Nascer nas casas de parto do Brasil: panorama de saúde mental perinatal

Abstract

Considering the current scenario of perinatal care, experience obstetric violence during pregnancy, childbirth and the postpartum period. Associated with this, maternal mental health has shown high rates of illness and dissatisfaction with the care received may be impacting this situation. Objective: Investigate the impact of obstetric violence on post-traumatic stress disorder in women who gave birth in birthing centers or reference hospitals. Methodology: This study was based on the study "Nascer nas Casas de Parto" the aim was to evaluate the care provided in Birth Centers (BC) and compare it with the care provided in hospitals. The population was postpartum women attended in eight BC in Brazil, with more than 100 births in 2019, as well as the referral hospitals of the BC, in addition to monitored intra and postpartum transfers, also to neonatal transfers. Data collection took place between August 2022 and June 2025, reaching the previously calculated sample of 1,560 participants, incorporating data from healthcare professionals, managers, as well as prenatal care records and medical charts. For this study, data from stages three and four were used, with remote interviews using forms on The City Birth Trauma Scale and on mistreatment and abuse in the BC/Hospital, with the data recorded on the RedCap platform. Data analysis was performed using STATA software, version 17, and through the analysis, the sociodemographic profile, mean and scale scores were described, in addition to calculating prevalence and statistical significance considering p<0.05. The study was approved by the ethics committee and followed the resolutions on research with human beings. Results: 50.4%, of women, suffered some type of obstetric violence, negligence and inadequate vaginal examinations being the most frequently reported. The location where the woman gave birth and needed C-section were the factors that most influenced women to suffer obstetric violence. The City Birth Trauma Scale, with a validated score in Brazil >28, showed black women, without a partner, with a history of psychological problems and who underwent a C-section, had statistically significant mental health alterations. Conclusion: Women who needed to be transferred reported more obstetric violence, in addition to having a higher incidence of alterations in The City Birth Trauma Scale. In contrast, women who have birth in a BC had more positive experiences, with greater autonomy and female empowerment, as well as higher rates of vaginal births and lower rates of unnecessary interventions. Despite this, the study demonstrated the prevalence, even at lower rates, of obstetric violence in BC. Therefore, it is essential to encourage these birthing facilities to reduce C-section rates and promote positive experiences for women and families, while maintaining monitoring and educational practices to address obstetric violence in all care settings.