Institutional violence during the parturition process in Brazil: integrative review

Marrero, Lihsieh; Brüggemann, Odaléa Maria

doi:10.1590/0034-7167-2017-0238

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Brasil

Revista Brasileira de Enfermagem

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Brasil

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Sumário

REVIEW • Rev. Bras. Enferm. 71 (3) • May-Jun 2018 • https://doi.org/10.1590/0034-7167-2017-0238 copy

Institutional violence during the parturition process in Brazil: integrative review

Violência institucional durante o processo parturitivo no Brasil: revisão integrativa

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the types of institutional violence of childbirth reported by the woman, the birth companion and health professionals.

Method:

Integrative review that analyzed 33 articles in the LILACS, BDENF, INDEXPSI, regional SciELO, Scopus, Web Of Science and PubMed databases.

Results:

Women were the main violence rapporteur, with predominance of the psychological type. Precarious infrastructure and the imposition of professional decisions were identified by the companion as violence. For health professionals, performing procedures without consent does not characterize violence, but guarantees childbirth security.

Final considerations:

The most common types of violence in Brazilian maternity hospitals are psychological, physical and structural. Most of the time, violence is reported by women, although professionals also perceive and admit its perpetuation.

Descriptors:
Humanizing Delivery; Labor, Obstetric; Hospitals, Maternity; Health Services; Violence

Author, year and approach	Subject and sample (n) of the study	Objectives of the study	Type of reported violence	Time of violence occurrence
Aguiar e Tanaka⁽¹⁵15 Aguiar CA, Tanaka ACA. Memórias coletivas de mulheres que vivenciaram o near miss materno: necessidades de saúde e direitos humanos. Cad Saude Publica [Internet]. 2016 [cited 2016 Aug 21]; 32(9):e00161215. Available from: http://www.scielo.br/pdf/csp/v32n9/1678-4464-csp-32-09-e00161215.pdf http://www.scielo.br/pdf/csp/v32n9/1678-... ⁾ 2016 Qualitative	Woman (n=12)	To analyze the collective memories in narratives of women who lived the maternalnear miss.	Psychological Physical	Delivery
Andrade et al.⁽²²22 Andrade PON, Silva JQP, Diniz CMM, Caminha MFC. Fatores associados à violência obstétrica na assistência ao parto vaginal em uma maternidade de alta complexidade em Recife, Pernambuco. Rev Bras Saude Matern Infant [Internet]. 2016 [cited 2017 Feb 02]; 16(1):29-37. Available from: http://www.scielo.br/pdf/rbsmi/v16n1/1519-3829-rbsmi-16-01-0029.pdf http://www.scielo.br/pdf/rbsmi/v16n1/151... ⁾ 2016 Quantitative	Woman (n=603)	To analyze the factors associated with practices not recommended in obstetric care.	Physical	Labor Delivery
Belfort et al.⁽²³23 Belfort IKP, Kalckmann S, Batista LE. Assistência ao parto de mulheres negras em um hospital do interior do Maranhão, Brasil. Saude Soc [Internet]. 2016 [cited 2016 Sep 18]; 25(3):631-40. Available from: http://www.scielo.br/pdf/sausoc/v25n3/1984-0470-sausoc-25-03-00631.pdf http://www.scielo.br/pdf/sausoc/v25n3/19... ⁾ 2016 Qualitative	Woman (n=26)	To describe obstetric care to black women in the State of Maranhão.	Psychological Structural	Labor Delivery
Diniz et al.⁽¹⁶16 Diniz SG, Niy DY, Andrezzo HAA, Carvalho PCA, Salgado HO. A vagina-escola: seminário interdisciplinar sobre violência contra a mulher no ensino das profissões de saúde. Interface [Internet]. 2016 [cited 2016 Aug 24]; 20(56):253-9. Available from: http://www.scielo.br/pdf/icse/v20n56/1807-5762-icse-20-56-0253.pdf http://www.scielo.br/pdf/icse/v20n56/180... ⁾ 2016 Quantitative	Woman (n=23.940)	To analyze socio-demographic inequalities in maternity hospitals care in the Southeast Brazil.	Psychological Structural Physical	Labor Delivery
Biscegli et al.⁽²⁴24 Biscegli TS, Grio JM, Melles LC, Ribeiro SRMI, Gonsaga RAT. Violência obstétrica: perfil assistencial de uma maternidade-escola do interior do Estado de São Paulo. Cuidarte Enferm [Internet]. 2015 [cited 2016 Sep 05]; 9(1):18-25. Available from: http://fundacaopadrealbino.org.br/facfipa/ner/pdf/Revistacuidarteenfermagem%20v.%209%20n.1%20%20jan.%20jun%202015.pdf http://fundacaopadrealbino.org.br/facfip... ⁾ 2015 Quantitative	Woman (n=172)	To verify the prevalence of obstetric violence in a maternity-school.	Psychological Physical	Labor Delivery
Luz et al.⁽²⁵25 Luz NF, Assis TR, Rezende FR. Puérperas adolescentes: percepções relacionadas ao pré-natal e ao parto. ABCS Health Sci [Internet]. 2015 [cited 2017 Feb 02]; 40(2):80-4. Available from: https://www.portalnepas.org.br/abcshs/article/view/735 https://www.portalnepas.org.br/abcshs/ar... ⁾ 2015 Qualitative	Woman (n=11)	To verify the perception of adolescents who have recently given birthabout the care received during prenatal care and childbirth.	Psychological Physical Verbal Discrimination	Labor Delivery
Rodrigues et al.⁽²⁶26 Rodrigues DP, Alves VH, Penna LHG, Pereira AV, Branco MBLR, Silva LA. A peregrinação no período reprodutivo: uma violência no campo obstétrico. Esc Anna Nery Rev Enferm [Internet]. 2015 [cited 2016 Aug 24]; 19(4):614-20. Available from: http://www.scielo.br/pdf/ean/v19n4/1414-8145-ean-19-04-0614.pdf http://www.scielo.br/pdf/ean/v19n4/1414-... ⁾ 2015 Qualitative	Woman (n=56)	To describe and analyze the perceptions of women about obstetric care during the labor and delivery process.	Psychological Structural Discrimination	Admission
Santo et al.⁽¹⁷17 Santos JO, Pacheco TS, Oliveira PS, Pinto VL, Gabrielloni MC, Barbieri M. Perfil obstétrico e neonatal de puérperas atendidas em maternidades de São Paulo. J Res Fundam Care [Internet]. 2015 [cited 2017 Mar 08]; 7(1):1936-45. Available from: http://www.redalyc.org/pdf/5057/505750945018.pdf http://www.redalyc.org/pdf/5057/50575094... ⁾ 2015 Quantitative	Woman (n=424)	To describe the socio-demographic and obstetric profile of women in São Paulo.	Psychological Physical	Delivery
D'Orsi et al.⁽²¹21 D’orsi E, Brüggemann OM, Diniz CSG, Aguiar JM, Gusman CR, Torres JA, et al. Desigualdades sociais e satisfação das mulheres com o atendimento ao parto no Brasil: estudo nacional de base hospitalar. Cad Saude Publica [Internet]. 2014[cited 2016 Dec 01];30(Supl):S154-68. Available from: http://www.scielo.br/pdf/csp/v30s1/en_0102-311X-csp-30-s1-0154.pdf http://www.scielo.br/pdf/csp/v30s1/en_01... ⁾ 2014 Quantitative	Woman (n=15.688)	To identify factors associated with the satisfaction of women related to the health professionals in hospital delivery and its influence on the overall satisfaction of women.	Psychological Physical Verbal	Labor Delivery
Leal et al.⁽¹²12 Leal MC, Pereira APE, Domingues RMSM, Theme Filha MM, Dias MAB, Nakamura-Pereira M, et al. Obstetric interventions during labor and childbirth in Brazilian low-risk women. Cad Saude Publica [Internet]. 2014 [cited 2016 Sep 09];30(Sup):S17-47. Available from: http://www.scielo.br/pdf/csp/v30s1/en_0102-311X-csp-30-s1-0017.pdf http://www.scielo.br/pdf/csp/v30s1/en_01... ⁾ 2014 Qualitative	Woman (n=6.740)	To evaluate the use of good practices and obstetric interventions.	Physical	Delivery
Cardoso e Barbosa⁽²⁷27 Cardoso JE, Barbosa RHS. O desencontro entre desejo e realidade: a “indústria” da cesariana entre mulheres de camadas médias no Rio de Janeiro, Brasil. Physis [Internet]. 2012 [cited 2016 Aug 28]; 22(1):35-52. Available from: http://www.scielo.br/pdf/physis/v22n1/v22n1a03.pdf http://www.scielo.br/pdf/physis/v22n1/v2... ⁾ 2012 Qualitative	Woman (n=15)	To learn and understand, from the perception of women, the mismatch between the desire for vaginal delivery and the outcome in cesarean section.	Psychological Structural Discrimination	Labor Delivery
Santos e Pereira⁽²⁸28 Santos LM, Pereira SSC. Vivências de mulheres sobre a Assistência recebida no processo parturitivo. Physis [Internet]. 2012 [cited 2016 Oct 17]; 22(1):77-97. Available from: http://www.scielo.br/pdf/physis/v22n1/v22n1a05.pdf http://www.scielo.br/pdf/physis/v22n1/v2... ⁾ 2012 Qualitative	Woman (n=19)	To understand the experiences of puerperal women about the care received during the parturition process in a public maternity hospital.	Psychological Structural Physical	Labor Delivery
Aguiar e D'Oliveira⁽²⁹29 Aguiar JM, D’Oliveira AFPL. Violência institucional em maternidades públicas sob a ótica das usuárias. Interface [Internet]. 2011 [cited 2016 Aug 21]; 15(36):79-91. Available from: http://www.scielo.br/pdf/icse/2010nahead/aop4010 http://www.scielo.br/pdf/icse/2010nahead... ⁾ 2011 Qualitative	Woman (n=21)	To present and discuss experiences of childbirth and mistreatment experienced by users in a health service.	Psychological Physical Verbal Discrimination	Labor Delivery
Freire et al.⁽³⁰30 Freire NC, Nunes IM, Almeida MS, Gramacho RCCV. Parto normal ou cesárea? a decisão na voz das mulheres. RBE [Internet]. 2011 [cited 2016 Oct 15]; 25(3):237-47. Available from: https://portalseer.ufba.br/index.php/enfermagem/article/view/6027 https://portalseer.ufba.br/index.php/enf... ⁾ 2011 Quantitative	Woman (n=12)	To describe women's decision making about the way of delivery.	Psychological	Labor Delivery
Carvalho et al.⁽³¹31 Carvalho VF, Kerber NPC, Busanello J, Costa MMG, Gonçalves BG, Quadros VF. Práticas prejudiciais ao parto: relato dos trabalhadores de sul do Brasil. Rev Rene [Internet]. 2010 [cited 2017 Jan 03]; 11:92-8. Available from: http://www.revistarene.ufc.br/revista/index.php/revista/article/view/466 http://www.revistarene.ufc.br/revista/in... ⁾ 2010 Qualitative	Healthcare professional (n=23)	To identify the use of harmful practices in a university hospital.	Physical	Delivery
Milbrath et al.⁽³²32 Milbrath VM, Amestoy SC, Soares DC, Siqueira HCH. Vivências maternas sobre a assistência recebida no processo de parturição. Esc Anna Nery Rev Enferm [Internet]. 2010 [cited 2017 Jan 03]; 14(3):462-7. Available from: http://www.scielo.br/pdf/ean/v14n3/v14n3a05.pdf http://www.scielo.br/pdf/ean/v14n3/v14n3... ⁾ 2010 Qualitative	Woman (n=6)	To know maternal care experiences during labor and delivery.	Psychological Structural Verbal	Labor Delivery
Wolff e Waldow⁽³³33 Wolff LR, Waldow VR. Violência Consentida: mulheres em trabalho de parto e parto. Saude Soc. 2008 [cited 2016 Aug 24]; 17(3):138-51. Available from: http://www.scielo.br/pdf/sausoc/v17n3/14.pdf http://www.scielo.br/pdf/sausoc/v17n3/14... ⁾ 2008 Qualitative	Woman (n=33)	To describe, analyze and discuss the representations of women about parturition process assistance.	Psychological Physical	Delivery
Carraro et al.⁽¹⁹19 Carraro TE, Knobel R, Radünz V, Meincke SMK, Fiewski MFC, Meincke SMK, Fiewski MFC, Frello AT, Martins MS, Lopes CV, Berton A. Cuidado e conforto durante o trabalho de parto e parto: na busca pela opinião das mulheres. Texto Contexto Enferm [Internet]. 2006 [cited 2016 Dec 01];15(esp):97-104. Available from: http://www.scielo.br/pdf/tce/v15nspe/v15nspea11 http://www.scielo.br/pdf/tce/v15nspe/v15... ⁾ 2006 Quanti-qualitative	Woman (n=84)	To assess the opinion of puerperal women about care and comfort during labor and delivery.	Psychological Physical Verbal	Labor Delivery
Dias e Deslandes⁽³⁴34 Dias MAB, Deslandes SF. Expectativas sobre a assistência ao parto de mulheres usuárias de uma maternidade pública do Rio de Janeiro, Brasil: os desafios de uma política pública de humanização da assistência. Cad Saude Publica [Internet]. 2006 [cited 2016 Aug 24]; 22(12):2647-55. Available from: https://www.arca.fiocruz.br/bitstream/icict/347/1/Expectativas%20sobre%20a%20assistencia_2006.pdf https://www.arca.fiocruz.br/bitstream/ic... ⁾ 2006 Qualitative	Woman (n=22)	To analyze expectations of pregnant women about the care they will receive during childbirth and the evaluation of care in previous births.	Psychological Structural Physical Verbal	Labor Delivery
McCallum, e Reis⁽³⁵35 McCallum C, Reis AP. Re-significando a dor e superando a solidão: experiências do parto entre adolescentes de classes populares atendidas em uma maternidade pública de Salvador, Bahia, Brasil. Cad Saude Publica [Internet]. 2006 [cited 2016 Aug 24]; 22(7):1483-91. Available from: http://www.scielo.br/pdf/csp/v22n7/12.pdf http://www.scielo.br/pdf/csp/v22n7/12.pd... ⁾ 2006 Qualitative	Woman (n=26)	To examine childbirth in a public maternity hospital based on the perspective of young women and adolescents.	PsychologicalStructural Physical Verbal Discrimination	Labor Delivery
Teixeira e Pereira⁽³⁶36 Teixeira NZF, Pereira WR. Parto hospitalar: experiências de mulheres da periferia de Cuiabá-MT. Rev Bras Enferm [Internet]. 2006 [cited 2016 Aug 24]; 59(6):740-4. Available from: http://www.scielo.br/pdf/reben/v59n6/a04.pdf http://www.scielo.br/pdf/reben/v59n6/a04... ⁾ 2006 Qualitative	Woman (n=10)	To analyze cultural aspects of experiences of women who had normal hospital delivery.	Psychological Physical	Labor Delivery
Leal et al.⁽³⁷37 Leal MC, Gama SGN, Cunha CB. Desigualdades raciais, sociodemográficas e na assistência ao pré-natal e ao parto, 1999-2001. Rev Saude Publica [Internet]. 2005 [cited 2016 Aug 24]; 39(1):100-7. Available from: http://www.scielo.br/pdf/rsp/v39n1/en_13.pdf http://www.scielo.br/pdf/rsp/v39n1/en_13... ⁾ 2005 Qualitative	Woman (n=9.633)	To analyze the social inequalities of access to the delivery service.	Estrutural	Admission Labor Delivery
Domingues et al.⁽³⁸38 Domingues RMSM, Santos EM, Leal MC. Aspectos da satisfação das mulheres com a assistência ao parto: contribuição para o debate. Cad Saude Publica [Internet]. 2004[cited 2016 Aug 24];20(Supl1):S52-62. Available from: http://www.scielo.br/pdf/csp/v20s1/06.pdf http://www.scielo.br/pdf/csp/v20s1/06.pd... ⁾ 2004 Qualitative	Woman (n=246)	To analyze factors associated with the satisfaction of women with attention to normal childbirth in maternity.	Psychological Structural Physical Verbal	Labor Delivery
Tornquist⁽³⁹39 Tornquist C. Paradoxos da humanização em uma maternidade no Brasil. Cad Saude Publica [Internet]. 2003[cited 2016 Aug 24];19(Sup.2):S419-27. Available from: http://www.scielo.br/pdf/csp/v19s2/a23v19s2.pdf http://www.scielo.br/pdf/csp/v19s2/a23v1... ⁾ 2003 Qualitative	Woman (n=27)	To investigate obstetrical care on respect for human rights, cultural and social differences and good practices.	PsychologicalFísica	Delivery
Brüggemann et al.⁽⁴⁰40 Brüggemann MO, Ebsen ES, Ebele RR, Batista BD. Possibilidades de inserção do acompanhante no parto nas instituições públicas. Cienc Saude Colet [Internet]. 2016[cited 2016 Aug 24];21(8):2555-64. Available from: http://www.scielo.br/pdf/csc/v21n8/1413-8123-csc-21-08-2555.pdf http://www.scielo.br/pdf/csc/v21n8/1413-... ⁾ 2016. Qualitative	Healthcare professional (n=17)	To unveil the possibilities of the companion insertion in childbirth in public or contracted institutions.	Psychological Structural	Labor Delivery
De Aguiar et al.⁽⁴¹41 De Aguiar, JM, D’oliveira AFPL, Schraiber LB. Violência institucional, autoridade médica e poder nas maternidades sob a ótica dos profissionais de saúde. Cad Saude Publica [Internet]. 2013 [cited 2016 Aug 24]; 29(11):2287-96. Available from: http://www.scielo.br/pdf/csp/v29n11/15.pdf http://www.scielo.br/pdf/csp/v29n11/15.p... ⁾ 2013 Qualitative	Healthcare professional (n=18)	To present and discuss institutional violence from the point of view of health professionals in public maternity hospitals.	Psychological Structural Verbal Discrimination	Labor Delivery
Carvalho et al.⁽³¹31 Carvalho VF, Kerber NPC, Busanello J, Costa MMG, Gonçalves BG, Quadros VF. Práticas prejudiciais ao parto: relato dos trabalhadores de sul do Brasil. Rev Rene [Internet]. 2010 [cited 2017 Jan 03]; 11:92-8. Available from: http://www.revistarene.ufc.br/revista/index.php/revista/article/view/466 http://www.revistarene.ufc.br/revista/in... ⁾ 2012 Quantitative	Healthcare professional (n=23)	To know the justification of professionals for the use of harmful practices at birth.	Psychological Structural	Labor Delivery
Busanello et al.⁽⁴²42 Busanello J, Kerber NPC, Lunardi Filho WD, Lunardi VL, Mendoza-Sassi RA, Azambuja EP, et al. Parto humanizado de adolescentes: concepção dos trabalhadores de saúde. Rev Enferm UERJ [Internet]. 2011 [cited 2017 Jan 03]; 19(2)218-23. Available from: http://www.facenf.uerj.br/v19n2/v19n2a08.pdf http://www.facenf.uerj.br/v19n2/v19n2a08... ⁾ 2011 Qualitative	Healthcare professional (n=23)	To analyze the conceptions of professionals about obstetric assistance to adolescents.	Psychological Structural	Delivery
Ângulo-Tuesta et al.⁽²⁰20 Ângulo-Tuesta A, Giffin K, Gama AS, D’orsi E, Barbosa G. Saberes e práticas de enfermeiros e obstetras: cooperação e conflito na assistência ao parto. Cad Saude Publica [Internet]. 2003 [cited 2016 Dec 01]; 19(5):1425-36. Available from: http://www.scielo.br/pdf/csp/v19n5/17815.pdf http://www.scielo.br/pdf/csp/v19n5/17815... ⁾ 2003 Qualitative	Healthcare professional (n=35)	To understand the representations of obstetricians and nurses about teamwork in the parturient care.	Psychological Structural Physical Verbal.	Delivery
Resende et al.⁽⁴³43 Resende LV, Rodrigues RN, Fonseca MC. Mortes maternas em Belo Horizonte, Brasil: percepções sobre qualidade da assistência e evitabilidade. Rev Panam Salud Publica [Internet]. 2015[cited 2016 Aug 24];37(4/5):218-24. Available from: https://pdfs.semanticscholar.org/4f54/0d85d475d0badf96a8d227f5eb82e2e518b0.pdf https://pdfs.semanticscholar.org/4f54/0d... ⁾ 2015 Qualitative	Companion (n=11)	To know the relatives' perception of women victims of maternal death and their circumstances.	Psychological Structural Discriminatória	Admission Labor Delivery
Souza e Gualda⁽⁴⁴44 Souza SRRK, Gualda DMR. A experiência da mulher e seu acompanhante no parto em uma maternidade pública. Texto Contexto Enferm [Internet]. 2016 [cited 2017 Jan 03]; 25(1):e4080014. Available from: http://www.scielo.br/pdf/tce/v25n1/en_0104-0707-tce-25-01-4080014.pdf http://www.scielo.br/pdf/tce/v25n1/en_01... ⁾ 2016 Qualitative	Companion (n=11) Woman (n=11)	To know the experience of women and their companions in the process of childbirth.	Psychological Structural Physical	Labor Delivery
Reis e Patrício⁽⁴⁵45 Reis AE, Patrício ZM. Aplicação das ações preconizadas pelo Ministério da Saúde para o parto humanizado em um hospital de Santa Catarina. Cien Saude Colet [Internet]. 2005 [cited 2016 Aug 24];10(Supl):221-30. Available from: http://www.scielo.br/pdf/csc/v10s0/a23v10s0.pdf http://www.scielo.br/pdf/csc/v10s0/a23v1... ⁾ 2005 Qualitative	Companion (n=11) Woman (n=11) Healthcare professional (n=10)	To analyze the application of the recommended actions for the humanized delivery in a General Hospital of Santa Catarina.	Psychological Structural Physical	Labor Delivery
Lino e Diniz⁽⁴⁶46 Lino HC, Diniz SG. “You take care of the baby’s clothes and i take care of the delivery” communication between professionals and patients and decisions about the mode of delivery in the private sector in São Paulo, Brazil. Rev Bras Crescimento Desenvolv Hum [Internet]. 2015 [cited 2016 Sep 05]; 25(1):117-24. Available from: https://www.revistas.usp.br/jhgd/article/view/96825 https://www.revistas.usp.br/jhgd/article... ⁾ 2015 Qualitative	Woman (n=14) Healthcare professional (n=14)	To describe the perceptions of health professionals and private sector users about childbirth and contributing factors.	Psychological Structural Discriminatória	Delivery

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[1] AUTOR CORRESPONDIENTE: Lihsieh Marrero E-mail: lihsiehm@gmail.com