Nascer no Brasil: Parto, da violência obstétrica às boas práticas

Birth in Brazil Research was a very big research it was carried out by various research institutions And it was coordinated by Fiocruz Foundation It was the first research that gave voice to women to talk about their labour and birthing of their babies here in Brazil. When we are all alone, suffering a lot of pain, with no support from anyone, it seems that the pain doesn't pass. When a nurse came and stood by my side and gave me support, and helped me, I felt more courage, I would try harder to help the baby to come quickly.

I was so anxious to see it. I only know that all I did was cry because I was alone, I wanted someone to be with me, but they didn't allow. I was left alone, they didn't allow anyone to come in, they didn't let my family come in.

They didn't let anyone get in the labour room. Which is very sad, because if you don't have support of no one, not from a nurse, not from a doctor, you are left there feeling abandoned. It's really hard, because we are already in a tough situation feeling weak, tired, sensitive.

The law of having a companion with you at the time of childbirth is not yet being obeyed. Only 19 % of women had companionship during the hospitalization. They put me there, and did vaginal exam in me again and it was time for the baby to be born.

They put me in the correct position. Spread your legs, put them apart. Stay close to the doctor, hold on to the protection bars, that way the baby girl will come sooner.

We can't scream because she will go up again. You can't yell, but it hurts so much that there is no way you can not scream. The doctor told me not to scream.

But then he saw I was in much pain then he said I wasn't going to be able do it anyway He pressed his arm right here he said he squeezed it to help me have my little girl. I could only push when I had a contraction, but it stopped. Then the contraction stopped and everyone stopped.

Then when I had another one I had to push again to deliver her. He pressed this way, and that was when she came out. It took a long time, but she got out.

Lithotomy a position which is not favorable to giving birth WHO recommends it, because there are many studies that the best position for women to give birth, is exactly the vertical position she chooses. It can be squatting, it can be on her knees she could be sitting but on vertical position. Because this will increase the strength of her push.

Here in Brazil more than ninety percent of women will give birth, according to studies, laying down which is the worst possible way. Put the hand on top of the belly to help push to help the baby be born. When the girls were helping me, I felt it tightening, suffocating.

As such I asked them to stop, they would hold my hand. 36% of all women receive a Kristeller maneuver, which is uterine fundal pressure to expel the baby They have no idea they are being violent. Some times they do the Kristeller maneuver that is when they put pressure on the uterus and they think: wow we saved her life!

You know, they accept because they have to stay quiet in their place. they say: "I can't make any noise or else they will hurt me inside. " Then we say: do whatever you want.

If you want to scream, scream. If you want to walk, just walk. If you want to sing, just sing But they lost that thing of letting it be natural, the instinctive.

It was physically exhausting. It hurt me a lot physically. Every time they did a violent vaginal exam, they suffer in silence.

It was possible to see, by their expression that it was not cool that it was not being good for her but she was trying to show everyone that it was all right <i>Because of fear</i> Fear ! She would push and they would help her down there pulling that is why the head came out odd shaped. It is sad to see that women who arrive a little more empowered the ones who ask not do the procedure, or something like that the ones who ask to change their position, and sometimes it is not allowed.

They are not directly mistreated. At least not when we were there witnessing everything I didn't see anyone being seriously mistreated. But they are left aside they are seen as annoyance.

This is sad Since the very beginning I always said: Lady, the mother will not hide her pain, labour pain is something terribly painful But don't make a scandal, because that will be worse. They will leave you behind, they will mistreat you Be strong! Yesterday, at the bedside I was talking about this, I said: be calm, stay calm!

Think positive. When the baby is born, you will thank God. Then she just had to stand it !

I found out that the drip is some sort of punishment for the woman. It hurts too much women. Then, if you want a normal birth then you need to go through the natural way, the normal pain of the woman's body.

The moment of the woman. and not give you a lot of medication and induce the pain and leave you there. Because in my case I took it out !

My arms are totally bruised. Why increase my pain? At one moment or another it will be born there is a right time, so it is not necessary.

Drp with Oxytocin, a synthetic hormone is used to accelerate uterine contractions accelerate labour with Oxytocin, which is very painful then, here in Brazil, when women arrive this is another practice not recommended by WHO she goes on a drip. This is not recommended Only if the woman, only in the cases when the woman is at risk but we are talking here about women without any problems, which is the majority 80 percent of women. She should not have a drip because when she is given a drip she can't walk she can't move and this is what helps labour to progress this is something well studied.

<i>It stimulates? </i> It stimulates a better progress of labour Then she receives a drip and in the drip there is oxytocin. The doctor take notes on the medical records and says: " I am going over there for a coffee".

Or he will talk to the nurse about the new car he is going to purchase how much it will cost which is the best color for the new car. And the patient is waiting in the room screaming of pain, yelling and asking for help, but no one goes there or even comes near They only go when you scream: it is coming, the baby is coming now, the baby is going to fall! Then someone kind of crazy, desperate arrives afraid that the baby will fall on the floor what if the child gets hurt, what if the child bangs on the floor.

After taking out the drip, I was still in pain, and then my girl was born alive and healthy. And almost alone! I could not stand the drip, the pain anymore.

I dropped on the floor, I didn't have any strength to stand up I couldn't stand the pain! Than I knelt on the floor and peed right there. The doctor that was there and saw it said that I didn't have God in my heart he also said that what I had done was horrible.

That I was doing that there and that it was extremely rude. That I was arrogant and boastful that I was abusing of the staff member who were there. that I did that just there just because I wanted the employee to return to clean it.

I was mistreated from the moment I was admitted, I was told I was fussy; I had a terrible pain nothing was done to alleviate my pain. I was admitted at 2 am, 5 fingers dilated I suffered until ten to seven at night with her an hour and a half pushing and they got her out with iron rod. I had several internal stitches.

It was a vaginal delivery, but I had several stiches Episiotomy is a surgical cut done in perineum These are procedures that do not help labour progress they make it more painful, and then, at the time of birth they cut too much they perform too much episiotomy, that cutting in the vagina. and that today is not recommended anymore, and why? Because it was observed that when you cut they cut more than what would be a tear or a cut that naturally would occur with the baby coming out.

And sometimes some important nerves are cut! and the woman has later problems. Then, this is not recommended anymore.

I suffered very much afterwards too After leaving the delivery room I looked at my husband and said: never again in my life I want to have another baby. This side of by rib was completely bruised I was totally bruised for more than 15 days. Underneath my vagina I had too black hematomas that is what happened after the probe was taken off these hematomas, are still there.

It hurts a lot. And she was a small baby, 2,810 kg and 46 cm she was not a big baby. She was a small baby they didn't even tell me if I was pushing the right way or not.

They didn’t say: that's it keep going or stop ! No one helped me, not even the nurses. They have to be warriors to have a baby here I could not see myself in this situation To be treated with all this useless violence and still be able to deliver the baby.

I think they are really good because delivering at home, with the help of a lot of people is much easier. But here, to be able to bring your child into the world in a normal birth with all they give them! they are very strong.

It's not the SUS (Unified Health System) in itself. It is the problem of the staff and the people. It is the problem of the staff and the people.

people judge Brazil, they judge everything but it's the people themselves that make Brazil what it is Who helped me was the midwife she whispered in my ear like an angel and said "mummy, she will have to come out, so we won't loose neither you nor her. anything you need I am here for you" Than she gave me a really good hug I think that was what I needed since the very moment I came in. From that moment on, I put everything in the hands of God and my baby girl was born.

<i>And how old is she now? </i> nine years old The experience which made use of good obstetric practices The predominant model of childbirth care in Brazil which denies rights and still does not adopt best practices needs to be overcome. We have made many efforts to improve the quality of birth care in Brazil Many Brazilian maternities in the Stork Network have already implemented these best practices they have now given more attention to this issue to the content, to the meaning of labour and birth to women, to the babies, to the family and it has totally changed its practices.

And what we see are exceptional places of production of life and health for these women, for these babies, for these families totally transforming the model of care that was once based in procedures and birth seen as a disease the exclusion of families a strictly biological view of childbirth to an expanded model of care which is centered in the well-being of women and their families to look at these babies as a sentient being. And to promote this moment as a significant moment to that woman's life, to that baby's life, to that family's life This can bring great satisfaction to health professionals changing their position from an embarrassing way of being who is dealing with an event, which has a certain intensity which is extremely intense, from being in a place very external, very distant, to being beside, being next to giving real support protecting and nourishing this moment. In her delivery I was admitted at 9:25 and my daughter was born at 10:05 You know that birth of your dreams?

It was a dream delivery ! It came to compensate and prove that normal births do really exist. Because the delivery I had was an inhumane birth and this was a humanized birth with everyone by my side supporting me and the whole time they were saying to me that everything would be really fast.

I received a lot of loving care from all the girls around me I remember Mariane very well, because she gave me a hug when I first arrived and said: "It looks like you are dying of pain, lets take care of it So that's what you need, someone to calm you down. You know? To be welcomed like that when you arrive at the hospital Very different.

10 years have gone from my life. It was more or less a delivery and at the same time it was good, because there were people saying comforting words that way we feel better and deliver the baby sooner. I thought I wouldn't be able to do it even in the moment of birth I asked: wouldn't it be possible to have a caesarean?

I won't be able to do it to push my daughter out. The doctor: "There is no other way because she is already on her way out and you will be able to do it" She made me believe that I was going to be able to do it! I never thought I would feel so much pain, but I did, it's all in a days work.

And when I saw her, It was beautiful. I think I got the best shift. We already got here feeling so insecure when they transferred us And we got here, everything was totally different we saw the facilities, so cool, the staff, so cool, and we are being well taken care up to now.

We are so happy because we planned her for four years she is so healthy well, we are super happy. The delivery of my other baby took a lot more time and I was in pain much longer because since my admission I had to lay down all the time. But this time it was different, they taught me the right exercise to do to kneel, to stand up and massage when the contractions start.

I think the dilatations were much faster. Every time there was a contraction they would massage me. She stayed with me the whole time.

She helped me in the bath. I took many showers, I stayed under the shower for long periods to increase contractions. The doctor helped when it was time to give birth They asked me to choose if I wanted to take a shower, or work with the ball if I wanted to sit on the tilting horse if I wanted to be massaged on the back to feel better.

And this massage they teach here helped a lot When she touched me here! Oh God! It seemed as the pain went away faster, the contractions.

I massaged the back, the arms, and near the. . .

on the back, on the side. And I would kneel and stand up. Smell the flower and blow the candle.

Smell the flower and blow the candle, I thought that this relieved my pain. The setting helped, the hot water helped of all things, what helped me the most was the massage. There was no cut.

There was no need to cut. Because many maternities cut you without any need but here no, it was different, there was only one little slash there was only one stich, but they didn't cut. No, I did not have a cut.

She weighed 3,218 kilos, normal, she got out super normal. She got out without any cuts As soon as she was born I put her on my chest They put her near, on my chest. Then she breastfed and was quiet.

And then my mother cut the umbilical cord it was super emotional. they asked if I wanted to cut the umbilical cord myself. Then I did it myself.

I was so impressed, I liked it, I love it ! It was so beautiful. We see this on films, we see this on the soap opera, but the real thing We see this on films, we see this on the soap opera, but the real thing for me it's everything.

I have only good things to say about my delivery. People say horrible things about delivery. they say it's bad, it's hopeless for me it was bad too, it was despair but at the same time it was wonderful.

You go through a lot of pain, a lot of suffering and when you feel love coming out of yourself you see the face of your baby you hold him, you smell him you feel the warmth of something that is yours, that you created during nine months, thank goodness, it's so good! She came straight to me and she was very quiet I cried her dad cried because, he was there at the moment. He took her and held her close, like this.

I smelled her and kissed her, my daughter, it was really good.