Transferências maternas e neonatais em parto domiciliar planejado: vivências dos enfermeiros obstetras e obstetrizes no Brasil

Abstract

Planned Home Birth (PHB) in Brazil, if effectively integrated into the health system, has the potential to enhance safety for the mother–newborn dyad. However, it continues to face numerous challenges, including the absence of formal regulation and guiding policies, limited access to essential supplies, legal insecurity and insufficient institutional support. This qualitative study, with a descriptive–exploratory design, aims to understand and analyze the experiences of nurse-midwives and midwives regarding transfers from planned home birth to hospital care in Brazil. A total of 20 professionals from all regions of the country participated, selected from the database of a larger study. Among them, 19 identified as female and one as male; their ages ranged from 30 to 59 years, and most had been providing PHB care for over 10 years. Data collection took place between march and april 2025 through semi-structured video-call interviews. The study followed the COREQ guidelines and data were analyzed using Bardin’s Content Analysis. Two main thematic categories emerged: (1) facilitators and barriers and (2) emotional responses and professional repercussions. Additionally, subjective information was extracted regarding reasons for transfer, frequency and nature of the transfers. The findings indicate that transfer remains a major point of vulnerability within PHB. The processes involved are complex and emotionally demanding, underscoring the need for strengthened interprofessional integration, formalized transfer protocols, improved legal-professional support and enhanced communication strategies.