Project in São Bernardo takes care of doulas to favelas

Social educator Katarina Yalodê, 25, was in the final stages of her pregnancy when the Covid-19 pandemic began. It was not an easy birth. At the HMU (Municipal University Hospital) in São Bernardo do Campo, Greater São Paulo, she had to be alone for 18 hours in the service room.

The delivery lengthened and lasted 20 hours. She cannot rely on a companion or any kind of support. “I only found my partner after that time, who had to leave right away because of the pandemic,” he recalls.

Since then, Katarina has worked to strengthen the role of pregnant people during pregnancy itself, giving birth and the postpartum phases. She is the creator of the Trilunar project, in Jardim Limpão, on the outskirts of São Bernardo.

In addition to being a social educator, Katarina is also a doula, a person who helps with a more humanized childbirth. “It’s important to have the doula at these stages, because the medical team usually doesn’t have enough professionals to maintain a welcoming service”, he says.

During pregnancy, she even took part in prenatal care at Casa Angela, a humanized birth center in the south of the capital.

Katarina saw the importance of a service that would bring perinatal education to the peripheries (a period that begins at 22 complete weeks of pregnancy and ends seven days after birth), with information on childbirth, postpartum, maternity, paternity and parental responsibility.

And Trilunar came up with this proposal. The independent project was created in June 2020, with activities applied from September of the same year.

It is focused on assisting pregnant and postpartum women (people who are going through the puerperium, postpartum period) assisted by the SUS (Unified Health System) and who live in social vulnerability.

The social educator says that the name Trilunar relates the influences of the moon phases to the development phases of a woman’s body. “Maternity makes us rediscover and reconstruct ourselves. Trilunar brings this meaning in its essence, the sacred feminine, the forces of gestation and ancestral rescue.”

So far, the project covers Jardim Limpão, Vila Esperança and Montanhão, outskirts of São Bernardo do Campo. About ten women have already gone through the support of the project that Katarina applies alone, for now, guiding and answering questions from a fixed group of five mothers.

“The postpartum dialogues took place online. Except for the face-to-face visits I made to advise on problems such as misguided attachment [quando o bebê tem dificuldade de pegar no peito da mãe] at the time of breastfeeding, which can cause physical trauma to the breast and the health of babies”, he says.

In this group that maintains a messaging app, mothers also exchange tips on what to do to reduce their children’s colic, in addition to strengthening the support network that some do not find at home.

One of the members is the teller operator Paloma Chaves Moura, 24.

“I seek advice from my mother on what to do, but it seems she sees it more as an ‘ah, but I’ve been through this too, it’s normal’. But I don’t know if I can trust it even if some situations are normal,” he says. Paloma, eight months pregnant.

In the case of Sabrina Nascimento, 21, the support helped her through the pregnancy phase of her son Nicolas, 1. “At the beginning of the pregnancy I didn’t want to do anything, not even to get up,” she says. “Katarina helped me a lot, from start to finish, teaching me how to handle the baby so I could breastfeed, she did foot baths when I was stressed.”

Doulship in the slums

To bring the subject of douling to the city’s slums, Katarina conducts conversation circles and personalized service based on the needs of the pregnant woman, the parturient (a term that indicates the woman in labor or who has just given birth) and those who are in the puerperium.

“From an empathic perspective of motherhood, the puerperium does not have a stipulated time, because it is a transition of hormones, emotions, identity constructions, being as a woman and now a mother”, says the doula, who still provides information on the pages of Trilunar on Facebook and Instagram to reach more people.

With the reduction in Covid-19 cases, the Jardim Limpão doula has been returning to face-to-face activities. Every Friday, at 4 pm, she strengthens the monitoring by various activities, such as workshops on sensory toys and motor coordination for babies.

For this, it currently has a partnership with the headquarters of the Jesus de Nazareth Community Council, in the Vila São José neighborhood, in São Bernardo.

The social educator also wants to train doulas as of the second half of 2022. The idea is that mothers who have gone through Trilunar become future doulas.

She intends to count on the collaboration of Coletiva Raízes do Parto, a multidisciplinary group of ABCDMRR (São Bernardo do Campo, Santo André, São Caetano do Sul, Diadema, Mauá, Ribeirão Pires and Rio Grande da Serra) focused on public policies for doubling and for humanized care.

Doula and placente Mariana Clara de Souza Neves, 31, resident of Santo André, is one of the members of the collective. And she points out insufficiency in the assistance provided by the HMU.

“A resident of the post-ferry region [bairros que ficam após a travessia da balsa na represa Billings], for example, runs the risk of taking up to two hours to get to that hospital,” he says.

In a statement, the Municipal Health Department of São Bernardo do Campo states that the HMU performed an average of 345 births per month between January and September 2021. Of the total, 67% (231) of these obstetric procedures were vaginal and 33% (114 ) cesarean sections. According to the folder, prenatal care is offered at 33 basic health units, with monitoring by a multidisciplinary team.

As for the HMU, the city government says that the hospital provides assistance for vaginal births with tools to humanize labor, such as the backrest (stretching bar), massage and bathtub, with the support of obstetric nurses. At the moment, Primary Care does not offer the service of doulas.