Violência física entre parceiros íntimos na gestação como fator de risco para a má qualidade do pré-natal

Abstract

OBJECTIVE:To evaluate physical intimate partner violence during gestation as an independent risk factor for low quality of prenatal care. METHODS:A cross-sectional study was carried out at three public maternity wards of the municipality of Rio de Janeiro (Southeastern Brazil). The 528 puerperal women included in the study were selected by simple random sampling from all babies born at term in 2000. Prenatal care information was collected through the pregnant woman's card and face-to-face interviews. The Kotelchuck index was employed to assess the quality of prenatal care. In order to identify violence situations, the Brazilian version of the instrument Revised Confl ict Tactics Scales was used. Non-conditional logistic regression was used to assess the effect of exposure, after controlling for confounding variables. RESULTS:Even after adjustment for socioeconomic, demographic, reproductive, and couple's lifestyle variables, physical intimate partner violence during gestation remained associated with low quality of prenatal care. Women exposed to physical violence during gestation had 2.2 times more chance of presenting inadequate prenatal care compared to those without history of physical violence. CONCLUSIONS:These fi ndings point to the need of identifying family confl ict situations since the beginning of prenatal care in order to address the issue and enable higher adherence to follow-up among victimized pregnant women. DESCRIPTORS:Pregnancy. Battered Women. Spouse Abuse. Violence Against Women. Prenatal Care. Domestic Violence.

Prevalence and factors associated with alcohol use among pregnant adolescents

“…Alcohol use during pregnancy is related to some factors such as not having a partner, not being religious, and the presence of depressive episodes and episodes of violence, which would favor the acquisition or intensification of the habit (6)(7)(8)(9) . In this context, this study becomes relevant due to alcohol consumption during pregnancy being a practice that has serious repercussions for the mother and fetus.…”

Situations which precipitate conflicts in the conjugal relationship: the women's discourse

“…In the case of pregnant women, knowledge about the risk of complications is necessary, above all due to the experience of violence, such as: depression, low self-esteem, frequent vaginal bleeding, and the threat of premature labor, among others. 29 As it is perceived that pregnancy makes the woman vulnerable to conjugal violence, a better understanding of this phenomenon is necessary.…”

“…The consumption of alcoholic drinks by the partners is one of the main causes leading the partner to commit crime. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Attention is also called to the fact that the women state that the use of drugs/alcohol is the event causing conjugal violence, it being considered that if this is absent, the conjugal relationship is healthier. The women studied declared that when their partners drink, they are transformed, attacking them, initially verbally, and then progressing to other types of violence.…”

Violência física entre parceiros íntimos: um obstáculo ao início do acompanhamento da criança em unidades básicas de saúde do Rio de Janeiro, Brasil?

“…Uma vez que a violência pode levar ao uso inadequado do serviço de saúde tanto no pré-natal 30 quanto após o nascimento da criança, é fundamental que as equipes de saúde identifiquem as gestantes, prioritariamente, e as mães faltosas às unidades de saúde, já que entre essas a probabilidade de ocorrência de violência físi-ca entre parceiros íntimos é maior. O pré-natal é um momento privilegiado para identificar as mulheres que vivem em situações de violência e oferecer o atendimento apropriado, tendo em vista não só o acompanhamento dos casos para a interrupção do processo, como também a prevenção de problemas no cuidado com a criança.…”