Fatores associados à violência obstétrica na assistência ao parto vaginal em uma maternidade de alta complexidade em Recife, Pernambuco

Abstract

Objectives: to examine factors associated with obstetric abuse according to practices not recommended for vaginal birth care at a maternity teaching and referral hospital in the city of Recife, Brazil. Methods: a prospective cross-sectional study with 603 puerperal women conducted between August and December 2014. The socio-demographic, clinical and access to care data were obtained from medical records and interviews with patients. The prevalence of obstetric abuse was based on the recommendations of the World Health Organization regarding practices recommended for vaginal birth care. Associated factors were investigated using Poisson’s multivariate regression, with a level of significance of p<5%. Data wereanalyzedusingStata 12.1 SE. Results: the prevalence of obstetric abuse was 86.57%. The most frequent harmful practices were forced pulling (65%), administration ofoxytocin (41%) and routine use of the supine/lithotomy position (39%). The only variables significantly associated with obstetric abuse were not having graduated high school (p=0.022) and having been attended by a medical professional (p<0.001). Conclusions: the large number of obstetric interventions used amounts to obstetric abuse and shows that, despite the Ministry of Health’s promotion of humane care, results fall far short of these recommendations.