Institutional violence and quality of service in obstetrics are associated with postpartum depression

Abstract

OBJECTIVE: To investigate the association between institutional violence in obstetrics andpostpartum depression (PP depression) and the potential effect of race, age, and educationallevel in this outcome.METHODS: This is a cross-sectional study about the health care conditions for the maternaland child population of the Federal District, Brazil, carried out in 2011. The study has used aprobabilistic sample of 432 women, whose children were aged up to three months, stratified byclusters. Indicators of institutional violence and demographic characteristics have been used ina logistic regression model to estimate the probability of occurrence of postpartum depression.RESULTS: The model has identified a high prevalence of postpartum depression, being it higheramong non-white women and adolescent females, besides having a strong positive associationbetween the several indicators of obstetric violence and postpartum depression. Positiveinteractions on a multiplicative scale have also been observed between: violence by negligenceby health care professionals and race and age; physical violence from health care professionalsand age; and, verbal violence from health care professionals and race.CONCLUSIONS: The indicators adopted to reflect institutional violence in obstetric care arepositively associated with postpartum depression, which calls for a reflection on the need to makethe health care protocols adequate to the precepts of the Brazilian humanization of childbirthcare policies and changes in the obstetric care model