Violência obstétrica durante a assistênica pré-natal e parto em Belo Horizonte, Brasil

Abstract

Obstetric violence (OV) is a gender-based, multidimensional violence with structural roots that affects women on all continents of the world and is a barrier to accessing quality obstetric care. This primary research on obstetric care in Belo Horizonte focuses on the violence that occurs during prenatal care and childbirth in order to analyze its prevalence and the perception of women in Belo Horizonte. A total of 851 women between 19 and 47 years old participated in the research, answering the programmed questionnaire on the LimeSurvey platform, hosted at UFMG, anonymous, online, self-applied, disseminated by digital networks (social, institutional emails, reports) and who had childbirth in Belo Horizonte, between January 1, 2018 and April 30, 2021. The Stata 12 software was used to perform frequency distribution and bivariate analysis using Pearson's chi-square test to verify associations between sociodemographic, pregnancy, childbirth and assistance with the spontaneous perception of women about obstetric violence. As well as the analysis of OV reports after stimulation and using care markers of violence with the spontaneous perception of women about obstetric violence, making it possible to observe obstetric violence not named or identified like OV by women, called in the study hidden OV. Among the variables associated with the perception of OV, the most important were being black, not straight, primiparous, wanting a vaginal birth, not having a baby who was born well in skin-to-skin contact, and the type of financing for the birth. Most women were white (63%), with high education (92%) and users of supplementary health (84%). The proportion of OV reported at childbirth was 18% for exclusive users of supplementary health, 11.87% for exclusive users of the SUS and 6.25% for women who made private payments. The OV in prenatal care was 70.86%, in childbirth it was 73.33% and in prenatal care and delivery it was 58.05%. The total OV was 86.14%, accounting for only 13.86% of women free from violence. Hidden obstetric violence during prenatal care was 85.76% and hidden obstetric violence during childbirth was 82.44%. It is concluded that OV is still a frequent occurrence in care practice in prenatal care and childbirth, which violates the human rights of women, hinders access to quality obstetric care and has a high prevalence among the women surveyed. It is a little-noticed phenomenon, even among women with a high level of education, users of supplementary health and whites, the predominant population in the research. Further studies can help to understand OV in Belo Horizonte and in other contexts, especially among women users of the public health system.