Mayra Malavé (IFF/Fiocruz)
Fernandes Figueira National Institute for Women, Children and Adolescents Health (IFF/Fiocruz) was visited in November by a group of 13 foreign midwives that wanted to learn more about the activities undertaken by each reference area of the institution, like the Breast Milk Bank (BLH-IFF) and the Pregnancy Care Center. This was the first trip to Brazil organized for foreign midwives as a response to the number of obstetric nurses in the United Kingdom, Australia and New Zealand interested in opportunities to learn about their occupation in different contexts. In addition to IFF/Fiocruz, the group also visited other hospitals and birth centers in Rio de Janeiro, São Paulo, Manaus and Salvador.
The visit had been planned more than a year in advance by a professional and educational tourism company based in London. According to Gina Carmo, owner of the Brazilian tourism company that enabled such exchange with foreign institutions, midwives were interested in understanding the reasons for the high number of C-sections in Brazil and they read a lot about it before the trip. "We were already familiar with IFF/Fiocruz work and we visited them last September to meet them in person. We were quite impressed, so we decided to add the institution to our group-visit itinerary and this idea was well-accepted by the areas of the Institute that were involved", she explained.
IFF/Fiocruz director Fábio Russomano welcomed the group of midwives with a general institutional presentation about the nature and mission of the Institute. During the visit, managers of the Breast Milk Bank and the Pregnancy Care Center walked around the facilities of these places to talk about the services offered by the areas visited.
BLH-IFF manager Danielle Aparecida Silva and Maíra Domingues, in charge of the care activities offered in the sector, led the midwives and provided information on work flows, the international presence of the Global Network of Breast Milk Banks (rBLH) and their importance in protecting and promoting breastfeeding to reduce infant mortality.
According to the midwives, one of the most impressive aspects was that BLH can collect and distribute certified-quality breast milk according to the specific needs of each baby by means of low-cost technological development. "The work done in the breast milk bank is quite impressive. This was a new concept to them and they were truly happy to learn about it", said Gina Carmo about the experience of the midwives at IFF/Fiocruz BLH.
"I will return with a very positive idea of the work done in the Breast Milk Bank. The support you offer to mothers so that their babies are only fed with human milk is really brilliant. Breast milk is designed for infants, it has everything they need", added Mary Norton, an obstetric nurse from the United Kingdom.
In IFF/Fiocruz Pregnancy Care Center, Luciana Filies and José Paulo Pereira, managers in charge, and obstetric nurse Adriana Peixoto led visitors through all units of the sector: Labor and Delivery Nurse, Admission, Rooming-In, Obstetric Surgical Center, and Fetal Medicine.
Adriana Peixoto led the presentation during the visit to this area, explaining the activities of the Institute, like the reference hospital for high-risk pregnancies to the fetus and high-risk pregnancies to the mother, like pregnant women with zika virus, HIV or other diagnoses requiring special attention.
"They were a bit surprised with our number of birth defects, but I told them we are a reference institution for congenital malformations, as well as for issues that can be corrected surgically. Here, we invest in these babies. That's why we are different from what they usually see in their country of origin. There, they usually do not invest in high-risk pregnancies, they terminate those pregnancies. Here, pregnancies are only terminated with a court order", explained Adriana.
She also explained to the midwives the high rate of C-sections performed at IFF/Fiocruz, approximately 50%, due to the fact that several hospitals providing prenatal care refer risky pregnancies to the Institute when babies cannot be born by vaginal delivery.
Among the work methods of the Pregnancy Care Center, the use of non-pharmacological technologies in vaginal birth was seen as very positive by the midwives, as the same technologies are used both in the United Kingdom and in Australia. These are non-invasive technologies used to relieve pain and provide relaxation: massage in body parts referred by pregnant women as most painful, aromatherapy - use of natural plant extracts in some parts of the expulsion stage -, auriculotherapy, and positions to facilitate birth, among others, explained by Viviane Mendes Araújo, expert nurse in the segment.
To Cathy Warwick, leader of the visitors group and executive coordinator of the Royal College of Midwives, in the United Kingdom, "the most surprising aspect was the support provided to mothers for a humanized vaginal birth. It was quite interesting, I was impressed with the level of interest of the Institute to include these practices. It is very enriching. I will sure return home and talk about how Brazilians provide care in surgical and vaginal birth", she added. According to Gina Carmo, in light of the success of this visit, in the future, more foreign professionals from different healthcare areas will be interested in learning more about the work of IFF/Fiocruz in other areas of care.