It is good to hear about positive news about midwifery from across the globe. Dianne Garland, Freelance Midwife, Founder Midwifeexpert.co.uk, shares her recent trip to Sao Paulo, Brazil, and her visit to a thriving birth centre.
In October 2025 I was invited to speak at the Siaparto conference Sao Paulo Brazil.
“Siaparto is an international event that brings together childbirth professionals from around the world, promoting the exchange of knowledge and advancement of best practices in maternal and neonatal health.”
This organisation run numerous conferences aimed at education, networking and the improvement of maternity services in Brazil.
As in many countries, Brazil have high caesarean section, intervention rates and a shortage of midwives. The government have a strategy to improve education, employment and health care.
There were five English speakers who attended. David Hayes (USA) and Betty Ann Davis (Canada) speaking about vaginal breech birth, Kenneth Clarke Johnson (Canada) discussing statistics and Paul Golden (UK) on human rights and childbirth. My own session was about the implications on practice following the publication of the POOL study (Sanders et al 2024). The session was well received, with many questions and contact follow ups.
These are a couple of colleagues who networked during the conference; time to swap stories, experiences and the future of waterbirth and maternity care.
During my short stay I was keen to visit one of the few birth centres in Brazil. Casa Angela opened in 2009 and had 375 births in 2024. I was welcomed by Thaís Trevisan one of the supervisor midwives, (responsible for the Nucleus of Education, Research and Consultancy) who shared their wonderful statistics; particularly of interest was the use of water (24 % in baths and 5% in a shower) during labour/birth. The birth centre has a 70:30 ratio of primigravid to multigravida mothers. Thais shared the Casa Angela presentation showing a 20.9% transfer rate, with an ambulance and driver readily available, with a 5-minute transfer time. Other of note statistics were that they had no episiotomies, 0.5% third degree tears (no 4th degree tears), PPH rates 13.3% and positive breast feeding rates above 98% at discharge.
I particularly liked the home-made food available to women in the centres own kitchen, a small garden space for mothers and a herbal bed. The pictures on walls shared the passion that this centre have for birth.
Interestingly, unlike so many units in the UK this birth centre stayed open throughout the covid pandemic, a huge congratulations to all the staff and parents during such a stressful time.
Dianne and Thaís Trevisan at entrance to birth centre.
Dianne Garland, Freelance Midwife Founder Midwifeexpert.co.uk.
December 2025
Information about the Casa Angela birth centre is available at: https://www.casaangela.org.br/