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Informed choice and childbirth: women´s perspectives: pulic and health insurance consumers

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Bianca Alves de Oliveira Zorzam
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
Defense date:
Examining board members:
Carmen Simone Grilo Diniz; Maria Luiza Gonzalez Riesco Bellini; Angela Maria Belloni Cuenca
Advisor: Carmen Simone Grilo Diniz

Introduction The right of women to informed choice about their experiences of pregnancy and childbirth is the result of the historical journey of sexual and reproductive rights, supported on ethical foundations of autonomy, bodily integrity, equality and diversity. In Brazil, its political and social history is being constructed through dialogue with the women\'s movement and the government apparatus, propelling public policies that guarantee these rights. However, gender inequalities within the medical and scientific knowledge led to a pessimistic approach to the female body, resulting in an a experience of childbirth as a pathological event, dependent on technology and unnecessary interventions in care. Objective To describe and analyze the women\'s perspective on the dynamics of availability, access and quality of information on prenatal care for the negotiations of the type of delivery and the procedures of care, focused on episiotomy, oxytocin and companion in public and insurance- managed health services. Methodology A qualitative study, based on the theoretical perspectives of gender and reproductive rights, conducted through semi-structured interviews of three types (email, Skype and face), with 26 women who attended the two health sectors in various regions of the country. Results Although guaranteed by public policy, it is still difficult for women to access quality information that support their choices and decisions about interventions in childbirth care. This difficulty is embedded in social, economic, cultural and gender aspects that transfer the power to decide on the type of delivery and interventions in childbirth to medical professionals and their institutions. Conclusions Often, the availability of information on prenatal care was insufficient in both health sectors, revealing the \"silence\" around childbirth. In prenatal care, women are not encouraged to actively search for information, and when information is available it is often inaccurate and ignoring of women`s reproductive rights. Even when there is access to information coming from specific route of humanizade care is no complete assurance about the possibility of negotiation. Also, not all women are able to access it. In general, information alone does not represent the possibility of success for decisions in labor, given the various difficulties that professional and institutional mechanisms impose on women (AU)

FAPESP's process: 11/05179-3 - The negotiation informed for the choices in the childbirth: between the possibilities and limits
Grantee:Bianca Alves de Oliveira Zorzam
Support Opportunities: Scholarships in Brazil - Master