Suely

Ashoka Fellow
Brazil,
Fellow Since 1991
C.A.I.S do Parto

Citation

This profile was prepared when Suely Carvalho Neves was elected to the Ashoka Fellowship in 1991.
The New Idea
Suely has assisted hundreds of births in her profession, and she has learned to identify the very specific physical and psychological needs of women who are in labor--needs that modern medicine tends to mask and neglect. As a young nursing midwife in a hospital in Parana State, Suely monitored the final stages of up to 14 births per shift. She observed how out of place the women felt in a hospital environment, and how frightened and psychologically unprepared they were for a phenomenon nature had physically designed them for. While monitoring a birth through its various stages, Suely would try to calm the mother, massaging her belly and talking to her softly to put her at ease. She began to make small changes in hospital procedure that made big differences in the mothers' comfort: breathing exercises alleviated contractions and cramps; vaginal massages with natural ointments such as sesame seed oil eased the passage of the emerging fetus; and if the mother were in a half-seated position at the moment of expulsion, dilation increased by two full centimeters.To promote these practices, Suely wants to strengthen the group of professionals long linked with this tradition of giving birth -- midwives. For this, she is training health agents as midwives, identifying retired midwives and learning from them (recycling their know-how), and creating a national network of midwives.As this network gains strength, Suely will encourage the creation of "birth centers," especially in poor urban and remote rural areas where hospitals and services are scarce. A "birth center" is a house run by a midwife, with all the equipment needed for natural childbirth as well as pre- and post-natal care. One such birth center can serve a population of approximately 30,000. Suely also plans to persuade existing hospitals to organize the same type of services and eventually to include midwives in Brazil's national health system.
The Problem
The Strategy
The Person

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