Childbirth at home in Portugal

practices between the forties and sixties to nowadays recommendations

Abstract

Introduction

In portugal, between the 40’s and 60’s, the birth was considered a "household affair" carried out with the help of expert women in the area. The lack of skilled assistance to pregnancy and childbirth was revealed by the high rates of maternal and neonatal mortality, observed during this period.

The birth was an experience that involved not only procedures and elementary tools but also the work of women, called midwives, without proper training. The assistance during childbirth had improved tremendously up to nowadays. Progresses were also made in maternal health as well as in the obstetric and neonatal fields. Along with scientific developments, childbirth at home is currently and once again under consideration mainly by women and professionals that defend a humanist approach during the childbirth act.

Objective

To explore scientific evidences and the experience of childbirth at home during the 40’s and 60’s in portugal.

Methods

An integrative literature review according to the picod method and an exploratory research with 55 portuguese women aged between 72 and 97 years old who have lived the experience of childbirth at home.

Results

The results revealed that in the 40’s to 60´s, women were mainly assisted by midwives who used very elementary procedures. The most used positions were gynecological and side-lying position and the majority of women remained with sequelae due to poor assistance conditions, therefore the deformation of the vagina and urinary incontinence can be highlighted as the most common consequences.

Conclusion

The advance of the art of childbirth at home was an advantage to our time because it contributed to a significant reduction of maternal and perinatal mortality rates and to the increase of the quality in care system to the woman and the newborns. It is essential that health professionals reflect on the advantages and disadvantages of each type of childbirth and on the most humane and safe conditions for this procedure. Health policies should be focused on women and should not only ensure the possibility of choice in accessing the type of care in the pre- and post-natal but also in the childbirth place. Women should be able to choose the type of birth they want as well as and its place, so the planned home birth should not be neglected, but considered as a right and a choice for the woman and her family. However it is essential that health policies invest in the dimension of providing obstetric care to these women, ensuring a safe and humanized perinatal care at home, based on the best scientific evidence/ recommendations