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.

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