Assistência à saúde de mulheres grávidas e puérperas no sistema prisional de Chapecó: análise do itinerário terapêutico

Abstract

Introduction: Women in prision have guaranteed rights to healthcare healthcare assistance. When they are pregnant, healthcare is intensified, and it is important to have an organized flow to ensure adequate prenatal, childbirth, and postpartum care. In this sense, prison complexes have been organizing themselves to provide these care services, although in many places, networks and workflows are still insufficient. Therefore, this research sought to understand the services offered and the care paths available to pregnant women in prision. Objective: To analyze the therapeutic itinerary of women in prison involving their prenatal, childbirth, and postpartum care in the prison system of Chapecó/SC municipality, according to the principles of the Unified Health System (SUS). Methodology: Qualitative research conducted with six pregnant women and/or postpartum women through interviews, non-participant observation, and documentary research (medical records and pregnancy notebook). The interviews were conducted in the prison complex in a room provided by the management from September 2022 to May 2023. Data analysis was carried out according to the method presented by Bardin in his book "Content Analysis," which suggests 1) pre-analysis, 2) material exploration, and 3) treatment of results, inference, and interpretation. The project was approved by the ethics committee, and the participants signed the Informed Consent Form. Results: The results were divided into five categories of analysis: Social characteristics, care process, and itineraries followed by the participants; Prenatal care: between anguish and uncertainty; Childbirth: the long-awaited day; Postpartum period: a storm of emotions and their final perceptions; and Observational process of the researchers. The therapeutic itinerary of the women was marked by the provision of care in primary healthcare, specialized outpatient services, and hospitals. However, in the care itinerary, it was observed that many women were not listened to regarding their complaints, experienced obstetric violence, and had difficulty communicating with healthcare professionals who attended to them. Final consideration: In this study, the main obstacle encountered was the scarcity of precise information on the subject, as well as interference in the interview process by some professionals in the prison complex. In this sense, a lack of coordination between the Health and Security sectors was observed, which hinders the assistance to women experiencing the pregnancy and postpartum period in prision.