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Os direitos da mulher no ciclo gravídico-puerperal: prevenção da violência obstétrica
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A promoção dos direitos da mulher no ciclo gravídico-puerperal tem-se afirmado como condição estruturante de cuidados respeitadores e estratégia de prevenção da violência obstétrica, num contexto de crescente clarificação jurídico-normativa em Portugal. A revisão da literatura, com nove estudos incluídos, evidenciou convergência em três eixos: desconhecimento de direitos e naturalização da Violência Obstétrica; educação/empoderamento, incluindo o Plano de Nascimento (PN), como estratégia preventiva; formação profissional e cultura institucional como condições para que o conhecimento se traduza em proteção efetiva.
Com base neste enquadramento, foi implementado o Plano de Projeto, nos seis contextos de ensino clínico, recorrendo a diálogo clínico intencional, educação para a saúde, disponibilização de um recurso digital de literacia acessível por QR code, materiais de divulgação e formação a profissionais quando exequível. A recolha de informação integrou-se na prática clínica quotidiana e combinou roteiros em contexto hospitalar e formulários em Cuidados de saúde primários (CSP) e no site, totalizando 57 registos/respostas. Os dados foram tratados predominantemente por análise qualitativa de conteúdo, complementada por estatística descritiva.
Os resultados evidenciaram literacia em direitos frequentemente baixa e maioritariamente extrainstitucional, sendo que apenas 28,6% referiu ter recebido informação por profissionais de saúde. O PN apresentou reduzida operacionalização em contexto hospitalar, enquanto em CSP aumentou a intenção de o elaborar após intervenção educativa. Conclui-se que literacia em direitos e PN podem reforçar a participação informada, mas o efeito preventivo depende de rotinas institucionais e comunicação eficaz que assegurem consentimento informado contínuo, privacidade e decisão partilhada.
The promotion of women’s rights throughout the pregnancy–puerperal cycle has increasingly been recognized as a cornerstone of respectful maternity care and a strategy to prevent obstetric violence, particularly amid growing legal and regulatory clarification in Portugal. A literature review including nine studies identified convergence across three key axes: limited rights awareness and the normalization of obstetric violence; education and empowerment, including the Birth Plan (BP), as preventive strategies; and professional training and institutional culture as prerequisites for rights knowledge to translate into effective protection. On this basis, a Project Plan was implemented across six clinical training settings, using intentional clinical dialogue, health education, a digital rights-literacy resource accessed via QR code, dissemination materials, and staff training when feasible. Data collection was embedded in routine clinical practice and combined hospital field-note records with questionnaires in primary care and via the website, totaling 57 records/responses. Data were analyzed primarily through qualitative content analysis, supplemented by descriptive statistics. Findings indicated that rights literacy was frequently low and largely derived from extra-institutional sources; only 28.6% reported receiving rights-related information from health professionals. The Birth Plan showed limited operationalization in hospital settings, whereas in primary care intention to develop a Birth Plan increased after the educational intervention. It is concluded that rights literacy and the Birth Plan may strengthen informed participation; however, preventive impact depends on institutional routines and effective communication ensuring ongoing informed consent, privacy, and shared decision-making.
The promotion of women’s rights throughout the pregnancy–puerperal cycle has increasingly been recognized as a cornerstone of respectful maternity care and a strategy to prevent obstetric violence, particularly amid growing legal and regulatory clarification in Portugal. A literature review including nine studies identified convergence across three key axes: limited rights awareness and the normalization of obstetric violence; education and empowerment, including the Birth Plan (BP), as preventive strategies; and professional training and institutional culture as prerequisites for rights knowledge to translate into effective protection. On this basis, a Project Plan was implemented across six clinical training settings, using intentional clinical dialogue, health education, a digital rights-literacy resource accessed via QR code, dissemination materials, and staff training when feasible. Data collection was embedded in routine clinical practice and combined hospital field-note records with questionnaires in primary care and via the website, totaling 57 records/responses. Data were analyzed primarily through qualitative content analysis, supplemented by descriptive statistics. Findings indicated that rights literacy was frequently low and largely derived from extra-institutional sources; only 28.6% reported receiving rights-related information from health professionals. The Birth Plan showed limited operationalization in hospital settings, whereas in primary care intention to develop a Birth Plan increased after the educational intervention. It is concluded that rights literacy and the Birth Plan may strengthen informed participation; however, preventive impact depends on institutional routines and effective communication ensuring ongoing informed consent, privacy, and shared decision-making.
Descrição
Palavras-chave
violência obstétrica direitos da mulher literacia em saúde plano de nascimento EE-ESMO obstetric violence women`s rights health literacy birth plan midwife
Contexto Educativo
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Licença CC
Sem licença CC