A woman’s rights in labor and doulas in Brazil: what the law says and where its limits are

A woman in labor in Brazil has several separate rights: to a companion of her choice, to a doula’s presence and to clear explanations before interventions. The first two are established by law, while the admission procedure and restrictions, for example in the operating room, are set by the facilities themselves. A doula does not perform medical procedures and does not replace a doctor.

A companion: what does the law establish?

The right to a companion in labor in SUS (the public health system) was established by Lei 11.108/2005: SUS services must admit one companion named by the woman during contractions, birth and immediately after. In 2023, Lei 14.737/2023 rewrote this provision and extended it to public and private facilities: at appointments, examinations and procedures, a woman has the right to be accompanied by an adult companion of her own choosing; there is no need to give advance notice.

The law makes several exceptions:

• in the operating room and intensive care, where safety restrictions are justified by the medical team, only a companion who is a health professional is admitted (§ 4);
• for procedures with sedation, a refusal of a companion is put in writing no later than 24 hours before (§ 2-A);
• in urgent cases the team may act even without a companion (§ 5);
• the facility must post a notice of the right to a companion (§ 3).

A doula: what do the two laws say?

The federal law Lei 15.381/2026 has been in force since April 9, 2026. The Santa Catarina state law Lei SC 16.869/2016 has been in force since 2016 (with amendments of 2017 and 2020).

Choosing a doula remains the woman’s decision. Her presence does not exclude a companion and does not replace the work of doctors and midwives (Lei 15.381, art. 5 and 6, § 1 and 5). The law lists what she does: helps find information based on current scientific evidence, suggests comfortable positions, teaches breathing, uses massage, a warm shower and compresses, and supports newborn care and feeding (art. 4). How this looks with Katerina is described in the section “Doula support for birth”.

What do the maternity hospitals themselves require?

The law sets the framework, and the facility sets the admission procedure. Two examples from official documents:

• HU-UFSC, doula registration (norms of March 28, 2025): the doula first attends an open visit to the maternity hospital (visita aberta), then registers and brings a form, a copy of a photo ID, a copy of her doula course certificate and a signed commitment on conduct. Reviewing the documents takes up to 15 working days;
• HU-UFSC, birth: the woman’s consent and a written description of methods are needed. Under internal norms, one companion and the doula are admitted to the operating room. Responsibility for care remains with the doctor;
• HU-UFSC, prohibitions: a doula may not attend two women in labor at once, interfere in the actions of medical staff, or photograph, film or publish images of the premises, staff and other patients without their permission or the facility’s permission;
• Maternidade Carmela Dutra (FAQ): a woman may bring both a companion and a doula of her choice; the doula follows the rules in the hospital’s materials.

That is why the question of a doula is settled weeks before the birth: ask the hospital for its rules in writing. The admission procedure is also described on the page “For maternity hospitals”; on the other criteria for choosing a hospital, see the directory of Florianópolis maternity hospitals.

What explanations and consent can you expect?

Resolution CFM 2.284/2020 refers to two norms of the Code of Medical Ethics. Under art. 22, a doctor must obtain the consent of the patient or the legal representative after explaining the procedure, except in the case of an immediate threat to life. Under art. 34, the doctor must tell the patient the diagnosis, prognosis, risks and aims of treatment; the exception is cases where direct disclosure may harm the patient: then the legal representative is informed.

Under the same resolution, in a planned situation a woman has the right to choose a cesarean after detailed information about vaginal birth and about the operation, and the decision is recorded in written consent (CFM 2.284/2020). At normal risk, such an operation on request is performed no earlier than 39 full weeks, and a doctor may decline and refer the woman to a colleague.

In Santa Catarina, the state law Lei SC 18.322/2022 defines obstetric violence (violência obstétrica) as any act by a doctor, a team, a relative or a companion that insults a pregnant woman, a woman in labor or a woman who has just given birth in word or deed (art. 34). In federal law and among doctors this term remains a subject of dispute; here it is used in the sense of the Santa Catarina law.

Among such actions the law (art. 35) names, in particular, any procedure without permission and a plain-language explanation, a ban on the presence of a companion of the woman’s choice, painful, unnecessary or humiliating procedures (for example, an enema and shaving of the pubic area) and an episiotomy without need. Facilities must post this list and contacts for complaints (art. 37). The list is also published by HU-UFSC.

Where do you turn if your rights are violated?

1. Immediately ask for the head nurse or the shift supervisor and calmly ask on what grounds you are being refused.
2. File a complaint at the facility itself (as the HU-UFSC page says): Carmela Dutra, for example, has an ouvidoria, a citizens’ complaints service (the hospital’s page).
3. HU-UFSC also names other channels: a call to 180 (Ligue 180, a helpline for women) or to 136 (Disque Saúde, the Ministry of Health hotline), the ANS line 0800 701 9656 (the regulator of insurance plans; if the complaint is about an insurance plan), the medical and nursing councils (CRM and COREN), the Defensoria Pública (state legal aid) or a private lawyer if you need a suit for damages. If a crime is suspected, contact the police or the Ministério Público (the prosecutor’s office).

The sanctions the Santa Catarina law on doulas provides for facilities are shown in the table above (Lei SC 16.869/2016, art. 3).

What we don’t guarantee

• that a maternity hospital will admit a particular doula without prior registration;
• that both a companion and a doula can be in the operating room: that depends on the facility’s rules and the condition of mother and baby;
• the outcome of a complaint and how long it will take;
• that the norms will not change: the data are given as of October 3, 2026.

When you need a lawyer or a doctor

For compensation or to defend your rights, you need advice from a Brazilian lawyer or the Defensoria Pública. Clinical decisions are made by a doctor, not by a doula and not by a website. If life is at risk, call SAMU (the ambulance service) at 192: the call costs nothing, and the service works around the clock.

If you need help preparing for the birth and communicating with the team, you can write to Katerina.