Experiências de mulheres negras com a assistência obstétrica no contexto da covid-19

Abstract

The black Brazilian population faces social inequalities and difficulties in accessing health information, services, policies and actions. The manifestations of racism in obstetric care in the context of covid-19 from the perspective of black women are the research object of this dissertation. The general objective of the research was to analyze the experiences and perceptions of black women about the manifestations of racism in obstetric care and their interfaces with the Covid-19 pandemic. And the specific objectives to describe the experiences of black women about obstetric care in the context of the Covdi-19 pandemic and discuss the manifestations of racism in obstetric care from the perspective of these women. This is a qualitative and descriptive study with twenty-two black women who had normal delivery or cesarean section during the Covid-19 pandemic, from march 2020 to february 2021. Data collection occurred from january to april 2021. Women were recruited on social media pages and apps. The semi-structured interviews occurred by video call. The thematic analysis proposed by Braun and Clarke was used. The study complied with the laws on the ethics of research with human beings. The thematic categories of the study were: Violence and institutional racism, Strategies against violence and racism, Fear and insecurity caused by Covid-19 pandemic. The black women resided in capitals in the southeastern, Southern and northeastern regions of Brazil. Twelve of them had completed higher education, five were in higher education and the others had completed high schcool. The mentioned situations of violence and racism during obstetric care, characterized by prejudiced, disrespectful, negligent attitudes and situations of physical and psychological violence during prenatal care and childbirth, reflecting the intersection between racism, sexism and social inequality operating in this area of health care. Black women used to protect themselves from violence and institutional racism through class privileges that allowed them to use their own resources to pay for exams and hire professional services to support them in childbirth in search of qualified and respectful care in public health units and private, despite being insuficiente in the face of institutional racism. The Covid-19 pandemic caused feelings of fear and insecurity due to the risk of contagion by the SARS-CoV-2 virus during pregnancy and childbirth, the inadequacies of the recommended protection measures during care in health unist and the restrictions caused by the social distancing and the right to a companion in maternity. The manifestations of racism in the obstetric care of black women during the Covid-19 pandemic are undeniable and reveal institutional obstetric racism as a public health problem that needs to be clarified, debated and faced, and can not longer be covered up and explained only through the inappropriate practices and disrespectful attitudes that characterize obstetric violence. It is suggested to expand studies and debates on racism in obstetric care to change this reality of social inequity that not only harms the health of black women, but violates their human dignity.