaginal birth and that is
it. In today’s reality, with so many unnecessary interventions,
that can even be a traumatic experience for the mother and her
baby. Humanized childbirth is childbirth that respects the role
and importance of the mother at this time of her life, it may be
natural or not, but with the certainty that interventions will
only be used if necessary and in agreement with the pregnant
woman, respecting her choices.
2.
Humanized care of childbirth is in line with the latest and best
scientific evidence available, so it is the safest way to bring a
baby into the world.
3. Humanized childbirth has nothing to
do with home birth. Homebirth, Hospital birth, Birth Center are
the places where you may give birth. Humanized care of childbirth
refers to a care model and has nothing to do with the place where
childbirth occurs.
4. Humanized childbirth care includes a
multidisciplinary teams where you may have the presence of your
partner/family, midwife, doula, doctor, a friend, where everybody
understands their importance on that moment, where they are
helping each other, respecting first of all the woman wishes, her
needs, and her baby needs, just performing medical interventions
when they are really necessary and respecting the time of birth,
because birth takes time and cannot be fit into someone else
schedule besides the mother and her baby’s time.
5. A
cesarean section, if necessary, can be considered a humanized
birth too. Again this is about the care model. Even during
surgery, we can include practices and attitudes, the best way
possible, to make the process a unique, loving and welcoming
experience for both mother and baby. For example, in the surgery
room should prevail silence and as soon as the baby comes out, he
or she can be put on her mother's chest, the umbilical cord clamp
can be delayed, and the baby can be put on the mother’s breast in
the first half-hour of birth.
6. The use of techniques to
relieve pain and also the active participation of the pregnant
woman in labor, by having freedom of movements and autonomy, are
also practices related to the humanization of childbirth and
considered to favor the baby’s progression in the different stages
of labor and respect the women's physical features, providing
greater comfort.
7. Humanized care is also related to the
way women are treated, approached, how their doubts are cleared or
simply how their needs are listened, understanding the profound
effect that the whole experience has on the mother and her baby.
The woman should feel free to express herself as she wants, scream
if she needs to and being loved and nurtured all the time in a
place of non-judgment but of understanding and comprehension. So
humanized care should reinforce the principles of empathy,
respect, and equity.
By all of this we can conclude that
the concept of humanization relies in actions, practices,
behaviors, and knowledge based on the healthy development of labor
and childbirth processes, putting the key on the respect for the
individuality, needs and valuation of women and their babies, in
which professionals are more focused on the natural experience of
the mother and her baby and not more on techniques and
interventions, guided by medicalized norms and routines that are
no longer evidence based and totally disrespect women's rights.
*this article was based on a study by Nursing
School Anna Nery - Humanization of childbirth: meanings and
perceptions of nurses.
Quem sou eu?
Olá! Eu sou Susana, sou educadora prénatal e professora de yoga. No meu dia a dia, se não estou com meus 3 filhos, eu ajudo e dou apoio às necessidades das novas mães e dos seus bebés. Sou a fundadora do Programa Yoga para Grávidas, Yoga pós-parto e Yoga para Toda a Família, autora do livro Yoga e Maternidade, membro da APPPAH (Associação de Psicologia e Saúde Pré-natal e Perinatal) e Presidente da Associação Norueguesa de Educação Prénatal. Para mim a gravidez, nascimento e maternidade conscientes envolvem uma conexão muito mais profunda connosco próprias, com o nosso corpo, com as nossas emoções, com o poder da maternidade em nós, e uma conexão mais profunda com bebé. Tenho mais de quinze anos de experiência como professora de yoga e hoje orgulho-me de ter ajudado centenas de mulheres um pouco por todo o mundo.
O livro Yoga e Maternidade é o primeiro
livro em Portugal, de uma autora portuguesa, dedicado aos
benefícios do yoga durante a gravidez, para aliviar o stress e
o desconforto típicos deste período, e para estimular o
vínculo entre mãe e bebé.
Começando pela sua experiência pessoal de
três gestações, educadora pré-natal e experiência da prática
do yoga por mais de 20 anos, Susana Lopes oferece neste livro
uma série de técnicas de respiração, posições, meditações e
relaxamentos, adaptados às necessidades específicas das
mulheres e que lhes permitem sentirem-se mais presentes em
todas as diferentes fases da sua gravidez, aumentando o seu
bem-estar, autoconfiança e oferecendo uma maior conexão e
comunicação com a vida que está a ser gerada dentro de si.
Esta é uma leitura inspiradora
acompanhada de fotos, ilustrações e informação acessível a
mães, professores do yoga e profissionais que trabalham com
gestantes.