In the last 50 years, a rapid increase in the use of technology to start, augment, accelerate, regulate and monitor the process of birth has frequently led to the adoption of inadequate, unnecessary and sometimes dangerous interventions. Although research has shown that the least amount of interference compatible with safety is the paradigm to follow, vaginal birth is still being treated as if it carries a high risk to women's health and sexual life in Brazil. This paper describes the impact of the intervention model on women's birth experience, and discusses how the organisation of public and private maternity services in Brazil influences the quality of obstetric care. Brazil is known for high rates of unnecessary caesarean section ("the cut above"), performed in over two-thirds of births in the private sector, where 30% of women give birth. The 94.2% rate of episiotomy ("the cut below") in women who give birth vaginally, affecting the 70% of poor women using the public sector most, receives less attention. A change in the understanding of women's bodies is required before a change in the procedures themselves can be expected. Since 1993, inspired by campaigns against female genital mutilation, a national movement of providers, feminists and consumer groups has been promoting evidence-based care and humanisation of childbirth in Brazil, to reduce unnecessary surgical procedures.

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4.0 Internacional. http://creativecommons.org/licenses/by/4.0/ Abstract:In this article we analyze how gender violence and social class inequalities intersect in the experiences of young women from different social classes with their sexuality. Departing from an analysis using both quantitative and qualitative data collected among young women who lived in middle-class neighborhoods and in poor communities (favelas) located in the central-south region of Belo Horizonte, we investigated the impact of gender violence on these young women's sexuality. Our results showed how a partner's violent and controlling behavior reduces young woman's autonomy in this area, affecting her capacity of negotiating condom use,

In Brazil in the last decade there has been an increase in the susceptibility of young women to HIV. This study explored the link between autonomy, or control over major domains of economic, social and sexual life, and susceptibility to HIV infection among poor young women living in an urban slum area of Brazil. A cross-sectional survey was carried out on a random sample of 356 young women between 15 and 24 years old. The study found that indicators of autonomy that relate to sexuality, mobility and freedom from threat by partners were significantly correlated with practices linked to HIV prevention and with access to health services promoting prevention, especially among adolescents. Young women who talked to their partner about condom use before first intercourse and co-decided with them on condom use were more likely to use condoms. In contrast, those who had ever been victim of physical violence by a partner or whose partners restricted their mobility were less likely to use condoms. The study found that young women were more likely to have accessed health services for gynaecological examinations, family planning services and HIV testing if they had ever been pregnant. The findings indicate that structural gender inequalities translate into unequal relationships and reduced autonomy, increasing young women's susceptibility to HIV. A bias in HIV testing and reproductive health services towards pregnant women leaves many susceptible youth without early access. The study suggests the development of a reproductive health policy that ensures that young women access services before they get pregnant and that also reaches young males.

In this article, we investigate how gender-based violence (GBV) affects the sexual and reproductive health of impoverished adolescents and young adults. We analyse data from a 2011 survey of 450 young women and 300 young men aged 15-29, living in poor neighbourhoods of three middle-sized cities in Minas Gerais, Brazil. In this survey we used a closed-ended questionnaire to collect data from 150 women and 100 men in each city. Our main goal was to explore the relationship between GBV and young women's autonomy in relation to their sexuality, using indicators appropriate to Brazil. Our results showed a decreased prevalence of condom use at first intercourse and an increased prevalence of teenage pregnancies among young women who were in a relationship with a controlling and violent partner. Lower condom use was observed mostly among young men who acknowledged being violent and controlling towards a partner and they also were more likely to have made a partner pregnant as teenagers themselves. We conclude that some variables utilized here as indicators of control and violence from a partner and of young women's autonomy can help us to understand how GBV inside relationships affects the reproductive and sexual health of young men and women, and how empowering them can reduce their susceptibility to unwanted pregnancies and HIV and other STI infections.

O artigo tem por objetivo analisar as desigualdades nas trajetórias profissionais de médicos e enfermeiros no Brasil atual, a partir de uma abordagem quantitativa que permitiu contrastar trajetórias representativas de diferentes posições no espaço profissional. Os dados derivam de um survey on-line aplicado em uma amostra composta por 188 médicos e 186 enfermeiros. Parte-se do pressuposto de que as trajetórias tendem a se diferenciar de acordo com recursos herdados da família de origem, o percurso de formação no ensino superior (graduação e pós-graduação), o tipo de inserção no mercado de trabalho e o estágio na carreira. A abordagem metodológica utilizou a combinação de Análise de Correspondências Múltiplas e análise de cluster. Os resultados contribuem para o entendimento de como as diferenças inter e intraprofissões tanto reproduzem quanto reforçam as desigualdades no interior do espaço profissional.

The way women learned midwifery is the most important determinant of their practice.