PREGNANCY IN BRAZIL DURING THE COVID-19 PANDEMIC: OLD NEW AND NEW OLD PROBLEMS
Name: DAYENY KARYNE CORDEIRO SABINO BRAGA
Publication date: 14/06/2024
Examining board:
Name |
Role |
|---|---|
| CÁSSIA MARIA CARLOTO | Examinador Externo |
| FABIOLA XAVIER LEAL | Examinador Interno |
| LEILA MARCHEZI TAVARES MENANDRO | Examinador Interno |
| MARIA LUCIA TEIXEIRA GARCIA | Presidente |
| MAURICIO DE SOUZA SABADINI | Examinador Interno |
Pages
Summary: 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.
