Entre o cuidado e a violência obstétrica: uma análise das experiências de mulheres grávidas e puérperas custodiadas na unidade materno infantil do Centro de Recuperação Feminino de Ananindeua-Pa

Abstract

Among the facets that encompass the theme of violence against women, the one experienced during labor and birth, called “obstetric violence”, stands out. The forms of manifestation and naturalization of this type of violence lead us to consider a worrying national reality of labor and birth, since recent research shows that its rates of occurrence are extremely high, affecting 1 in 4 women (ABRAMO, 2010). By directing these perspectives to the conditions of female incarceration, we can see that the theme of pregnancy and motherhood behind bars generates important reflections in the Social Sciences and related areas. In view of the above, this dissertation aims to understand the experiences of care and obstetric violence of pregnant and postpartum women held in custody at the Maternal and Child Unit (UMI) of the Female Reeducation Center of Ananindeua-PA. The specific objectives of this study were to identify the care provided by multidisciplinary health teams and prison police officers to pregnant and postpartum women in prison; to understand the narratives of pregnant and postpartum women about the process of labor and delivery in prison; and to characterize the expressions of care and possible practices of obstetric violence present in the pregnancy and postpartum period of women admitted to the UMI. To this end, during the methodological path, a qualitative approach was used through semi-structured interviews, direct observation and field diary. The narratives of 06 (six) female inmates comprised the sample and the data collected were treated according to the content analysis technique, resulting in 06 (six) thematic categories that pointed to the existence of an architectural structure conducive to welcoming the particularities of the pregnancy and postpartum phase. However, violations were identified in the context of obstetric and neonatal health demands, if considered based on constitutional provisions, legislation and international conventions protecting the Human Rights of this segment. Field records indicated that the significant advances at the regional level since the pioneering work of this UMI in the North of Brazil do not diminish the dimensions of obstetric violence in this scenario; on the contrary, the phenomenon presents new intramural imbrications through its physical, sexual, psychological and institutional characteristics. The ambiguities between violence and care, as an unusual result, permeated daily relationships not only between fellow inmates, but also with prison staff. Finally, the articulation of public policies still proves to be a great challenge to ensure the guarantee of humanization in the health care of inmates in situations of pregnancy, postpartum and of babies who stay with them during breastfeeding, which makes the deprivation of liberty, in gender specificities, more exhausting and harmful than that experienced by men.