“O limbo do parto”: uma análise sobre a violência obstétrica contra as mulheres negras atendidas em maternidades públicas, em São Luís/Ma, em 2022.

Abstract

This Thesis analyzes obstetric violence against black women treated in public maternity hospitals, in São Luís/MA, in the year 2022, who express their pregnancy experiences with regard to prenatal care, childbirth, pre-birth and postpartum. childbirth. The object of study is outlined considering the concept of intersectionality, considering the interaction between two or more axes of subordination, in this sense: race, gender and class, which, linked to other systems of oppression, create structuring inequalities that contribute to the support of the system capitalism that has a concrete impact on the lives of black women and contributes to the emergence of countless forms of violence experienced by them, such as racism and sexism. Such issues are not adequately analyzed or addressed by traditional conceptions of feminism, which are often centered on the perspective Eurocentric. In this sense, the concept of intersectionality is essential as an indication of the need to analyze obstetric violence against black women, based on a concrete reality, that is, in the institutional health space – perhaps riddled with racism and sexism with a tendency to bring consequences unpleasant to the maternal health of black women and, as such, contributes to the non-fulfilment of their sexual and reproductive rights. In this study, I understand violence. obstetrics as a public health problem and as gender-based violence, whose experiences of black women are analyzed from this perspective considering the model of patriarchal oppression also based on slavery. The study is of a qualitative nature based on the critical-dialectic conception necessary for the apprehension of the object of study in its multiple determinations, being carried out in loco at the Maternidade Nossa Senhora da Penha, at the Maternidade de Alta Complexidade do Maranhão (MACMA), both linked to the State Department of Health of Maranhão (SES/MA) and at the Maternal and Child Unit - HUMI - linked to the University Hospital of the Federal University of Maranhão - HUUFMA. The data collection technique was based on a semi-structured interview script carried out with 15 (fifteen) postpartum women who self-declared to be black and hospitalized in the aforementioned health units. The analysis of the results allows us to capture women's conceptions of obstetric violence, the types and ways of coping, which impact their daily prenatal, pre-delivery, childbirth and postpartum routine. Through the analysis of the reports, I found that women who have recently given birth suffer obstetric violence in different ways: neglect, verbal, physical and psychological that occur during their pregnancies, childbirth and postpartum, according to studies that show the naturalization of this type of occurrence by health professionals based on institutional racism under an implicit racial bias. However, the majority of women are unable to associate the acts committed by professionals with obstetric violence, due to the lack or insufficient information on the subject or the difficulty in identifying it as an act of disrespect that affects their autonomy and human rights, sexual and reproductive and, above all, as violence; It also does not identify the existence of a relationship with obstetric violence and the fact that they are black women, which is in line with studies on the subject based on bibliographical research. However, they recognize that racism is present in the reception of black women treated in maternity wards and that, above all, it is necessary to discuss this problem better in order to combat it. They believe that discrimination related to social class is the most present and frequent axis, since poverty and social inequality determine care/reception, which can directly affect access to health actions and services offered in maternity hospitals. Through systematic observation, the maternity hospitals surveyed do not address the issue of obstetric violence in the routine of multidisciplinary care; this is still invisible and/or its approach is considered unusual, and racial, gender and class issues are also little considered in the scope of professional relationships, in team work processes and in the context of the increase in management models implemented, even in the face of initiatives aimed at women, the Policy for the Integral Health of the Black Population and Rede Cegonha indicated as parameters that lead to the discussion on ethnic/racial and gender relations. Finally, black postpartum women, in this work, who suffer obstetric violence are silenced, crossed by racial, gender and social class discrimination that, in general, are completely unaware of the identification and ways of coping with obstetric violence suffered in the day-to-day labor and birth. The study complied with ethical and legal aspects, in accordance with the recommendations of the National Health Council and Resolution 466/12, which deals with.