Perinatal palliative care in Brazil: Practices and barriers from the perspective of healthcare professionals

ABSTRACT

This qualitative study aimed to understand the meanings and practices in palliative care from the perspective of healthcare professionals working in perinatal care in the Country, as well as their perceptions regarding the difficulties in developing these practices. It is an excerpt from a thesis that investigated the challenges of incorporating this care as a practice in the perinatal line. Semi-structured interviews were conducted with professionals working in the five regions of the Country, between March 2023 and March 2024. Thematic analysis according to Minayo, and interpreted through the lens of Moscovici’s theory of social representations, gave rise to a central category: work processes, reception practices and their barriers. Findings revealed regional variation in the representation and practice of palliative care, with a notable scarcity of interdisciplinary teams with specialized training and exclusive dedication to this field. Fragmentation was observed between prenatal planning, birth and postpartum care, in addition to difficulties in communication, lack of institutional support, and insufficiently trained professionals. These issues compromise the continuity of care and the effective application of the principles of palliative care and comprehensive health. The study concludes that perinatal palliative care in Brazil is still incipient, lacking structuring, interprofessional coordination and institutional policies that support its effective implementation.

KEYWORDS
Palliative care; Perinatal care; Health personnel; Health knowledge; attitudes; practice; Barriers to access of health services.