From the ‘Rede Cegonha’ to ‘RAMI’: tensions between paradigms of maternal and infant health care

Abstract

In April 2022, the Ministry of Health published the Ordinance number 715, aiming to establish the new Maternal and Infant Health Care Network (RAMI). Having in mind the pre-existence of an organized network to protect and promote maternal and infant health (Rede Cegonha), we decided to analyze the models of care intrinsic to each of them. For this purpose, we used the research with discursive practices as a theoretical-methodological framework, identifying repertoires regarding three predefined categories: subjects, places and agents of care. In our analysis, we could observe paradigmatic differences between the two health care networks. From such distinctions, we conclude that the ‘Rede Cegonha’ is based on a conception of pregnancy and childbirth as normal events of sexual and reproductive life, whereas ‘RAMI’ is structured through an emphasis on risk, which results in a model of care centered on the doctor and the hospital as a privileged location for childbirth.