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Home or Hospital? Holding  the Space for Human Birth: Saraswathi Vedam

A banalização da violência obstétrica no cotidiano das maternidades

Segue abaixo o resumo e o link do artigo intitulado Violência institucional, autoridade médica  e poder nas maternidades sob a ótica dos  profissionais de saúde publicado no periódico Cadernos de Saúde Pública, na edição de novembro.
As autoras do artigo são Janaina M. de Aguiar, Ana Flávia P. L. de Oliveira e Lilia B. Schraibe
http://www.scielo.br/pdf/csp/v29n11/15.pdf

Em resumo, o artigo traz uma discussão sobre a violência institucional em maternidade sob a ótica dos profissionais de saúde. Foram entrevistados 18 pessoas que trabalham na rede pública e privada (médicos obstetras, enfermeiras e técnicas em enfermagem), sobre experiência profissional e conceito de violência. Os resultados mostram que os profissionais citam práticas discriminatórias e desrespeitosas às gestantes, parturientes e puérperas (jargões pejorativos como formas de humor, reprimendas e negligência no manejo da dor), mas geralmente não as reconhecem como formas de violência. Estes exemplos de práticas do cotidiano são tratados pelos entrevistados como exercícios de autoridade, num contexto considerado "difícil". Segundo as autoras, este contexto revela a banalização da violência institucional travestida de boa prática. O que parece ser feito para o bem da paciente torna invisível a violência no cotidiano da assistência.

Mulheres grávidas com hepatite C podem transmitir aos recém-nascidos uma cepa viral muito eficaz para a replicação| Medcenter

Segue o link para notícia sobre os resultados de uma pesquisa recente e importe.

Mulheres grávidas com hepatite C podem transmitir aos recém-nascidos uma cepa viral muito eficaz para a replicação| Medcenter

BBB Niterói

Olá!

Este é um convite para conhecer o trabalho que o Parto Ecológico está iniciando com o NUANCE.

O Parto Ecológico funciona em rede e tem como missão abordar ecologicamente os processos físicos e emocionais que surgem durante a gestação parto e pós-parto, unindo a melhor e atualizada tecnologia com cuidado individualizado e holístico.

A Roda de Barrigas Bebês e Bigodes tem o objetivo de trazer temas relevantes da gestação, parto e pós-parto para a circulação de informação com qualidade. Os diálogos podem ser permeados por recursos lúdicos e corporais, aproximadamente a cada 30 dias.

Alguns temas a serem abordados:

• Alimentação e gestação
• A formação da nova família
• Sexualidade
• Arte viva
• Parto fisiológico
• pós-parto e amamentação
• Trabalho de parto
• Dinâmicas de parto

Traga sua sugestão de novo tema!

Esperamos você!

Será que eu entendi bem?!

I invite you, dear reader, to lead your reading to the last line of this article to share the understanding of the statement of medical authority:

"Epidurals are completely safe, but They are linked with a small Increase in instrumental birth"

Women who give birth under the primary care of a midwife are more likely to have full-term births and fewer medical interventions, a major review has found.

The results have led the highest international authority for assessing medical evidence, the Cochrane Collaboration, to call for all women who are not at high risk of complications to be offered midwife-led care.

Australian obstetricians are rejecting the call, saying it is safest for women to be treated by midwives working in tandem with doctors.

The Cochrane review examined the evidence of 13 trials involving more than 16,200 women randomly assigned to either midwife-led care or other models, such as having an obstetrician in charge.

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It found several benefits of midwife-led care and no negative effects, concluding ''most women'' should be offered midwife-led care and be encouraged to ask for it.

Australian College of Midwives spokeswoman Hannah Dahlen said the high-level review was significant. "We are one of only two countries in the developed world that has such a huge amount of private obstetric care," she said. ''Yet this is high-level evidence … showing midwife-led care is linked to a significant reduction in pre-term birth.''

Women treated by midwives were 23 per cent less likely to give birth prematurely and foetal death before 24 weeks was 19 per cent less likely, the review found.

Premature birth is one of the leading causes of sickness and death in otherwise healthy babies in Australia. About 8 per cent of children are born early.

Professor Dahlen said what lowered the risk was not clear, but it could be related to continuity of care and midwives' emphasis on social and mental well-being.

''When you go into the hospital system it can be really scary,'' she said. ''But when you have that relationship, that assurance, and you feel safe, what we call the 'cascade of normal birth' kicks into place."

The review found midwife-led care was also linked to lower use of epidurals and forceps or vacuum use, and longer labour. There were no differences in caesarean rates, overall foetal death, labour induction or use of opiate painkillers.

Professor Dahlen, of the University of Western Sydney, said obstetricians were still very much needed, but should assist more high-risk and fewer low-risk births.

Royal Australian and New Zealand College of Obstetricians and Gynaecologists president Michael Permezel said there was "nothing" within the review that indicated Australia should shift towards more midwife-led care.

"Good care involves collaboration," he said. "Up to 40 per cent of women identified as low risk during pregnancy develop complications so collaboration between midwife and obstetrician provides the best maternity care for all women."

He said the finding that pre-term birth was less likely under midwife-led care was "counter-intuitive" and there was ''no reason on earth'' for it.

But he said the review was otherwise unsurprising.

"What this review is showing is that midwives don't encourage pain relief, whereas obstetric staff are more accepting of the patient's request to have epidural pain relief," Professor Permezel said. "Epidurals are completely safe, but they are linked with a small increase in instrumental birth."

Read more: http://www.smh.com.au/national/health/mothers-urged-to-call-the-midwife-20130821-2sbn0.html#ixzz2cjMng0Hb

Parto e Enfermeiras Obstétricas

Delaying UmbilicalCord Clamping Benefits Newborns Later

Medscape Madical News

Diedtra Henderson / Jul 11, 2013

Pausing 1 to 3 minutes after birth before clamping the umbilical cord halps full-term newborns in the near-term by boosting indicators of healthy blood levels and halving the risk for deficiency up to 6 months later without increasing teh chance of maternal hemorrhaging acoording to a meta-analysis.

Susan J. McDonald, PhD, from the Midwifery Professorial Unit at La Trobe University/Mercy Hospital for Women in Melbourne, Australia, and colleagues reported the results of their systematic review of data from 15 trials in an article published online July 11 in the Cochrane Library.

The research team scoured the Cochrane Pregnancy and Childbirth Group's Trials Register, excluding 37 trials and including 15 randomized trials involving 3911 women and their newborns to determine the pluses and minuses of the timing of umbilical cord clamping for mothers and newborns.The time at which umbilical cords are clamped varies in high-income countries, with active management of the "third stage of labor" sometimes timed to coincide with the crowning of the infant's head, when the anterior shoulder emerges, or after the newborn's birth, according to Dr. McDonald and colleagues. With "early" clamping, 1 clamp is placed near the infant's navel and a second clamp is positioned farther up the umbilical cord; the cord is snipped between the 2 clamps roughly 1 minute after birth. With "late" clamping, the cord is cut roughly 3 minutes after birth, allowing for up to 30% more fetal blood and 60% more red blood cells to be transferred to the infant, the researchers write.

"There were significantly lower infant haemoglobin concentrations at birth for babies in the...early clamping group compared with those in the late clamping group ([mean difference] -2.17 g/dL 95% [confidence interval (CI)] -4.06 to -0.28; random-effects model)," Dr. McDonald and coauthors write.

"Infants in the late clamping group were significantly less likely to have iron deficiency (average [relative risk] 2.65 95% CI 1.04 to 6.73; with a [late clamping event rate] ranging from 0.5% to 70%, I² 82%)," the research team continued.

The authors found no significant difference in the risk for sever postpartum hemorrhaging for mathers (risk ratio, 1.04; 95% CI, 0.65 - 1.65).

Deleyed cord clamping did sligtly increase the risk for jaudice however. "The benefits of deleyed cord clamping need to be weighed against small additional risk of jaudice in newborns." said coauthor Philippa Middleton, form the Autralian Research Center for Health of Women and Babies. Robinson institute, Univeersity of Adelaide, in a news release. "Later cord clamping to increaseiron stores might be particularly beneficial in settings where severre anaemia is common."

"A more liberal approach to delaying clamping of the umbilical cord in healthy term infants appears to be warranted, particularly in light of growing evidence that delayed cord clamping may be of benefit in the longer term in promoting better iron stores in infants, as long as access to treatment for jaundice requiring phototherapy is easily accessible," the authors conclude.

Support for the study was provided by the University of Adelaide, the Department of Health and Ageing, the National Institute for Health Research, and the National Health and Medical Research Council. One study author disclosed receiving financial support from the National Institute for Health Research National Health Service Cochrane Collaboration Programme grant scheme. The remaining authors have disclosed no relevant financial relationships.

Cochrane Library. Published online July 11, 2013.