Gestar no Brasil durante a pandemia de Covid-19: velhos novos e novos velhos problemas
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Data
2024-06-14
Autores
Braga, Dayeny Karyne Cordeiro Sabino
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Universidade Federal do Espírito Santo
Resumo
This thesis' aim is to analyze whether and how the guarantee of pregnancy, childbirth and the puerperium in Brazil were ensured by health actions in the context of the Covid-19 pandemic between 2020 and 2021, verifying whether the rights to health and life protection were guaranteed to pregnant women, parturients and puerperae, within the scope of the Unified Health System. To accomplish this, we've compared data from the pandemic period (2020 and 2021) with data from the period before the health crisis (2000 to 2019). Thus, using the Prenatal and Birth Humanization Program (2000), the National Policy for Comprehensive Women's Health Care (2004), the National Pact for the Reduction of Maternal Mortality (2004) and the Stork Network (2011) as a reference, we've sought answers to the question: how has Covid-19 pandemic impacted on the changing of childbirth and puerperium care in the Unified Health System throughout Brazil? From a methodological point of view, we've conducted a mixed-methods study. In qualitative research, we've analyzed the National Health Plans from 2004 to 2023, the Annual Management Reports from 2004 to 2021, and the Technical Notes issued by the Ministry of Health in 2020 and 2021 that provided guidance on health care for women in the pregnancy-puerperium cycle during the new coronavirus pandemic. On the quantitative side, we've analyzed public data from the Mortality Information System, the Live Birth Information System, the Primary Health Care Information System and the Severe Acute Respiratory Syndrome Database on Covid-19, using the variables region, age group, race/ethnicity and education level of pregnant women, parturients and puerperal women. We've also analyzed the data on puerperium care reported by the Ministry of Health, requested via the Access to Information Law, through the Fala Br system, using the variables region, age group and race/ethnicity. We've carried out statistical tests such as chi-square, relative risk and odds ratios to decipher whether or not there was statistical significance, validated by the confidence interval, as well as the risk of maternal death or chances of survival of pregnant and postpartum women infected with SARS-CoV-2. The results indicate that the COVID-19 pandemic has led to changes in the guarantee of women's reproductive rights in the pregnancy-puerperium cycle, with new expressions of social matters, mainly regional, age and schooling aspects, in addition to maintaining and deepening old inequities in maternal health, with emphasis on the women's ethnic-racial aspect in health actions is paramount for Brazilamian health policies' improvement. It was concluded that the old problems guarantee the reproductive rights of this group coexisted with the worsening of maternal mortality during the pandemic, and that the centrality of the paradigm of integrality of women's health in health actions is fundamental for Brazil's reproductive health policies improvement. We affirm, based on this study, that the health crisis of 2020 and 2021 has widened social inequalities in childbirth and postpartum care in Brazil, especially in the ethnic-racial aspect. We also affirm that the pandemic has implied new nuances for the health of pregnant and postpartum women, among which we highlight regional, age and schooling inequalities. In addition, the pandemic caused by the new coronavirus has put Brazil even further away from achieving the Sustainable Development Goal target of reducing maternal mortality.
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Direitos reprodutivos , Ciclo gravídico-puerperal , Mortalidade materna