Violência obstétrica sob a percepção das mulheres que a vivenciaram

Abstract

Obstetric violence is a dehumanized assistance to women´s health during the pregnancy and puerperal period, and all health professionals may be responsible for it during the medical support. It´s based on the excessive use of medication, instrumentation and iatrogenic interventions in the delivery process, and starts a group of negative events over women’s body. This research aims to understand, under the gender perspective and reproductive rights, the factors that intervene in the assistance practices to women´s health during the pregnancy and puerperal period, focusing on obstetric violence. This is a qualitative research based on Jesus Gómez Critical Communicative Methodology (CCM), Paulo Freire and Jürgen Habermas as main theoretical support and, Lídia Puigvert Dialogic Feminism as genre theoretical support. The CCM aims to identify the transformative elements, that is, the ones that promoted a satisfactory experience in the pregnancy and puerperal period assistance, and the elements that exclude, that is, the ones that represents a wall to this experience, relating both to the categories lifeworld and system. The participants were nine (9) women who experienced delivery and birth and had their assistance in the “Sistema Unico de Saude” (SUS), the Brazilian public healthcare system .The data were collected from 05/19/2015 to 12/15/2015, using as instrument the communicative narration script. The data analysis was conducted using the basic level of analysis from the Critical Communicative Methodology, where the transformative and exclusion elements found in the narratives were analyzed in the lifeworld and system categories. The results showed a higher quantity of exclusion elements compared to transformative elements, being the exclusion ones related to the system. They indicate mistreatment, inadequate proceedings during delivery, lack of professional orientation, lack of support during breastfeeding, race and social class discrimination and lack of satisfaction with the service. It was a found a few transforming elements and most of them related to the lifeworld category. Among these elements, we can highlight family support, the presence of a companion, empowerment and conscience of a collective fight. This study shows that the “Sistema Unico de Saude” (SUS) has contributed a few to a dignified assistance during the pregnancy and puerperal period. The institutions responsible for the deliveries ignore the reproductive rights as human rights, and delegitimize the sexuality and reproduction of poor, black women and single mothers. In general, this research, at the same time, announces and is a denunciation of a public health system and a group of professionals who work at it in the practice of obstetric violence in the assistance of women health during the pregnancy and puerperal period. We denounce the lack of organization of the health system in the maternity assistance going against the humanization proposal and recommendations from the “Rede Cegonha”, a Brazilian maternity program and Health World Organization, making a violation against reproductive rights as human rights. The assistance is based in an unequal power relationship between genders, and socioeconomic, ethnics and racial fields. Besides, medical support is based on unequal power relationship between genders and also in socio-economic, ethnic and racial context.