“YOU TAKE CARE OF THE BABY’S CLOTHES AND I TAKE CARE OF THE DELIVERY” – COMMUNICATION BETWEEN PROFESSIONALS AND PATIENTS AND DECISIONS ABOUT THE MODE OF DELIVERY IN THE PRIVATE SECTOR IN SÃO PAULO, BRAZIL

Authors

  • Helena da Costa Lino Psychologist. Master in Public Health. Rua Cayowáa, 1590, apartamento 21. Sumaré, São Paulo, SP.
  • Simone G. Diniz MD, PhD, Associate Professor, Department of Maternal and Child Health, School of Public Health. University of São Paulo.

DOI:

https://doi.org/10.7322/jhgd.96825

Keywords:

natural birth, cesarean, supplementary health, satisfaction with care, gender.

Abstract

High rates of cesarean sections and invasive interventions in labor and delivery, disregarding recommendations on safety and quality of healthcare characterize childbirth care in the Brazilian private sector. We aimed to understand how professionals and patients communicate about risks and benefits of the interventions and take decisions in the Internet era. We interviewed 28 professionals and female users of the private health sector in São Paulo, including those we will call “typical” and “atypical” of the national scenario. The communication about procedures among “typical” patients was scarce, biased or actively blocked, tending to strengthen a behaved attitude. “Atypical” patients sought further information from professionals and peer groups and used more Internet resources (discussion lists, evidence websites and narrative banks). The availability of such information allows more women to seek a care aligned to their values and notions of rights, frequently confronting the medical authority, creating needs to be (or not to be) satisfied.

Downloads

References

Victora CG, Aquino EML, Leal MC, Monteiro CA, Barros FC, Szwarcwald CL. Maternal and child health in Brazil: progress and challenges. Lancet. 2011; 377(9780): 1863-76. Doi: http://dx.doi.org/10.1016/S0140-6736(11)60138-4

Diniz SG, Chacham AS. “The cut above” and “the cut below”: the abuse of caesareans and episiotomy in Sao Paulo, Brazil. Reprod Health Matters. 2004; 12(23):100-10.

Dias MAB, Domingues RMSM, Pereira APE, Fonseca SC, Gama SGN, Theme Filha MM, et al. Trajetória das mulheres na definição pelo parto cesáreo: estudo de caso em duas unidades do sistema de saúde suplementar do estado do Rio de Janeiro. Ciênc Saúde Coletiva. 2008; 13(5): 1521-34. Doi: http://dx.doi.org/10.1590/S1413-81232008000500017

Leal MC, Pereira APE, Domingues RMSM, Theme Filha MM, Dias MAB, Nakamura-Pereira M, et al. Intervenções obstétricas durante o trabalho de parto e parto em mulheres brasileiras de risco habitual. Cad Saúde Pública. 2014; 30(Supl. 1): S17-32. Doi: http://dx.doi.org/10.1590/0102-311X00151513

Diniz SG. Gênero, saúde materna e o paradoxo perinatal. Rev Bras Crescimento Desenvolv Hum. 2009; 19(2): 313-26.

Barbosa GP, Giffin K, Angulo-Tuesta A, Gama AS, Chor D, Dorsi E, et al. Parto cesáreo: quem o deseja? Em quais circunstâncias? Cad Saúde Pública. 2003; 19(6): 1611-20. Doi: http://dx.doi.org/10.1590/S0102-311X2003000600006

Hodnett ED. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002; 186(5 Suppl): 160-72. Doi: http://dx.doi.org/10.1016/S0002-9378(02)70189-0

Maia MB. Humanização do Parto: política pública, comportamento organizacional e ethos profissional. Fiocruz; 2010.

Enkin M, Keirse MJNC, Neilson J, Crowther C, Duley L, Hodnett E, et al. Guia para atenção efetiva na gravidez e no parto. 3ª edição, Rio de Janeiro: Guanabara Koogan; 2005.

Atrash K, Carpentier R. The evolving role of public health in the delivery of health care. Rev Bras Crescimento Desenvolv Hum. 2012; 22(3): 396-399.

Diniz SG, Bick D, Bastos MH, Riesco ML. Empowering women in Brazil. Lancet. 2007; 370(9599): 1596-8. Doi: http://dx.doi.org/10.1016/S0140-6736(07)61671-7

Rubin G. O tráfico de mulheres: notas sobre a economia política do sexo. Recife: SOS Corpo; 1993.

Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 8 ed. São Paulo: Hucitec; 2004.

Benatti L, Min M. Parto com amor. São Paulo: Panda Books; 2011.

Salgado HO, Niy DY, Diniz CSG. Groggy and with tied hands: the first contact with the newborn according to women that had an unwanted C-section. J Hum Growth Dev. 2013; 23(2): 190-97.

Hotimsky SN. A formação em obstetrícia: competência e cuidado na atenção ao parto. Interface (Botucatu). 2008; 12(24): 215.

Aguiar JM, d’Oliveira AFPL, Schraiber LB. Violência institucional, autoridade médica e poder nas maternidades sob a ótica dos profissionais de saúde. Cad Saúde Pública. 2013; 29(11): 2287-96. Doi: http://dx.doi.org/10.1590/0102-311x00074912

Yajahuanca RSA, Fontenele CV, Sena BF, Diniz SG. Parto no posto de saúde e em casa: uma análise da assistência ao parto entre as mulheres Kukamas Kukamirias do Peru. Rev Bras Crescimento Desenvolv Hum. 2013; 23(3): 322-33.

Diniz SG, d’Oliveira AFPL, Lansky S. Equity and women’s health services for contraception, abortion and childbirth in Brazil. Reprod Health Matters. 2012;20(40): 94-101. Doi: http://dx.doi.org/10.1016/S0968-8080(12)40657-7.

Faúndes AE, Cecatti JG. Operação cesárea no Brasil: incidência, tendência, causas, consequência e propostas da ação. Cad Saúde Pública. 1991; 7(2): 150-73. Doi: http://dx.doi.org/10.1590/S0102-311X1991000200003

Sakala C. Letter from North America: understanding and minimizing nocebo effects in childbearing women. Birth. 2007; 34(4): 348-50. Doi:

http://dx.doi.org/10.1111/j.1523-536X.2007.00196.x

Gutman L. A maternidade e o encontro com a própria sombra. São Paulo. Best Seller; 2010.

Downloads

Published

2015-04-07

Issue

Vol. 25 No. 1 (2015)

Section

Original Research

License

CODE OF CONDUCT FOR JOURNAL  PUBLISHERS

 

Publishers who are Committee on Publication Ethics members and who support COPE membership for journal editors should:

 

Publishers should:

 

  • Define the relationship between publisher, editor and other parties in a contract
  • Respect privacy (for example, for research participants, for authors, for peer reviewers)
  • Protect intellectual property and copyright
  • Foster editorial independence

 

Publishers should work with journal editors to:

 

  • Set journal policies appropriately and aim to meet those policies, particularly with respect to:

–         Editorial  independence

–         Research ethics, including confidentiality, consent, and the special requirements for human and animal research

–         Authorship

–         Transparency and integrity (for example, conflicts of interest, research funding, reporting standards

–         Peer review and the role of the editorial team beyond that of the journal editor

–         Appeals and complaints

  • Communicate journal policies (for example, to authors, readers, peer reviewers)
  • Review journal policies periodically, particularly with respect to new recommendations from the COPE
  • Code of Conduct for Editors and the COPE Best Practice Guidelines
  • Maintain the integrity of the academic record
  • Assist the parties (for example, institutions, grant funders, governing bodies) responsible for the investigation of suspected research and publication misconduct and, where possible, facilitate in the resolution of these cases
  • Publish corrections, clarifications, and retractions
  • Publish content on a timely basis