Obstetric Violence in the State of Rio de Janeiro: Nascer no Brasil II Study
DOI:
https://doi.org/10.11606/s1518-8787.2025059006536Keywords:
Obstetric Violence, Prevalence, PaturitionAbstract
OBJECTIVE: To estimate the prevalence and co-occurrence profile of obstetric violence among women hospitalized for childbirth in the state of Rio de Janeiro, as well as its distribution according to demographic, socioeconomic, and current pregnancy-related characteristics.
METHODS: This is a perinatal cohort study. Data were obtained from the second telephone follow-up of the Nascer no Brasil II Study referring to the state of Rio de Janeiro. Obstetric violence (physical abuse; psychological abuse; neglect; stigma and discrimination; and inappropriate vaginal examinations) was assessed using a culturally adapted version of a World Health Organization-endorsed questionnaire. Prevalence and co-occurrence profile (Venn diagram) of the types of obstetric violence were estimated.
RESULTS: The overall prevalence of obstetric violence was 65.3%. The most prevalent types were inappropriate vaginal examinations (46.2%), neglect (31.5%), and psychological abuse (21.7%). Socioeconomic factors such as low educational level, unemployment, receipt of government benefits, and delivery under public healthcare financing were more frequent among women who experienced various types of obstetric violence. Other characteristics such as age ≥ 35 years, having gone into labor, and being a primipara were also associated with higher prevalence. The co-occurrence of the four most common types of obstetric violence (psychological abuse, neglect, stigma and discrimination, and inappropriate vaginal examinations) was 3%.
CONCLUSION: Findings indicate that obstetric violence is a significant public health issue in the state of Rio de Janeiro, and its occurrence reflects inequalities in care for specific subgroups of postpartum women.
References
World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth. Genebra: World Health Organization; 2015.
United Nation Organization. A human rights-based approach to mistreatment and violence against women in reproductive health services with a focus on childbirth and obstetric violence. United Nation Organization; 2019.
World Health Organization. Intrapartum care for a positive childbirth experience [Internet]. World Health Organization; 2018 [acessado em 4 abr. 2025]. Disponível em: https://www.who.int/publications/i/item/9789241550215
United Nation Organization. Transformando nosso mundo: A Agenda 2030 para o Desenvolvimento Sustentável [Internet]. Nova York: United Nation Organization; 2015 [acessado em 4 abr. 2025]. Disponível em: https://brasil.un.org/pt-br/sdgs
Leite TH, Marques ES, Esteves-Pereira AP, Portela Y, Do Carmo Leal M. Desrespeitos e abusos, maus tratos e violência obstétrica: um desafio para epidemiologia e para a saúde pública no Brasil. Ciênc Saúde Coletiva. 2020;27(2):483-91. https://doi.org/10.1590/1413-81232022272.38592020
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med. 2015;12(6):e1001847. https://doi.org/10.1371/journal.pmed.1001847
Leite TH, Carvalho TDG, Marques ES, Pereira APE, da Silva AAM, Nakamura-Pereira M, et al. The association between mistreatment of women during childbirth and postnatal maternal and child health care: Findings from "Birth in Brazil". Women Birth. 2022;35(1):e28-e40. https://doi.org/10.1016/j.wombi.2021.02.006
Leite TH, Pereira APE, Leal M do C, Silva AAM da. Disrespect and abuse towards women during childbirth and postpartum depression: findings from Birth in Brazil Study. J Affec Dis. 2020;273:391-401. https://doi.org/10.1016/j.jad.2020.04.052
Leite TH, Marques ES, Mesenburg MA, Silveira MF da, Leal M do C. The effect of obstetric violence during childbirth on breastfeeding: findings from a perinatal cohort “Birth in Brazil.” The Lancet Reg Health–Am. 2023;19:100438. https://doi.org/10.1016/j.lana.2023.100438
Abramo FP. Mulheres brasileiras e gênero nos espaços público e privado. São Paulo: Fundação Perseu Abramo; 2013.
Mesenburg MA, Victora CG, Jacob Serruya S, León RP, Damaso AH, Domingues MR, et al. Disrespect and abuse of women during the process of childbirth in the 2015 Pelotas birth cohort Prof. Suellen Miller. Reproductive Health. 2018;15(1):54. https://doi.org/10.1186/s12978-018-0495-6
Prefeitura do Rio de Janeiro. Casos de violência obstétrica no Rio poderão ser notificados na Central de Atendimento 1746 [Internet]. Prefeitura do Rio de Janeiro; 2021 [acessado em 14 jun. 2024]. Disponível em: https://prefeitura.rio/noticias/casos-de-violencia-obstetrica-no-rio-poderao-ser-notificados-na-central-de-atendimento-1746/
Leal M do C, Esteves-Pereira AP, Bittencourt SA, Domingues RMSM, Theme Filha MM, Leite TH, et al. Protocolo do Nascer no Brasil II: Pesquisa Nacional sobre Aborto, Parto e Nascimento. Cad Saúde Pública. 2024;40(4):e00036223. https://doi.org/10.1590/0102-311XPT036223
Theme Filha MM, Baldisserotto ML, Leite TH, Mesenburg MA, Fraga ACSA, Bastos MP, et al. Nascer no Brasil II: protocolo de investigação da saúde materna, paterna e da criança no pós-parto. Cad Saúde Pública. 2024;40(4):e00249622. https://doi.org/10.1590/0102-311XPT249622
World Health Organization. Recommendations on antenatal care for a positive pregnancy experience [Internet]. World Health Organization; 2016 [acessado em 6 nov. 2024]. Disponível em: https://www.who.int/publications/i/item/9789241549912
Bohren MA, Mehrtash H, Fawole B, Maung TM, Balde MD, Maya E, et al. How women are treated during facility-based childbirth in four countries: a cross-sectional study with labour observations and community-based surveys. Lancet. 2019;394(10210):1750-63. https://doi.org/10.1016/S0140-6736(19)31992-0
Brasil. Constituição da República Federativa do Brasil [Internet]. Brasil; 1987 [acessado em 17 jul. 2024]. Disponível em: https://www2.camara.leg.br/legin/fed/consti/1988/constituicao-1988-5-outubro-1988-322142-publicacaooriginal-1-pl.html
Convenção de Belém do Pará [Internet]. 1994 [acessado em 17 jul. 2024]. Disponível em: https://www.cidh.org/Basicos/Portugues/m.Belem.do.Para.htm
Terán P, Castellanos C, González Blanco M, Ramos D. Violência obstétrica: percepción de las usuarias. Rev Obstet Ginecol Venezuela. 2013;73(3):171-80.
Flensborg-Madsen T, Grønkjær M, Mortensen EL. Predictors of early life milestones: Results from the Copenhagen Perinatal Cohort. BMC Pediatr. 2019;19:420. https://doi.org/10.1186/s12887-019-1778-y
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Copyright (c) 2025 Tatiana Henriques Leite, Emanuele Souza Marques, Maria do Carmo Leal, Rosa Maria Soares Madeira Domingues, Marcos Nakamura-Pereira, Mariza Miranda Theme Filha, Marcia Leonardi Baldisserotto, Karina de Cássia Caetano, Thaiza Dutra Gomes de Carvalho, Fernanda Freitas Fernandes, Rafaelle Mendes da Costa, Amanda Chiavazzoli, Marília Arndt Mesenburg
This work is licensed under a Creative Commons Attribution 4.0 International License.
