The challenges related to World Patient Safety Day, which will be celebrated next Friday (17), were the subject of a virtual public hearing at the Legislative Assembly of Rio Grande do Norte (ALRN) promoted by state deputy Isolda Dantas on Monday (13/09). In 2021, the date has the theme “Safe maternal and neonatal care”, accompanied by the call to action “Act now to ensure safe and respectful childbirth”. The general director of the Santos Dumont Institute (ISD), Reginaldo Freitas Jr., was one of the speakers and detailed the need for more effective public policies to combat maternal and infant deaths. 

“This issue is one of the most serious issues faced by public health, and many people are still unaware of the extent of the social impact of maternal mortality. What we need to change first is the collective unconscious that childbirth is a difficult thing, because people think that maternal death after childbirth is just another facet of a mother who sacrifices herself for her child. So, deconstructing this idea is essential for the successful understanding of patient safety. And there is already scientific evidence capable of promoting maternal safety, what is missing is the realization of this right”, emphasized Reginaldo Freitas Jr., who is an obstetrician and professor of Medicine at the Federal University of Rio Grande do Norte (UFRN). 

According to the professor, both the woman and the newborn are subjects of rights and protagonists of this event called “childbirth,” which is also a social process. “I understand that measures to ensure a safe and respectful birth must take into account the human rights of women and their children,” he said, explaining the concept of maternal mortality, according to the World Health Organization. For the WHO, maternal mortality “is the death of a woman during pregnancy or within 42 days after its termination, regardless of the duration or location of the pregnancy – inside or outside the uterus – due to any cause related to or aggravated by the pregnancy or by measures related to it, but not due to accidental or incidental causes.” 

According to Reginaldo Freitas, 921,300 maternal deaths have preventable causes. “To analyze maternal mortality, it is not enough to just look at high blood pressure, hemorrhages or infections. It is extremely necessary to look at its deeper causes: social injustice, lack of appreciation for women in society and violation of women's human rights. Without addressing these issues, we will not reduce maternal mortality in our country,” he assured. 

He then showed a comparative map between maternal mortality and income. “Notice that the two maps are inversely proportional. Where there is more mortality, women earn less. In Brazil and in RN, for example, women are the majority of the population, but their salary difference compared to men is 22%. Our RN has a maternal mortality rate above the national and northeastern average, and the Covid-19 pandemic exposed this wound, which is bleeding like never before,” he lamented. According to what he explained at the public hearing, the solutions to the problem mainly involve reproductive planning, in which women should have the right to decide if, when and how to get pregnant. 

“In addition, it is necessary to take action during prenatal care, with facilitated access, care protocols based on scientific evidence, non-discrimination and connection to the reference maternity hospital and, above all, guaranteeing prenatal care until birth. During childbirth, it is important to guarantee an obstetric bed, good practices based on science, reducing cesarean section rates, managing emergencies and ensuring respect for women’s leading role,” he explained. Regarding postpartum care, he mentioned ensuring timely postpartum consultation, connection to reference services when there are complications and valuing the context of women’s lives. 

“Finally, I want to say that it is very important to investigate these deaths, so that they can provide a basis for future political decisions; replacing the culture of blame with one of learning; social mobilization; and the development of a collective critical consciousness, that is, of all citizens, in addition to managers, health professionals and the women involved”, concluded Reginaldo Freitas Jr.  

Theme

“Every year, the World Health Organization (WHO) chooses a theme for World Patient Safety Day. This year’s theme is justified by the risks to which women and newborns are exposed, especially now during the pandemic, with the lack of health professionals and the increase in poverty. This issue is extremely important to us, since it is related to the issue of women,” highlighted state deputy Isolda Dantas. The parliamentarian also spoke about the relevance of the SUS for the population’s quality of life. “When we see someone announcing cuts to the public health system, we feel very sad. The SUS is a heritage of the Brazilian people, especially in this issue of safe childbirth,” she added. 

The following speakers participated in the public hearing: Professor Zenewton André da Silva Gama, from the Department of Public Health at UFRN; and the State Secretary of Health, Professor Cipriano Maia.