Esterilização feminina, AIDS e cultura médica: os casos de São Paulo e Porto Alegre, Brasil

Abstract

This paper explores the factors associated with reproductive choices by HIV-positive pregnant women in two settings in Brazil, and particularly how health care providers and the local medical culture can affect these choices. Requesting and submitting to postpartum sterilization provide the focus of the analysis. The data come from a study conducted in prenatal care services in two cities, São Paulo and Porto Alegre. We employed two data collection strategies: collection of information from 427 patient records for HIV-positive women who had received prenatal care, and in-depth interviews with 60 women. While most women in both cities requested tubal ligation after delivery, a much higher proportion of women in Sao Paulo were actually sterilized, as compared to a tiny proportion of women in Porto Alegre. The local medical culture regarding sterilization and organization of prenatal care emerged as important factors for understanding the differences between the two cities.

Tubal ligation regret and related risk factors: findings from a case-control study in Pernambuco State, Brazil

“…Reproductive choices involve sensitive and complex issues. In order for women to make such decisions, health services and professionals need to guarantee access to all contraceptive methods and information on their risks and benefits 23 . It is also necessary to understand women's psycho-socio-demographic profile and their reasons for requesting surgery.…”

Puérperas con virus humano de inmunodeficiencia adquirida positivo (VIH+) y las condiciones de sus recién nacidos

“…La gestación en adolescentes (15)(16)(17)(18)(19)(20) ocurrió en 7,4% de los casos. En cuanto al consumo de alcohol, 7,4% respondieron afirmativamente y 11,1% eran usuarias de droga.…”

“…A diferencia de muchos países desarrollados, tales medicamentos están disponibles gratuitamente para todos los brasileños portadores de VIH 15 .…”

Changes in family structure and regret following tubal sterilization

“…In addition, the law prohibits sterilization during delivery, after an abortion, or in the 41 days following childbirth. Reproductive choices involve sensitive and complex aspects, and in order for women to make their decision, health services and professionals should guarantee their access to all contraceptive methods and information on their risks and benefits 30 , evaluate their profile and reasons for the request, and counsel them on family planning. Conscientious choice of tubal sterilization would help decrease the number of requests for reversal of the surgery, which leads to unnecessary problems and iatrogenic complications and places a burden on public health services.…”