Childbirth in Brazil has not always been a natural experience for either rich or poor. Vaginal birth is more frequent in the public health system and occurs almost always with great pain and with excessive use of interventions. In private sector establishments, caesarean section is often unnecessary and almost always pre-scheduled, becoming an option to minimize suffering. Given this peculiar scenario, the Ministry of Health decided to open a call for action via a grant from the National Council for Scientific and Technological Development (CNPq) for conducting a large national study designed to examine labor and birth in the country. The INOVA-ENSP project and Foundation for Supporting Research in the State of Rio de Janeiro (Faperj) also gave important support for this research.
This study was coordinated by Oswaldo Cruz Foundation (Fiocruz), and covered 266 hospitals that reported 500 or more deliveries per year, representative of hospital births in this universe, where 83% of all births occur in the country. 191 municipalities were visited and 23,940 women were interviewed between February 2011 and October 2012.
The results are presented in 14 original articles in this thematic issue, addressing methodological aspects of the sample, creating an algorithm for calculation of gestational age and estimation of maternal mortality; antenatal care outcomes; decision on the mode of delivery; interventions on low-risk mothers and newborns; mode of delivery in adolescents; satisfaction with care and the presence of a companion during hospitalization; maternal and neonatal near miss and mortality, an analysis of the structure of maternity care and a description of a successful experience for reducting caesareans in the private sector.
Conducting this research required the participation of a large number of universities and researchers who gathered to form a CNPq Research Group. Without this team, this research would have been more difficult and, above all, less significant. Likewise, the study enabled research training for a large number of young professionals, many of whom developed their masters dissertations and doctoral theses with these results.
The work of the technical team and IT support, was equally significant, given the complexity of the logistics in the fieldwork for a research of this size.
Hospitals that participated in this study deserve recognition for their trust and generosity in allowing their facilities to be visited and their documents handled.
In this final stage of publication, the participation of the editorial team of the Cadernos de Saúde Publica and the entire staff of the journal was of fundamental importance, resulting in publication in record time without sacrificing scientific rigor, as well as the tireless work of reviewing manuscripts.
We would particularly like to thank the women who responded to our invitation to join the research, because without them this study would not have happened. Statements were video-recorded and organized in the form of videos. We hope that the information provided by them can show to Brazilian society an overview of labor and birth in Brazil by raising awareness among health professionals, policy makers, care managers, pregnant women and their families for the need to change the current model of obstetric care.
- Publication in this collection