BETWEEN THEORY AND PRACTICE: CHALLENGES OF HUMANIZING CHILDBIRTH IN THE BRAZILIAN PUBLIC HEALTH SYSTEM – AN INTEGRATIVE REVIEW

Abstract

The humanization of childbirth is a key strategy for promoting woman-centered obstetric care grounded in respect for women's autonomy, the physiology of childbirth, and the best available scientific evidence. However, despite advances in public policies regarding maternal health, various challenges still hinder the implementation of these practices within health services. This study aimed to analyze the challenges of implementing childbirth humanization within the context of Brazilian obstetric care, with a focus on the role of nurse-midwives. It is an integrative literature review based on the analysis of studies published over the last ten years, selected according to pre-established inclusion and exclusion criteria. Twelve studies were included, addressing the role of nurse-midwives, challenges in implementing humanized practices, and strategies to strengthen childbirth care. The results demonstrated that nurse-midwives play a fundamental role in promoting the humanization of childbirth, contributing to the strengthening of women's autonomy, the valuing of physiological birth, and the prevention of obstetric violence. Nevertheless, obstacles persist, including the persistence of the biomedical model, structural limitations in health services, insufficient human resources, and the need for continuous professional training. The study concludes that the effective implementation of childbirth humanization depends on collaboration among professionals, managers, and health institutions; strengthening public policies, continuing education, and the professional recognition of nurse-midwives are essential for consolidating safe, ethical, and woman-centered care.