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      Mujeres en embarazo, parto, y posparto: una mirada desde el pensamiento feminista* Translated title: Women in pregnancy, delivery, and postpartum: a look from the feminist point of view

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          Abstract

          RESUMEN Este ensayo analiza los aportes del enfoque de género del pensamiento feminista para comprender la relación de las mujeres en el embarazo, parto, y posparto con el personal de los servicios de salud. Se analizaron investigaciones originales de diseño cualitativo en las cuales se visualiza la relación de las mujeres con el personal de salud. Se concluye que el enfoque de género del pensamiento feminista es una aproximación útil para comprender la problemática de las relaciones de las mujeres con el personal de los servicios de salud en aspectos como la violencia obstétrica, el cuidado y la intersección del género con otras categorías, en el marco del sistema de salud.

          Translated abstract

          ABSTRACT This essay analyzes the contributions of the gender approach of feminist thinking to understand the relationship of women in pregnancy, childbirth, and postpartum with health service personnel. Origi nal qualitative design research was analyzed, were the relationship of women with health personnel is visualized. It is concluded that the gender approach of feminist thinking is a useful approximation to understand the problem of women’s relations with health service personnel in aspects such as obstetric violence, care and the intersection of gender with other categories, in the framework of the health system.

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          Most cited references20

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          Violência institucional, autoridade médica e poder nas maternidades sob a ótica dos profissionais de saúde

          O presente artigo discute a violência institucional em maternidades sob a ótica de profissionais de saúde, com base nos dados de uma pesquisa sobre o tema na cidade de São Paulo, Brasil. Para tanto, foram entrevistados 18 profissionais de saúde atuantes nas redes pública e privada, dentre médicos obstetras, enfermeiras e técnicas em enfermagem. Foi utilizado um roteiro semiestruturado com questões sobre a experiência profissional e o conceito de violência. A análise revelou o reconhecimento desses profissionais de práticas discriminatórias e desrespeitosas no cotidiano da assistência a mulheres gestantes, parturientes e puérperas. São exemplos citados dessas práticas o uso de jargões pejorativos como forma de humor, ameaças, reprimendas e negligência no manejo da dor. Essas práticas não são geralmente percebidas pelos profissionais como violentas, mas sim como um exercício de autoridade em um contexto considerado "difícil". Tal contexto revela a banalização da violência institucional que travestida de boa prática, porque seria para o bem da paciente, acaba invisibilizada no cotidiano da assistência.
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            Conceptualising the prevention of adverse obstetric outcomes among immigrants using the 'three delays' framework in a high-income context.

            Women from high-mortality settings in sub-Saharan Africa can remain at risk for adverse maternal outcomes even after migrating to low-mortality settings. To conceptualise underlying socio-cultural factors, we assume a 'maternal migration effect' as pre-migration influences on pregnant women's post-migration care-seeking and consistent utilisation of available care. We apply the 'three delays' framework, developed for low-income African contexts, to a high-income western scenario, and aim to identify delay-causing influences on the pathway to optimal facility treatment. We also compare factors influencing the expectations of women and maternal health providers during care encounters. In 2005-2006, we interviewed 54 immigrant African women and 62 maternal providers in greater London, United Kingdom. Participants were recruited by snowball and purposive sampling. We used a hermeneutic, naturalistic study design to create a qualitative proxy for medical anthropology. Data were triangulated to the framework and to the national health system maternity care guidelines. This maintained the original three phases of (1) care-seeking, (2) facility accessibility, and (3) receipt of optimal care, but modified the framework for a migration context. Delays to reciprocal care encounters in Phase 3 result from Phase 1 factors of 'broken trust, which can be mutually held between women and providers. An additional factor is women's 'negative responses to future care', which include rationalisations made during non-emergency situations about future late-booking, low-adherence or refusal of treatment. The greatest potential for delay was found during the care encounter, suggesting that perceived Phase 1 factors have stronger influence on Phase 3 than in the original framework. Phase 2 'language discordance' can lead to a 'reliance on interpreter service', which can cause delays in Phase 3, when 'reciprocal incongruent language ability' is worsened by suboptimal interpreter systems. 'Non-reciprocating care conceptualisations', 'limited system-level care guidelines', and 'low staff levels' can additionally delay timely care in Phase 3. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              Neither Medicine Nor Health Care Staff Members Are Violent By Nature: Obstetric Violence From an Interactionist Perspective.

              This study sought to understand the meaning that women place on the health care practices carried out during labor. We used techniques from Grounded Theory such as coding, categorization, and constant comparison. A total of 18 interviews were conducted with 16 women who had given birth at least once in Colombia. Based on our results, we argue that obstetric violence is an expression of violence during the provision of health care, which occurs in a social environment favoring the development of power relationships between patients and health care staff. Its origin might lie in a health care system whose political and economic foundations encourage inequality on the basis of the patients' purchasing power. We conclude that rethinking and redefining the concept of obstetric violence is essential for understanding its nature and having an impact on it.
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                Author and article information

                Journal
                rins
                Revista Peruana de Medicina Experimental y Salud Publica
                Rev. perú. med. exp. salud publica
                Instituto Nacional de Salud (Lima, , Peru )
                1726-4634
                March 2020
                : 37
                : 1
                : 142-147
                Affiliations
                [2] Medellín Antioquía orgnameUniversidad de Antioquia orgdiv1Facultad de Odontología Colombia
                [3] Medellín Antioquía orgnameUniversidad CES orgdiv1Facultad de Psicología Colombia
                [1] Medellín Antioquía orgnameUniversidad CES orgdiv1Escuela de Graduados Colombia
                Article
                S1726-46342020000100142 S1726-4634(20)03700100142
                10.17843/rpmesp.2020.371.4981
                f2aac00e-f1f1-4d75-9575-46b2af3b4cd0

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 12 February 2020
                : 19 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 6
                Product

                SciELO Public Health

                Categories
                Simposio: Gênero y Salud

                Gender-Based Violence,Right to Health,Medicalization,Feminism,Maternal Heal th Services,Interpersonal Relations,Postpartum Period,Childbirth,Pregnancy,Gender,Derecho a la Salud,Medicalización,Violencia de género,Feminismo,Servicios de Salud Ma terna,Relaciones Interpersonales,Periodo Posparto,Parto,Embarazo,Género

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