Midwives and obstetric nurses in the Brazilian Unified Health System and Primary Health Care: for a systemic and progressive incorporation
DOI:
https://doi.org/10.5712/rbmfc10(34)1106Keywords:
Obstetric Nursing, Prenatal Care, Violence Against Women, Humanizing Delivery, Humanization of AssistanceAbstract
The objective of this paper is to present a proposal for a gradual and systemic incorporation of midwives and obstetric nurses into the Brazilian Unified Health System (SUS) and Primary Health Care (PHC). The proposal was born from contact with the British experience, based on midwives, which is briefly described. In Brazil, these professionals would progressively take over the prenatal, delivery and postpartum care for pregnant women of usual risk in a region, in partnership with the PHC teams. This creates a specific niche for practicing, monitoring and evaluating the pregnancy care, based on the specific life cycle continued care with the user closely linked to the PHC team. There are technical and institutional conditions favorable to the development of this type of proposal, but there is a need to overcome the political obstacles. Its realization is a powerful strategy to reduce the high rates of obstetric violence, especially the significant cesarean rates in Brazil, contributing to humanization of childbirth in the SUS.Downloads
Metrics
References
The Free Dictionary by farlex. [acesso em 2014 Jul 01]. Disponível em: http://www.thefreedictionary.com/midwife
McCarthy M. Health system report ranks UK first, US last. BMJ 2014;348:g4080. http://dx.doi.org/10.1136/bmj.g4080 DOI: https://doi.org/10.1136/bmj.g4080
World Bank. Maternal mortality ratio (modeled estimate, per 100,000 live births). [acesso em 2014 Jul 01]. Disponível em: http://data.worldbank.org/indicator/SH.STA.MMRT
Ministério da Saúde (BR). DATASUS: Sistema de Informações de Nascidos Vivos. [acesso em 2014 Jul 01]. Disponível em: http://www.datasus.gov.br/catalogo/sinasc.htm
Agência Nacional de Saúde Suplementar (ANS). Resolução Normativa - RN nº 368, de 6 de janeiro de 2015. Dispõe sobre o direito de acesso à informação das beneficiárias aos percentuais de cirurgias cesáreas e de partos normais, por operadora, por estabelecimento de saúde e por médico e sobre a utilização do partograma, do cartão da gestante e da carta de informação à gestante no âmbito da saúde suplementar. [acesso em 2014 Jul 01]. Disponível em: http://www.ans.gov.br/index2.php?option=com_legislacao&view=legislacao&task=TextoLei&format=raw&id=2892
Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth: report of a landscape analysis. Bethesda (Maryland): USAID-TRAction Project; 2010.
Leal MC, et al. Assistência ao pré-natal no Brasil. Pesquisa Nacional sobre Parto e Nascimento. Cad Saúde Pública. 2014;30 Suppl:S85-100 2. DOI: https://doi.org/10.1590/0102-311X00126013
Venturi G; Godinho T, editors. Mulheres Brasileiras e Gênero nos Espaços Público e Privado: Uma década de mudanças na opinião pública. São Paulo: Editora Fundação Perseu Abramo: SESC-SP; 2013.
Barros, et al. Patterns of deliveries in a Brazilian birth cohort: almost universal cesarean sections for the better-off. Rev Saúde Pública. 2011;45(4):635–643. http://dx.doi.org/10.1590/S0034-89102011005000039 DOI: https://doi.org/10.1590/S0034-89102011005000039
Cardoso JE, Barbosa RHS. O desencontro entre desejo e realidade: a “indústria” da cesariana entre mulheres de camadas médias no Rio de Janeiro, Brasil. Physis. 2012;22(1):35–52. http://dx.doi.org/10.1590/S0103-73312012000100003 DOI: https://doi.org/10.1590/S0103-73312012000100003
O’Dougherty M. Plot and irony in childbirth narratives of middle-class Brazilian women. Med Anthropol Q. 2013;27(1):43-62. http://dx.doi.org/10.1111/maq.12015 DOI: https://doi.org/10.1111/maq.12015
Tesser CD, Knobel R, Rigon T, Bavaresco GZ. Os médicos e o excesso de cesárias no Brasil. Sau Transf Soc. 2011 [acesso em 2014 Jul 01]:2(1), 4-12. Disponível em: http://periodicos.incubadora.ufsc.br/index.php/saudeetransformacao/article/view/1088
Patah LEM, Malik AM. Modelos de assistência ao parto e taxa de cesária em diferentes países. Rev Saúde Pública. 2011;45(1):185–194. http://dx.doi.org/10.1590/S0034-89102011000100021 DOI: https://doi.org/10.1590/S0034-89102011000100021
Abenhaim, H. A., Welt, M., Sabbah, R., & Audibert, F. (2007). Obstetrician or family physician: are vaginal deliveries managed differently? J Obstet Gynaecol Can. 2007;29(10):801–5. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/17915063
Organización Mundial de la Salud (OMS). Reducción de la mortalidad materna: declaración conjunta OMS/FNUAP/UNICEF/ Banco Mundial. Organización Mundial de la Salud: Ginebra; 1999. Disponível em: http://whqlibdoc.who.int/publications/1999/9243561952_spa.pdf?ua=1
Tesser CD. Três considerações sobre a “má medicina”. Interface. 2009;13(31):273-86. http://dx.doi.org/10.1590/S1414-32832009000400004 DOI: https://doi.org/10.1590/S1414-32832009000400004
Mouta RJO, Progianti JM. Estratégias de luta das enfermeiras da Maternidade Leila Diniz para implantação de um modelo humanizado de assistência ao parto. Texto Contexto Enferm. 2009;18(4):731–740. http://dx.doi.org/10.1590/S0104-07072009000400015 DOI: https://doi.org/10.1590/S0104-07072009000400015
Narchi NZ. Análise do exercício de competências dos não médicos para atenção à maternidade. Saúde Soc. 2010;19(1):147–158. http://dx.doi.org/10.1590/S0104-12902010000100012 DOI: https://doi.org/10.1590/S0104-12902010000100012
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews. 2013;8. Art. No. CD004667. http://dx.doi.org/10.1002/14651858.CD004667.pub3 DOI: https://doi.org/10.1002/14651858.CD004667.pub3
Starfield B. Atenção Primária: equilíbrio entre necessidades de saúde, serviços e teconologia. Brasília: UNESCO: Ministério da Saúde; 2002. http://unesdoc.unesco.org/ulis/cgi-bin/ExtractPDF.pl?catno=130805&look=default&ll=1
Chamberlain G. British maternal mortality in the 19th and early 20th centuries. J R Soc Med. 2006;99:559–563. DOI: https://doi.org/10.1177/014107680609901113
National Institute for Health and Care Excellence. NICE clinical guideline 62. Antenatal care. 2008 Marc; atualizada em 2014 Dec [acesso em 2014 Jul 01]. Disponível em: http://www.nice.org.uk/guidance/cg62/resources/guidance-antenatal-care-pdf
Royal College of Midwives [acesso em 2014 Jul 01]. Disponível em: https://www.rcm.org.uk/clinical-practice-and-guidelines/better-births
NHS Careers. Training to be a midwife [acesso em 2014 Jul 01]. Disponível em: http://www.nhscareers.nhs.uk/explore-by-career/midwifery/training-to-be-a-midwife/
NHS choices. Your Antenatal care [acesso em 2014 Jul 01]. Disponível em: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/antenatal-midwife-care-pregnant.aspx#close
NHS Choices. Where to give birth: the options [acesso em 2014 Jul 01]. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/where-can-i-give-birth.aspx#close
Norman AH, Tesser CD. Prevenção quaternária na atenção primária à saúde: uma necessidade do Sistema Único de Saúde. Cad Saúde Pública. 2009;25(9):2012–2020. http://dx.doi.org/10.1590/S0102-311X2009000900015 DOI: https://doi.org/10.1590/S0102-311X2009000900015
Mangin D, Sweeney K, Heath I. Preventive health care in elderly people needs rethinking. BMJ. 2007;335:285. http://dx.doi.org/10.1136/bmj.39241.630741.BE1 DOI: https://doi.org/10.1136/bmj.39241.630741.BE1
Smith A, Dixon A. The Safety of Maternity Services in England. King’s Fund. London; 2007
Department of Health. Midwifery 2020: Delivering expectations. London; 2010.
NCT Maternity statistics – England [acesso em 2014 Jul 01]. Disponível em: http://www.nct.org.uk/professional/research/maternity%20statistics/maternity-statistics-england
NHS. Institute for Innovation and Improvement [acesso em 2014 Jul 01]. Disponível em: http://www.institute.nhs.uk/quality_and_value/high_volume_care/focus_on%3A_caesarean_section.html
Humaniza SUS, Ministério da Saúde (BR). Experiências do SUS que dá certo. Hospital Sofia Feldman. Belo Horizonte: MS [acesso em 2014 Jul 01]. Disponível em: https://www.youtube.com/watch?v=P8w-C-DTXGk
Downloads
Published
How to Cite
Issue
Section
License
By submitting a manuscript to the RBMFC, authors retain ownership of the copyright in the article, and authorize RBMFC to publish that manuscript under the Creative Commons Attribution 4.0 license and identify itself as the vehicle of its original publication.
