Pregnancy and childbirth in Brazil — prenatal care, maternity hospital, insurance, rights

Prenatal care in SUS

According to art. 8 of Lei 8.069/1990 as amended by Lei 13.257/2016, all women are ensured access to women’s health and reproductive planning programs, and pregnant women — adequate nutrition, humanized support during pregnancy, childbirth and the postpartum period, and full pre-, peri- and postnatal care through SUS.

• Pré-natal is conducted by the primary care level — the local health clinic (art. 8, §1). Registration for care starts there.
• Childbirth is preferably attended by the same physician who followed the pregnancy (art. 8, §2).

How many consultations are due. The Ministério da Saúde’s pregnant woman card of the 2026 edition names a minimum of seven pré-natal consultations with reference to Portaria GM/MS nº 5.350/2024. The figure “six”, which appears in articles and manuals, is the previous version of the regulation. After childbirth at least two postpartum visits are due.

Care does not depend on a passport. The same document lists what cannot influence treatment of a pregnant woman: race and skin color, age, sexual orientation, gender identity, social status, disability, citizenship and migration situation. This is the most direct wording on the question “do I, as a foreign woman, have the right” among Brazilian documents.

The maternal and child care network since 2024 is called Rede Alyne — the former name Rede Cegonha is found in older texts and on signs.

The general principle of access to SUS for a foreigner is discussed in Medical care and insurance in Brazil: the system must accept any person in the country.

The right to know your maternity hospital in advance (Lei 11.634/2007)

A provision that often does not exist in other countries, and here it is direct.

Every pregnant woman followed in SUS has the right to know in advance and to be assigned (art. 1) to:

1. the maternity hospital where her childbirth will be attended;
2. the maternity hospital that will receive her in case of complications during pregnancy.

The assignment is the responsibility of SUS itself, and it occurs at the moment of registration for pregnancy (§1). The maternity hospital must be demonstrably suitable for her level of gestational risk, including the postpartum period (§2). If the maternity hospital lacks technical or staffing capabilities, SUS considers a transfer request and provides safe transport (art. 2).

Practically this means: the question “where will I go to give birth” is asked at registration, not when labor starts.

Companion — in public and private facilities

Art. 19-J of Lei 8.080/1990 in its current wording (Lei 14.737/2023): at consultations, examinations and procedures in public and private medical facilities every woman has the right to be accompanied by an adult person during the entire appointment, without prior notice.

The woman chooses the companion herself (§1); the companion is obliged to preserve medical confidentiality. The provision is broader than “the partner at birth”: it applies to any appointments and to private clinics as well.

Private childbirth: insurance and waiting periods

Key norms — art. 12 of Lei 9.656/1998.

These are ceilings set by law; a specific contract can be more lenient, but usually is not. A policy for childbirth must be purchased at least ten months before the expected date, i.e. practically before pregnancy.

If obstetric coverage is present in the plan (art. 12, III):

• the newborn is covered for the first 30 days after birth — as the child of the insured or their dependent;
• the newborn can be added to the plan as a dependent without any waiting periods if this is done within 30 days of birth. A missed deadline means the usual carência for the child.

What remains if the waiting period is not met: childbirth in SUS or payment out of pocket. Emergency care is covered after 24 hours — but “emergency” is not the same as “planned childbirth”.

How to choose a doctor and a maternity hospital: RN ANS 368/2015

The resolution of the Agência Nacional de Saúde Suplementar gives the insured an instrument that few know about.

Percentages of cesareans. At the insured person’s request the operator must provide the percentage of cesarean sections and vaginal deliveries — for the operator itself, for the named medical facilities and for the named physicians (art. 2).

• The answer — within 15 days, with a protocol number, in writing, in clear language, by a method chosen by the requester (art. 2 §2, art. 4).
• The data — for the previous year; if requested from January 1 to March 31 — for the year before last (art. 2 §2, I–II).
• The operator must state that the figures refer only to births through it, not to the entire practice of the physician or clinic (§3).
• It is forbidden for the operator to compile rankings of physicians and clinics by these percentages (art. 3).

Cartão da Gestante — the pregnant woman’s card, the record document of pré-natal consultations. It remains with the woman, is presented at all facilities and at the maternity hospital upon admission in labor (art. 6). The operator must issue it upon request (art. 7). Inside — the “Carta de Informação à Gestante” and a minimum of data from the Ministério da Saúde’s card. The absence of the card cannot be a reason to refuse care (art. 6, §2).

Partograma — a graphical document of the course of labor and the condition of mother and fetus, at least to WHO standard (art. 8). It is part of the billing process for the childbirth service itself (art. 9); if for clinical reasons it was not kept, a detailed medical report is required.

What a maternity hospital must do — any, including private

Art. 10 of Lei 8.069/1990 (ECA) for public and private facilities:

• keep individual records and store them for 18 years;
• identify the newborn by footprint and fingerprint, and also by the mother’s fingerprint;
• perform newborn screening tests for metabolic disorders and provide explanations to parents;
• issue a declaração de nascimento indicating the features of the childbirth and the condition of the child — this is the document from which registration begins, see Birth of a child in Brazil — registration, citizenship, documents;
• ensure rooming-in (joint stay) of mother and child;
• support the establishment of breastfeeding.

Doula — by a separate law since April 2026

Lei nº 15.381 of 8 Apr 2026 regulated the profession of doula: a person who provides physical, informational and emotional support during pregnancy, childbirth and immediately after.

• The presence of a doula is ensured in maternity hospitals, birth centers and similar facilities of the public and private network, if the parturient requests it — for the duration of labor and the immediate postpartum period.
• Charging a separate fee for her presence is prohibited.
• A doula may be a person with completed secondary education and specific training; courses after the law’s entry into force must be not shorter than 120 hours. Those who can demonstrably prove having worked as doulas for more than three years by the date of publication of the law retain the right.

A doula does not replace the companion: the right to a companion of one’s choice exists separately and is not used up by the doula's presence.

Work: what cannot be done to a pregnant woman

• You cannot dismiss her without cause — from the moment pregnancy is confirmed and until 5 months after childbirth (ADCT, art. 10, II, “b”).
• She must be allowed time off for pré-natal consultations and examinations.
• Change of function for medical reasons — without loss of pay; removal from hazardous and dangerous work (CLT, art. 394-A).
• Breastfeeding: two half-hour breaks or one one-hour break during the shift, until the child is 6 months old, including in cases of adoption (CLT, art. 396).
• Leave at birth: maternity — minimum 120 days; paternity — minimum 5 days with phased expansion by years: 10 days in 2027, 15 in 2028, 20 in 2029. The Empresa Cidadã program allows the employer to extend maternity leave to 180 days, and paternity by another 15 days.
• If the mother or the newborn stayed in hospital for more than 14 days due to childbirth complications, maternity leave is extended to 120 days after discharge.

All these are rights of a formally employed worker. A newcomer without formal employment does not receive them, see Work and entrepreneurship in Brazil for foreigners (in Russian).

Money during maternity leave

Salário-maternidade — 120 days, starting in the interval from 28 days before birth up to the date of birth, is paid by Previdência Social (art. 71 of Lei 8.213/1991). The right exists for those insured in the Previdência Social system — i.e. a formally employed worker or someone who pays contributions independently. A newcomer without formal employment and without contributions is not entitled to the benefit, see Work and entrepreneurship in Brazil for foreigners (in Russian).

Sources

1. T1Lei nº 9.656/1998 — insurance waiting periods and newborn coverageplanalto.gov.br · primary source
2. T1Lei nº 8.080/1990 — right to a companionplanalto.gov.br · primary source
3. T1Lei nº 11.634/2007 — right of a pregnant woman to know her maternity hospital and be linked to itplanalto.gov.br · primary source
4. T1Lei nº 8.069/1990 (ECA) — prenatal care in SUS and obligations of maternity hospitalsplanalto.gov.br · primary source
5. T1RN ANS nº 368/2015 — access to cesarean rate percentages, cartão da gestante, partographans.gov.br · primary source
6. T1Lei nº 8.213/1991 — salário-maternidade, 120 daysplanalto.gov.br · primary source
7. T1Caderneta Brasileira da Gestante, Ministério da Saúde, 2026 — minimum seven consultations (Portaria GM/MS 5.350/2024), care regardless of citizenship and migration status, job stability, leave periodsgov.br · primary source
8. T1Lei nº 15.381 of 8 Apr 2026 — the profession of doula; presence at childbirth in the public and private network at the request of the woman in labor, additional payment prohibitedplanalto.gov.br · primary source

T1 — primary: law, agency site, price list. T2 — secondary: press, specialist sites. T3 — other.