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Normal labour and birth sixth international conference

Cecilia Leslie, a student midwife from Scotland, reports on the sixth international normal labour and birth conference.

RCM normal birth conference

I am a student midwife in Scotland but I was born in Brazil – an amazingly beautiful and diverse country, but one where caesarean section rates are extremely high, midwifery practise is not legally recognised and the medical model of care is prevalent. In becoming a student midwife in the UK, where women-centred care is in the heart of the profession, I could reflect back on the ‘medical-centred care’ largely practiced in Brazil, and felt I owed it to all women and their babies to challenge this sad reality.

I desperately wanted Brazilian women – and all women for that matter – to be restituted with the power of giving birth in their own terms. I did not know where to start my journey to make this wish a reality but recently taking part in the normal labour and birth sixth international research conference, held in Grange over Sands, provided me with some answers I had been looking for.

Through research and its resulting evidence, we can challenge and change the archaic ‘opinion based practice’ which still happens in Brazil and in so many other countries. I was delighted to have the opportunity to attend this conference and meet so many midwives, student midwives and researchers who, like me, believe in the physiology of labour and birth. Among them also, was a group of Brazilians who have been trying to legalise the midwifery profession and to establish normality around childbirth in our home country.

I feel encouraged, challenged and inspired by the conference and the people I met there, as I know I am not alone in my plea for globally normalising childbirth. I would like to encourage all midwives and student midwives who are looking to enrich, innovate or consolidate their practice in any way, to attend as many conferences as possible, as they will no doubt provide many opportunities as well as a more dynamic perspective on midwifery – like this one provided me with.

It would be very good for the Brazilian population if this form of medicine in specialized hospitals for pregnant women were equal in Brazil as there exists in the UK.

Arnaldo Arruda (29/07/2011 00:29:02)

Dear Cecilia, I am not sure what you mean when you say that midwifery is illegal in Brazil. I am currently working as a home birth midwife in Natal RN, (I am an American nurse/midwife trained in the USA. Many nurse/midwives are present in hospitals or in home birth practices (not enough of them, though), and the USP School of Midwifery is training midwives at a college level entry.

The federal health secretary is working hard to integrate many thousands of traditional midwives in the public health care system, and although the c/section rate is still too high, it has decreased a lot especially in the public health care system, where physiological and more humane birthing units (including birthing centers) are starting to surface.

Illegality of midwives in Brazil is not the issue, their autonomy and practice is challenged by many problems such corporativism of Md and scarcity of resources just to name a few...

I am sometimes frustrated to see the same discourse about Brazil, which has in that last 20 years changed a lot thanks to its new government policies regarding health and education.

Thanks for taking part in a huge reform and fighting for a more humane birth..

Regine Marton CNM , doula and parteira, in Natal RN Brasil

Regine Marton (29/07/2011 00:58:19)

Impressive lady this one, and the daughter-in-law of my dear friend Shirlie. I too was a midwife from Rhodesia, now know as Zimbabwe, and where I spent 20 magic years - 10 of them being an autonomous community midwife in an inner city area. I loved my 'girls' and their babies. We were saying all these things then. Why is it still so difficult to get a normal delivery with a midwife of your choice? I would have done the job for nothing. My ladies gave me much more than I ever gave them. Happy days indeed. How I miss them. Bev

Beverley D Thompson (23/08/2011 15:43:50)

In response to Regine,

I met a midwife at the conference who is Brazilian and trained at USP University. She reported that working and practicing as a midwife in the role of a midwife is not recognised as a legal profession. They can legally work in hospitals to assist doctors and women during childbirth but there is no legal recognition of their profession per se. Your reply explains this further in that the recognition and consequent autonomy as we know it in Britain is something many are fighting for but is yet to be achieved.

Cecilia Leslie

Cecilia Leslie (14/09/2011 15:46:27)

Dear Regine, to further the reply to your question, to clarify, I did not mention being a midwife was not legal. My point was it is not recognised as a profession by the authorities in Brazil. With that, I agree there is a midwifery course in Brazil offered by USP. I met a midwife who graduated at USP University and affirmed my understanding expressed in the original article, she graduated and could not get a registration to practice. If you may go to the USP university website, you will read that there is no guarantee that you will be able to register and consequently practice as a midwife after the course is completed. I don't understand why you get frustrated with such discourse. Although Brazil is slowly changing there is a long road ahead, and the more people who hear about our struggles the more the awareness will lead into change. I met at the conference, amazing researchers from Brazil who are passionate about the normality surrounding childbirth. I had the privilege to meet Dr Maria do Carmo Leal who is guiding authorities to make normal birth the norm through gathering national data on maternity services. In a TV interview with Dr Leal after her UK visit, in which she states that although there has been changes, midwifery as we know it in the UK is yet to be accepted by most authorities and population. Of course there are some that believe in, and is supportive of, normality. See: (http://video.globo.com/Videos/Player/Noticias/0,,GIM1578762-7823-CESARIANAS+REPRESENTAM+MAIS+DE+DOS+PARTOS+POR+ANO+NO+BRASIL,00.html). You mentioned C/S rates are decreasing, which is wonderful, but according to recent data, more than 45% of births per year in Brazil are C/S, corroborating with my original article. My heart rejoices in knowing that the Brazilians I've met are working so hard to bring on changes. I am delighted to hear that you have been engaging in and facilitating humane births. It has been fantastic to hear of your experience in my so loved country.

Cecilia Leslie (20/09/2011 10:56:17)