Analysis of changes in maternal and child health policy in a capital of northeastern Brazil. Dilemmas and challenges for care

Background The care to women’s health in pregnancy, childbirth and puerperium has being changing with the development of Brazil’s health policies. To discuss the implementation of the changes in perinatal care policy in a capital of the Northeast, analyzing the changes in the care and in organization of health services. Methods We used a qualitative approach with data collection between May and December 2015, with weekly visits in a Maternity, document review of municipal government, semi-structured interviews with users of the service, municipal managers, local managers of the federal government, professionals and managers of a municipal maternity. We conducted a focus group with volunteer doula. Findings Prenatal stands out difficulties in accessing some routine tests in primary care. It is still in the design phase to build a normal delivery centers in the city. Realize humanization of care initiatives as the introduction risk classification and the volunteer doulas program in a maternity, despite being hegemonic traditional obstetric model. There is no state regulation obstetric reflecting in the demand for care of parturient in obstetric emergency. Conclusions We perceive an incipient implementation of some key aspects of the perinatal care policy in the city, however, also identified several experiments in the routine of services pointing to the qualification of humanized care during labor and childbirth. keywords: Health Evaluation; Delivery of Health Care, Integrated; Maternal and Child Health; Perinatal Care; Humanization of Assistance.