Violência obstétrica: percepção e atuação de enfermeiros no cotidiano da maternidade

Abstract

Obstetric Violence is the term used to designate any violent act practiced by health professionals during maternal and child care, which disrespects the rights and physical, mental integrity, desires and choices of the woman, her child and all those who share her experience of motherhood and birth of a new life. This is a descriptive-exploratory study with a qualiquantitative approach, in which the perceptions and care behaviors implemented by nurses working in maternity hospitals in the states of the five Brazilian macro-regions, related to the prevention of Obstetric Violence, were described and explored. The scenario of this investigation was the maternity hospitals located throughout Brazil, and the research was carried out with professionais nurses working in maternity hospitals in each macro-region of the country, from September 2021 to January 2022, totaling 31 participants. During the study, it was possible to demonstrate that the nurses working in maternity hospitals in Brazil are predominantly female, aged between 18 and 49 years, with an average of 5 to 10 years of training, married and/or in a stable relationship, working in the Northeast Region. As for the knowledge of nurses about Obstetric Violence, most have diverse and at the same time limited understandings of the concept, ranging from verbal and physical violence to unnecessary interventions that disrespect the desires and wishes of women, not including other practices in disuse such as violent acts. Regarding the professionals’ perceptions regarding the use of the term Obstetric Violence, the class considered the nomenclature adequate and relevant for the definition of inappropriate conduct as violations. In addition, professionals claim to carry out preventive actions against the problem, however, they do not mention the inclusion of the family, the support network of many women, as participants in such actions. With regard to care behavior in the face of situations of violence, the participants mentioned having witnessed inappropriate practices manifested in the forms of inadequate verbal communication, performing episiotomies, Kristeller’s Maneuvers and unnecessary cesarean sections, and that they even managed to talk to their teams in the face of what had happened. , however, when taking the news to higher levels, such an event is viewed with indifference, in addition to receiving threats of having their professional life compromised, on the other hand, those responsible for the misconduct suffer nothing. In view of the results found in this study, the importance of combating Obstetric Violence is observed, since the subject proves to be a sad reality that still exists in the care context in Brazilian maternity hospitals. It is also clear, in view of the interpretations from the perspective of nurses, that obstetric care in Brazil, despite attempts to prevent and/or alleviate it, is still fragile and limited. Therefore, it is expected that such information will contribute to the confrontation and elimination of the problem, and encourage the development of public policies and resolute strategies regarding the care of women who suffer Obstetric Violence and the need to awaken in nurses a broader view of the creation of more ethical, unique and humane modes of care.