Analysis of newborn vitality in home births attended by nurse midwives in Rio de Janeiro-Brazil

Background: In Rio de Janeiro the medicalized technocratic model of childbirth care predominates, with the belief that safe childbirths only occurs in hospital, assisted by doctors, with a set of interventions such as... [ view full abstract ]

Background: In Rio de Janeiro the medicalized technocratic model of childbirth care predominates, with the belief that safe childbirths only occurs in hospital, assisted by doctors, with a set of interventions such as episiotomy, analgesia, amniotomy, manual placenta’s delivery, as well as a set of invasive procedures to the newborn. We noticed that women who choose home birth are more confident in the physiology of their own bodies. There are studies showing a high risk of newborns with Apgar Score lower than 7 in the first and fifth minutes of life in home birth. However, there is also evidence that nurse midwives’ care during home birth, especially from a demedicalized perspective, contribute to the birth of healthy newborns. Objective: To discuss the outcomes related to the newborn vitality based on Apgar Socre in home birth attended by nurse midwives, in Rio de Janeiro-Brazil. Methods: it is a descriptive, quantitative study which consisted of records referring to newborns whose mothers had home births, in Rio de Janeiro, Brazil, from 2013-2016. Apgar <8 analysis was considered at the 1st and 5th minutes of life. Data from 70 babies born at home, followed by nurse midwives were analyzed. Results: Data showed that 12 (17.14%) mothers needed to be transferred due to complications during labor. There were no fetal intercurrences in these situations and there were no transfers of newborns in the immediate postpartum period. Of the 58 (82.85%) babies who were born at home, 2 (3.44%) had Apgar Score lower than 8 in the 1st minute and only 1 (1.72%) in the 5th minute. Of the 12 women transferred to the hospital, 100% of the babies presented Apgar Score over than 8 in the 1st and 5th minutes of life. Conclusion: The results showed that nurse midwives’ care for babies who were born at home, based on the use of noninvasive care technologies, was effective. The low occurrence of the Apgar Score below 8 shows this efficacy. These positive outcomes in a large urban center contribute to making this practice more known and trustable among women and valued by professionals.