The recipe that lowered cesarean deliveries at Rosario’s Hospital

The recipe that lowered cesarean deliveries at Rosario’s Hospital

9 October 2017 | Health

It is the Roque Sáenz Peña. Chirurgic intervention was necessary in only 18% of the first 100 births.

By Mauro Aguilar

On August 28th, Rosa Méndez became a mother for the first time. Brianna’s weight was 2.4 kg and she had immediate contact with Rosa for 2 hours, a policy that wants to improve immediate attachment, and that is a strict one among the practices that are applied at the Roque Sáenz Peña Hospital in Rosario. The 20-year-old woman talks to Clarín in one of the rooms of the brand new Women Integral Attention Area and smiles. “I really liked it. The place, the space… we don’t have an insurance and the attention was amazing”, she explains.

She’s a part of a “friendly protocol in which, the protagonists are mothers and their children”, explains Gustavo Bacci Fava, chief of obstetrics and gynecology, and author of the 2011 project that allows great improvements in births.

In this place, only 18% of the cases were cesarean births, when the average in the public health centers of the city oscillates between 25% and 30%, and a 60% in private health facilities, similar to what happens in Buenos Aires. According to WHO, the percentage of cesarean births shouldn’t be higher than 15%.

After the first 100 births –in one month-, epidural anesthesia was used only in 12 of the cases –longs in Rosario rise to the 80%-, while the hormone used to stimulate contractions or fasten the labor, lowered from 78% to 16%, and the application of intravenous serum lowered from 80% to 28%.

Cutting of the vulva reduced from 25% to 8%, and tubal ligation went from 40% to 92%. 90% of the mother used shower or immersion for relaxing and as anesthesia before giving birth. Break the water that is a usual practice to accelerate birth, but that also alters the baby, reduced from 82% to 28%. “Numbers broke our heads”, says with enthusiasm Matías Vidal, director of the hospital. He explains that the goal is to “go back to simple”, trying to simulate a home birth, but with professional containment and resources.

Skin to skin contact (ssc) between mother and child is strict, even in the case of a cesarean birth, if the mother is in good conditions and she wants it. It has verifiable results: the newborn regulates his breathing, stabilizes hemodynamically, protects his brain development, adapts better to nursing. It’s a key.

“This we are doing is also the newest technology: humanizing the attention”, says Marisel Soldani, chief of neonatology. “In all neonatology units, morphine is used to calm the babies pain, here we use sugared water and place him on his mother. The baby gets calmed. Things like this are scientifically documented and we decided to do them here”, says Vidal.

Among the tools that help during labor are: fabric hung of the ceiling, balls, mats, stools or beds that take different positions for more comfortable labor technique. Bathtubs to relax the women and elicit under water births –there were 8 births like that- , accompaniment of the chosen family member during all the process, and permanent access of the mother and one partner to the neonatology room. This is what Leonardo Caruana, Health Secretary, calls “change of paradigm”.

In the first registered birth, the father could enter the room along with his other 2-years-old child. “You should’ve seen that little creature’s face”, say the professionals. They are part of a project that started five years and that required a building reform, plus buying stat-of-the-art equipment. Out of 130 counted births, only 8 babies went through neonatology. “When you respect the time, everything is less complicated”, says Vidal.

The hospital counts with 4 Labor and Recovery rooms con advanced equipment, heated and air-conditioned, with music and illuminated in order not to disturb the mothers and the babies. The professionals on the Roque Sáenz Peña say that the pregnant woman “is not a patient nor is ill”, but goes through a physiological process that requires time and special care. That’s how they try to refute that they are part of a “series production” mechanism.

From: Clarí