Violência obstétrica em mulheres atendidas no Sistema Único de Saúde um um município do sul do Brasil

Abstract

Objective: to analyze the frequency and main forms of obstetric violence, as well as associated sociodemographic and clinical factors. Among the secondary objectives, we sought to assess the perception of the occurrence of this violence, including knowledge of rights and guarantees. Methods: study with cross-sectional epidemiological design, carried out from December 2022 to April 2023 with women users of four basic health units in the city of Passo Fundo, RS. A structured questionnaire was used for data collection, developed for the study itself, and the interviews were conducted on the premises of the UBSs. The main outcome evaluated was obstetric violence (OV) measured from a set of 18 questions of the assessment instrument to determine the occurrence or not of OV. Among the independent variables, sociodemographic and clinical issues were investigated, including age, education, race/color, family income, marital status, number of children, place of delivery, satisfaction with delivery, type of delivery, prenatal care, number of consultations, the first trimester, receiving guidance on childbirth, receiving information about where to look for childbirth and preparation of a birth plan. The perception of the occurrence of OV, as well as the knowledge of rights and guarantees, was evaluated through a set of 7 questions about the recognition of OV and its rights. Descriptive statistics (n.%) and analysis of the outcome distribution according to independent variables were performed using the chi-square test, adopting a statistical significance level of 5%. Results: the final sample consisted of 159 women, of which 66% (95%CI 59-73) reported suffering some type of VO during childbirth and/or prenatal care, with physical violence being the main form of manifestation of this violence. Statistically significant associations were demonstrated between VO and mothers' brown and yellow skin color (p=0.014) and type of vaginal delivery (p<0.001). Approximately half of the participants do not know what VO is (45.3%) and among those who directly reported having suffered (10.7%), only 17.6% knew what to do in terms of rights and guarantees. Conclusions: The prevalence of VO was high and women's knowledge, as well as their rights and guarantees, is still scarce. Important sociodemographic and clinical indicators were related to this violence, such as skin color and type of delivery. Therefore, it is essential to develop educational activities that focus on changing the patterns that perpetuate violence in childbirth care in the context of the unified health system in Brazil.