Institutional violence in high-risk pregnancy in the light of pregnant women and nurses

Abstract

Objective: to understand the perception of high-risk nurses and pregnant women about institutional violence in access to basic and specialized care networks in pregnancy. Method: a qualitative study developed from March to June 2017 in the city of Fortaleza, state of Ceará, with nurses and pregnant women at high risk. A semi-structured interview was used, analyzed by the thematic analysis technique. Three categories emerged: access of pregnant women to care networks; institutional violence in the perception of nurses; and institutional violence in the perception of pregnant women. Results: participants revealed deficiencies in knowledge about institutional violence. Nurses perceived this violence in the lack of resources and access, few recognized as a violation of rights. The pregnant women reported deficient access to care networks, medicines, tests, and did not perceive this difficulty as violence. Final considerations: institutional violence is present in high-risk pregnancy, nurses and pregnant women do not always perceive this violence as a violation of rights.

Obstetric Violence in Childbirth Care in Baja California: Nursing Personnel Perceptions

“…However, indirect violence practices are detected in their discourse, such as the omission of service or prejudice when classifying pregnant women. This has also been seen in other studies in which the nursing staff, as well as the women interviewed after delivery, do not perceive these aspects as violent practices but rather as structural or institutional (Brilhante & Bessa Jorge, 2020;Da Silva Carvalho & Santana de Brito, 2017;Espinoza-Reyes & Solís, 2020). However, the World Health Organization, since 1997, and the Mexican Official Standard (NOM 007), mark these practices as violent, and such information is important for training nurses (Da Silva, Sousa, Oliveira, Amorim, & Almeida, 2020).…”

“…While most of these studies emphasize the violence exerted by doctors and obstetricians, this article highlights the perceptions of nursing staff about childbirth care and how they normalize, justify, and even exercise this type of violence. Although some studies (Brilhante & Jorge, 2020;Espinoza-Reyes & Solís, 2020) have explored the perception of obstetric violence from the point of view of nursing personnel, there is a need to analyze these cases as scant evidence suggests that the nursing staff also exerts violence during delivery care. In addition, they spend the most time with women during labor.…”

Tempo de espera ao acesso ambulatorial especializado no pré-natal de alto risco: estudo de método misto

“…Apesar do princípio doutrinário da universalidade do Sistema Único de Saúde (SUS), a gestante de AR vivencia dificuldades no acesso à rede de atenção, principalmente no SE, deparando-se com fila de espera, independente da sua condição e IG (Brilhante & Jorge, 2020;Monteiro et al, 2019).…”

“…Ressalta-se os avanços alcançados ao longo dos anos na assistência PN, por meio do acesso PN universal na maioria dos estados brasileiros, entretanto, persistem fragilidades assistenciais, quanto ao acesso a realização dos exames, em especial as ultrassonografias (Sanine et al, 2019;Brilhante & Jorge, 2020).…”

“…No presente estudo, houve predomínio de gestantes com início precoce do PN, sendo este um valioso recurso à identificação e encaminhamento da gestante com maior risco. Considerando a parcela de mulheres que iniciaram seu PN após compreendida e reconhecida por gestantes de AR e profissionais, sendo necessário ações efetivas à integração das redes de APS e SE; garantia de acesso ao PN de qualidade, medicamentos e exames em tempo oportuno; regionalização da atenção especializada; fortalecimento da referência e contra referência, assim como sua inclusão nos processos de formação profissional e educação em saúde à comunidade (Brilhante & Jorge, 2020).…”