Representações e experiências das mulheres sobre a assistência ao parto vaginal e cesárea em maternidades pública e privada

Abstract

This study analyzes the different representations and experiences of women from different social classes, including issues related to their relations with hospital staff in different institutional settings. This qualitative study focused on women who had experienced both types of delivery, in three maternity hospitals in Rio de Janeiro, Brazil (one public, one fully private, and another private under an outsourcing agreement with the public health system). The study showed that variations in public and private service models result in different types of delivery care and different relations with staff, and are reflected in different birthing experiences for the women. However, a critical gender perspective shows that in both cases, the service models reproduce the medicalization of childbirth and women's submission as objects in the birthing process. Although this is manifested in different ways in the three groups, the end result is to reduce the range of care and the possibility of women's empowerment during childbirth.

Vivência do parto normal ou cesáreo: revisão integrativa sobre a percepção de mulheres

“…11, 22.24 Childbirth is a unique and relevant experience that women expect to experience as a physiological process, something natural and healthy for themselves and their baby. 21,24 Childbirth is a thrilling moment of personal growth towards the construction of a new identity, the status of being a mother, [10][11][12][13][14][15][16][17][18] surrounded by positive feelings often described as joy, happiness and fulfillment. [15][16][17][18][19][20][21] The satisfaction, preference or advantages associated with vaginal birth, regardless of women's previous experience of childbirth, were found in descriptions like: little suffering, faster recovery, requiring less care, experiencing less pain after delivery, the possibility of returning to daily activities sooner and being discharged from the hospital sooner.…”

“…[15][16][17][18][19][20][21] The satisfaction, preference or advantages associated with vaginal birth, regardless of women's previous experience of childbirth, were found in descriptions like: little suffering, faster recovery, requiring less care, experiencing less pain after delivery, the possibility of returning to daily activities sooner and being discharged from the hospital sooner. 11 , 15,21,24 Other women said that this type of delivery does not present any disadvantages, 11 Analyze the subjective and objective cultural aspects of women from the outskirts of Cuiabá-MT when going through the experience of vaginal birth in public hospitals or those outsourced by the SUS.…”

“…Structured questionnaire and they highlighted the quality of the relationship with their baby, 24 being together with the child 20 and the thrill of first meeting their child. 17 Having information regarding the delivery, having some control over the event and the degree of relaxation are positive perceptions in regards to the childbirth experience.…”

“…10 These women perceive the pain as an intrinsic aspect of the childbirth act, almost as an essence of this process; they changed this experience from painful physical sensations into feelings of motherly love and saw the possibility to fully experience female role-playing as provided by motherhood. 18,21,24 They can deal with the pain using non-pharmacological methods and the minimum use of medication. 10 In relation to caesarean section, the reasons to consider it the best form of childbirth are associated with: absence of labor pains, 11,13,[23][24] avoiding the fear of childbirth, 23 the speed of the procedure, 11 the possibility of having a tubal ligation at the same time, 24 safety for the baby, 11,20 having information and control over the event (when the cesarean section is planned), being an overall pleasant experience and enjoying the child with safety.…”

“…14 Vaginal birth is perceived as a painful process, 11,17 with pain intensity viewed as greater than expected, 25 even for a short period of time, 21 added to by unexpected and painful procedures that contributed to higher levels of pain, 13,18,24-25 such as amniotomy or the administration of oxytocin to accelerate labor. 12,18,21,25 Discomforts associated with epidural analgesia, episiotomy and the type of delivery (with exception of elective cesarean section), 12,25 the transformation of the woman's body into an object of work, not respecting the woman's role in delivery and reproducing the medical model of care 19,24 also contributed to the negative perception of childbirth. Many women believe that the technical procedures used in hospitals are necessary and important, even though some of them are currently contraindicated, such as Kristeller's Maneuver.…”