Dr.ª Ivone Lobo

OBGYN 
Subspecialist in Maternal-Fetal Medicine
Head of Maternity HPA Gambelas

Birth in our maternity unit

HPA Magazine 10

Childbirth has changed throughout time, but a safe pregnancy and delivery are human rights. Advances in obstetrics have led to a drastic reduction in maternal morbidity and mortality, as well as that of the foetus, which is now considered to be a patient.
This is one of the reasons that make obstetrics so fascinating, as we treat not just one person, but two: the mother and the unborn child.
The experience of pregnancy and childbirth is considered to be one of the greatest and most enviable experiences in a woman’s life. 
All pregnant women and parents of new-borns have different feelings, ideas and expectations. All pregnancies are unique and special. 
Nowadays, childbirth is not reduced to the shape of the woman’s pelvis and the size and presentation of the foetus; more than a just a biomechanical process, it is also an emotional one.

There is no such thing as an ideal birth, because the care must be individualised for each woman; the necessities and choices of the family need to be taken into account and must be culturally sensitive.
In our maternity ward, we take a natural approach that is holistic, versatile and universal, which can be used to complement the needs of the woman at any stage of the pregnancy and delivery, whether by natural or C-section birth. We always try to conciliate the best of both worlds: the expectations of the parents and the safety of the mother and the unborn child.
We have abandoned the use of some of the traditional practices during the birth because there is a lack of evidence concerning their efficiency, and some can even have adverse effects and endanger the woman and the baby.
For example, the practice of fasting and applying a saline drip can provoke maternal and foetal hyperglycaemia. Enemas should only be used on women with painful constipation. There is no evidence of any advantage in perineal shaving. There are non-pharmacological means to control pain which are safe and moderately effective. Changes in position and alternative positions for delivery provide greater comfort and efficiency during the delivery; an episiotomy is not done by routine. 
We always do “skin-to-skin contact” after vaginal or C-section births (using “natural Caesarean” techniques whenever possible). 
We must assess the results of the improvement in modern obstetric care, not only in physical terms, which is essential, but also in emotional terms and in the woman’s satisfaction.
Our objective is that, no matter what type of delivery, the memory of the birth should always provoke positive emotions that allow her to appreciate motherhood to the fullest.
We also want the pregnancy to end with a healthy baby and mother, a primary objective in prenatal care that has not changed in the last hundred years.
The real voyage of discovery consists not in seeking new landscapes but in having new eyes.” (Marcel Proust).This is the principle of our daily practice.