CARMO GALLO NETTO

A Unicamp renewed, for another three years, a cooperation agreement in the area of ​​alternative birth (squatting) with the University of Alcalá (Spain). The agreement provides for the development of joint research projects, in addition to the implementation of distance learning courses via the Teleduc methodology, designed at Unicamp. The research, coordinated by Professor Hugo Sabatino, from the Department of Obstetrics at the Faculty of Medical Sciences (FCM), is based on the work carried out by the researcher at the Center for Comprehensive Attention to Women's Health (Caism).

Sabatino says that in June he will be taking to Spain his experiences on the process of preparing women so that childbirth can be seen in the most natural way, in addition to the practices that should be applied in squatting births in women called “civilized”, a since the method is part of indigenous cultures. The use of a chair developed at Unicamp is also planned. It can be used during squatting births as in other types of births. Easy to maintain, it is made of fiberglass material, which allows washing after the procedure.

Still in June, the researcher will be in Lanzarote, a Spanish resort, giving the inaugural class at a national congress organized by midwives (matrons), who constitute an organized professional class in the country with significant representation. On his trip, the professor will also be giving lectures in Malaga and Madrid. He considers that “for Brazil these participations are important because, in some way, the flow of technology is being reversed”.

Pioneering – Work involving alternative births began in 1980, serving a group of women who were looking for other, more natural forms of birth, avoiding conventional births, so as not to feel treated as sick. “Based on existing work, we began to study the possibility of giving birth in a squatting position, taking the woman out of bed, eliminating hair removal and intestinal lavage and allowing her to be accompanied by people of her choice, which caused a stir at the time because it went against established protocols,” says Sabatino. Many of these behaviors ended up being incorporated and today, by law, women can have company during childbirth.

The first specialist to draw attention to vertical birth, considering it much more natural, was the American doctor Howard, in the 50s, but without actually carrying it out. The pioneering spirit in the world considered “civilized” was the responsibility of the doctor Moyses Paciornick, who, in Curitiba, observed that the perineum of Indian women was much stronger than that of white women. This happened, among other reasons, due to the use of squatting births, which he began to adopt for his patients.

“We then adopted it and started to carry out a series of research, facilitated by the fact that we are part of a university”, says Sabatino. Among these, the doctor highlights two that he considers fundamental. The first, when, just a few years ago in Brazil, coming from Argentina, in collaboration with professor Hugo Fragnito, from the “Gleb Wataghin” Institute of Physics (IFGW) at Unicamp, he measured intravaginal pressures in pregnant women and compared the results at birth conventional, in the horizontal position, with those obtained in squatting birth.

Once these pressures were quantified, he discovered that in the upper part of the uterus, where the woman needs more strength, the pressure was greater when giving birth in a squatting position. Conversely, the pressure in the vagina is lower, which makes it easier for the child to exit, when compared to the values ​​obtained during birth in the horizontal position. The measurement model developed by Sabatino and Fragnito (called “Unicamp Units”) was published in international publications and supported squatting births.

Scientific rigor – The second research was based on 30 thousand births carried out at the Hospital de Clínicas da Unicamp, from which eight thousand were selected, involving patients who fully met the normal parameters and who did not present any clinical problems. Of this universe, 500 had been performed squatting. The results showed that children whose mothers had given birth in a squatting position were born in significantly better health conditions, when compared to those born in horizontal births.

Despite this, Professor Sabatino recognizes that there is still a lack of elements that allow the research to be given the scientific rigor required by academia: “This is what we intend to pursue with the cooperation agreement with Spain. We will carry out a study in which pregnant women will be randomly selected, in order to obtain elements that allow us to draw conclusions with greater scientific rigor. This will certainly be a big step, which for various reasons we were unable to take previously”.

The researcher understands that the University fulfilled its role by researching the method and demonstrating its applicability, although not everyone accepts it for various reasons, including not considering the data conclusive and sufficient. Controversies aside, Sabatino has just returned from a conference held in Mar Del Plata, Argentina, where he presented three works and one of them won an award.