Mother-Friendly Childbirth Initiative: effort to promote normal birth in Brazil

• Grant number: 18/26835-5
• Support Opportunities: Scholarships abroad - Research
• Start date: March 01, 2019
• End date: December 31, 2019
• Field of knowledge: Health Sciences - Nursing - Obstetrical Nursing
• Principal Investigator: Jamile Claro de Castro Bussadori
• Grantee: Jamile Claro de Castro Bussadori
• Host Investigator: Christine McCourt
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Institution abroad: City University London, England

Abstract

Currently in Brazil, regardless of the social class of the individual, birth has not been a natural experience, since most births are assisted within interventionist and obsolete care. Basic humans rights, such as racial equality, autonomy, information, bodily integrity and care based on good practice are not guaranteed. Although the need for innovations to improve maternal and child health, as well as public policies and social movements has been discussed for years, women have their rights to respectful care violated, abuse and disrespect during childbirth care are discussed. Woman are submitted to cesarean sections unnecessarily and do not find support and encouragement for breastfeeding, in addition to being exposed to high rates of near miss and maternal mortality. The World Health Organization (WHO), International Federation of Gynecology and Obstetrics (FIGO) and International Confederation of Midwives (ICM) believe that every woman has the right to a positive birth experience and to compassionate care from knowledgeable, skilled providers who recognize that each woman, family, and newborn is unique and deserving of individualized dignified care. To promote a better experience and a more woman-friendly care, measures like International Childbirth Initiative was created. In 2015 the International Mother-Baby Friendly Birthing Facilities Initiative (MBFBF) have launched.Is this feasible in highly medicalized settings, like Brazil? Aim: This study aims to compare childbirth care model through the activity system in two maternity hospitals of the Public Health System and the relationship with International Mother-Baby Friendly Birthing Facilities Initiative (MBFBF). This study aims to compare childbirth care model through the activity system in two maternity hospitals of the Public Health System and the relationship with International Mother-Baby Friendly Birthing Facilities Initiative. Metodology: This project is a sub-component of a thematic project "Strategies for the incorporation of innovations in childbirth: pilot intervention in the Brazilian Unified National Health System (SUS) of the International Mother-Baby Friendly Birthing Facilities Initiative (MBFBF)" (Process 2015/50498-0), which it is a quasi-experimental, before-and-after study with mixed methods and inspired by the methodology of the Laboratory of Changes. The first stage consisted of a qualitative exploration (observation of services, interviews, focus groups and documentary analysis) to study how professionals and managers perceive abuses in care, their relationship with the precariousness of training and working conditions. For this sub-component, a mixed study is being carried out, under the MBFBF concept, in which a qualitative step is being developed (service observation, interviews and focus groups) to study how professionals and managers perceive the insertion of the criteria of the MBFBF in labor and delivery, in the policies and protocols of the institution studied. And the quantitative cut has been structured in the application of a tool "Maternity Safety Thermometer: extended version", to identify the presence of MBFBF criteria assistance received by women. Results will be used to support the development of educational materials for accreditation at MBFBF. (AU)