A violência obstétrica como discursividade a ser combatida

Abstract

In 2019, the Ministry of Health issued an order in which it recommended the abolition of the expression “obstetric violence” from its official documents, claiming that there was no consensus as to its meaning and that the expression would have no value. This position, which was based on requests from medical institutions, such as the Federal Council of Medicine, goes against national and international initiatives to recognize obstetric violence. The woman's body is the locus where obstetric violence materializes. The female body has always been a target of interest in medicine and, since its desacralization with the advent of modern medicine and anatomopathology, it can be explored in the name of science. Medicine uses the discourse of science to prescribe what is best for women, from pregnancy to parturition. The doctor, in our view, remembers aspects of the sovereign, exercising his power over bodies through strategies of regulation and control of individual bodies, as well as the management of the human being as a species. The gesture of interdiction of the word, by the Ministry of Health and the Federal Council of Medicine, constitutes the discursive object of this work. Our objectives are: to present elements that could compose a genealogy of obstetrics to understand how the will to know/power allowed the consolidation of obstetrics as a specialty in a historical context that culminated in a new form of power: biopower; to investigate Foucault's understanding of the relations between discourse and order, from which he thinks about exclusion procedures linked to the field of knowledge and elaborates the notion of “interdiction” of/in discourse; to analyze how the gesture of interdiction of the word is formulated by the Ministry of Health and the Federal Council of Medicine, and how this formulation points to the relations between discourse, power, medical knowledge and governmentality. Our theoreticalmethodological framework follows the Foucauldian approach connected with authors of the French-Brazilian Discourse Analysis. In our analyses, we perceive an ideological alignment between the hegemonic traditional medicine, represented by the Federal Council of Medicine and the Bolsonarist rhetoric, represented by the current management of the Ministry of Health. We identified an anti-science discursive formation, on the part of the Federal Council of Medicine, which is also associated with the Bolsonarist negationist discourse. In our opinion, the gesture of abolishing the expression “obstetric violence” took place as an attempt to silence discussions on the subject, since Brazilian obstetric care is inserted in a broader context of cultural war. In this sense, obstetric violence was elected, both by the representatives of hegemonic medicine and by the Ministry of Health, as the enemy to be slaughtered. In the absence of silencing by linguistic annihilation, we postulate that the attribution of the label “hysteria” to the theme of obstetric violence and its spokespersons was another attempt to disqualify the debate on the subject.