Order of Doctors meets urgently to analyze DGS guidance on childbirth

The Order of Doctors (OM) regretted this Friday that it was not heard about the guidance of the Directorate-General for Health for health care during childbirth and will meet on Saturday urgently to define a position.

In a statement, OM said that it became aware of the guidance of the Directorate-General for Health (DGS) on health care during labor only through the media. The institution led by Carlos Cortes criticized the fact that the final report of the Commission for Monitoring the Response in Gynecology and Obstetrics and Delivery Blocks had not been previously sent to the order for its technical pronunciation.

“It is absolutely regrettable that the OM was not consulted before the decision was taken, especially since this is an issue with an impact on health care and the safety of mothers and children”, underlined the president, quoted in the statement.

According to Carlos Cortes, the fact that the Ministry of Health and the DGS “have excluded the Order of Doctors from the final document is a flaw that is difficult to understand”.

“In view of this situation, the Permanent Commission of the Order of Doctors and the College of Gynecology and Obstetrics will meet tomorrow [sábado]as a matter of urgency, to analyze this matter and define the next steps for action”, the statement also said.

At issue is a guideline from the DGS on health care during labor, which provides that hospitalization, in low-risk situations, “can be carried out by an obstetrics and gynecology doctor or by a nurse specialist in health nursing maternal and obstetric (EEESMO)”.

“In eutocic deliveries [sem recurso a qualquer tipo de instrumento]the person responsible for the delivery will preferably be an EHESM, while in instrumented vaginal deliveries it will always be an obstetrics and gynecology doctor”, further clarifies the DGS document.

These procedures were proposed by the Commission for Monitoring the Response in Urgent Obstetrics and Gynecology and the Delivery Block, with the aim of standardizing hospital health care during labor and clarifying the role of the various health professionals. In 2022, several emergency obstetrics and gynecology services and the birth ward in various parts of the country had to close for certain periods or operated with limitations, due to the difficulty of hospitals in completing the service rosters of specialist doctors.

In December, the executive board of the SNS announced the sharing of resources between several hospitals to guarantee the normality of emergency gynecology and obstetrics services during the Christmas and New Year periods, a network operation that still continues until the end of May. .

In June 2022, the Obstetric Violence Observatory lamented the “total dependence” of hospitals on specialist doctors, advocating that more autonomy should be given to maternal health and obstetrics nurses in monitoring pregnant women.

“The services are organized with total dependence on specialist doctors, instead of autonomy being given to specialist nurses in maternal health and obstetrics, which results in a total collapse of the support system for pregnant women in all phases of their follow-up”, he added. , at the time, the observatory in a statement.

According to the Ordem dos Enfermeiros, there are around 3,200 specialist nurses in maternal health and obstetrics in Portugal.

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