Bill 264.

Summary.

The bill establishes a healthy birth framework applicable throughout the Republic of Panama, whether delivery is vaginal or by cesarean section. Its protection extends from the preconception stage through pregnancy, childbirth, the postpartum period and newborn care. It calls for care grounded in scientific evidence and respect for human rights, and requires observance of the framework’s rights, definitions and principles and its implementing regulations. It recognizes compassionate, dignified and respectful treatment as guiding principles for the care of every woman.

It defines respectful childbirth as a model of care that takes account of a woman’s wishes and needs and respects her autonomy. It also defines obstetric violence as an act or omission by health personnel causing physical or psychological harm during pregnancy, childbirth or the postpartum period; a birth plan as the document setting out a woman’s preferences; and secure attachment as a lasting emotional bond between a baby and caregiver.

The provisions on women’s rights require information about possible medical interventions so women can choose among available alternatives. They protect privacy, individualized care and cultural practices, and recognize women’s participation in birth. The text recognizes a right to natural childbirth that respects biological and psychological timing and avoids invasive procedures or medication unjustified by health conditions or medical protocols. It provides for a birth guide through which the woman gives advance consent to nonurgent procedures, in line with the Technical and Administrative Standards and Care Protocol of the Comprehensive Women’s Health Program of the Republic of Panama.

Examinations or interventions for research require written consent under a protocol approved by the Bioethics Committee (Comité de Bioética). A woman may be accompanied by a person she chooses during labor, delivery and the postpartum period; public medical centers must accommodate that person in accordance with medical judgment. The bill also provides for mother and child to remain together when the newborn does not need special care. It calls for information and support on breastfeeding, guidance on maternal and newborn care, and information on the effects of tobacco, alcohol and drugs.

Newborns are entitled to dignified treatment, unequivocal identification and a shared hospital stay with their mother that is as short as their health permits. Interventions for research or teaching require written consent from their legal representatives under a protocol approved by the Bioethics Committee. Parents must receive guidance on care, growth, development and vaccination. Where a newborn is at risk, the parents would receive continuing information on diagnosis, prognosis and treatment, have access to and participate in the child’s care when circumstances permit, and receive guidance on special care. Breastfeeding must be facilitated when it does not adversely affect the newborn’s health. Their written consent is also required for research interventions.

The Ministry of Health (Ministerio de Salud), identified as MINSA, would prepare the National Strategic Plan for Respectful Childbirth and Nurturing and Responsive Newborn Care with the institutions of the National Health System (SNS). It would oversee implementation, coordinate budget planning and integration measures, enter into cooperation agreements, promote quality management, and develop regulations, protocols and technical standards with input from system institutions. It would also promote research and continuing education. The Ministry would oversee compliance in collaboration with the Social Security Fund (Caja del Seguro Social). Article 9 addresses breaches of obligations by public and private hospitals, medical centers, clinics, health professionals and their staff. These provisions concern those public bodies, maternity and neonatal care providers, and families receiving their services.