Das amas de leite às mães órfãs: reflexões sobre o direito à maternidade no Brasil / From wet nurses to orphaned mothers: reflections on the right to maternity in Brazil

Resumo O artigo aborda a retirada compulsória de filhos de mulheres em situação de vulnerabilidade no Brasil. Objetivou-se refletir sobre a violação do direito à maternidade; apresentar os limites impostos, especialmente às mulheres pobres, negras e indígenas e as estratégias de controle sobre sua vida e de seus filhos; e os movimentos de resistência que se contrapõem às segregações. Foram fontes da pesquisa: narrativas de mulheres em situação de vulnerabilidade, de familiares e trabalhadores da saúde; entrevistas com atores estratégicos; análise documental; diários de campo. Evidenciou-se que vulnerabilidades atreladas à criminalização da pobreza e ao preconceito racial têm justificado as separações. A desresponsabilização do Estado e da sociedade quanto à formação de uma rede de apoio às mulheres, a desvalorização de produções não hegemônicas de maternidades e o reforço de uma razão de mundo que produz a violência como ferramenta para exclusão vão conformando limites práticos quanto ao direito à maternidade. Mulheres e seus filhos são desconsiderados em suas singularidades. Os movimentos de resistência mostraram que diálogos intersetoriais são uma alternativa para superar discriminações e vulnerabilidades.

Abstract This article addresses the compulsory seizing of children from vulnerable women in Brazil. Its objectives were: to discuss the violation of the right to maternity; to present the imposed restrictions especially on poor, black and indigenous women; the strategic control over their lives and children, and the resistance movements that oppose segregation. The sources of the research were: narratives of women in vulnerable situations, family members and health workers; interviews with strategic actors; document analysis; field journal. It became evident that vulnerabilities -linked to the criminalization of poverty and racial prejudice- have justified these separations. The lack of responsibility that State and society practice towards the support network for women, the devaluation of non-hegemonic productions of maternity, and the reinforcement of a 'reason of the world', that produces violence as a tool for exclusion establishing practical limits on the right to maternity. Women and children are disregarded in their singularities. Resistance movements have shown that intersectoral dialogues are an alternative to overcome discrimination and vulnerabilities.

Desafios do processo gestacional de mulheres negras: uma revisão narrativa / Challenges in the gestational process of black women: a narrative review

Esta revisão narrativa procura discutir aspectos concernentes ao processo gestacional de mulheres negras, quais sejam: se existem diferenças de tratamento entre mulheres brancas e negras durante a gravidez e nos momentos do parto e pós-parto, como essas diferenças são influenciadas pelos aspectos fisiológicos de cada grupo étnico e como isso afeta as taxas de morbimortalidade. Para esta revisão, quatro bases de dados foram usadas (SciELO, LILACS, PubMed e MEDLINE) e 23 artigos foram lidos na íntegra, depois de selecionados por data de publicação, língua, país da pesquisa e análise dos títulos e resumos. Como principais resultados, os autores encontraram diferenças claras entre mulheres brancas e negras quanto ao acesso à saúde, sendo as negras mais propensas a usar os sistemas públicos e ter menos consultas pré-natal. Também foi observado que as mulheres negras reportaram maus-tratos mais vezes, tinham maiores chances de serem proibidas de ter um acompanhante durante o parto e recebiam menos anestesia para episiotomias. As características fisiológicas também foram apontadas várias vezes. Nesse sentido, altas taxas de anemia ferropriva e hipertensão durante a gravidez foram mais comuns entre as negras. Além disso, em se tratando de taxas de morbimortalidade, mulheres negras tinham uma chance consideravelmente maior de serem readmitidas pós-parto e maiores taxas de mortalidade, quando comparadas com mulheres brancas.(AU)

This review aims to discuss aspects related to the gestational process of black women, namely: if there is a difference in how black and white women are treated throughout pregnancy, partum and postpartum moments, how this difference is influenced by the physiological aspects of each ethnical group and how it affects their morbidity and mortality rates. For this review, four databases were used (SciELO, LILACS, PubMed and MEDLINE) and 23 articles were fully read, after being selected by publishing date, language, country of research, title and abstract analysis. The authors found as the main results clear differences between black women's and white women's access to health care, as black women are more likely to use public health care systems and have fewer prenatal appointments. It was also noticed that black women reported maltreatment more frequently, had a higher chance of being prohibited from keeping a companion during labor and suffering from less local anesthesia for episiotomy. The physiological characteristics were also pointed out several times, with high rates of iron deficiency anemia and hypertension during pregnancy being more common among black women. Moreover, when it comes to morbidity and mortality rates, black women had an extremely higher chance of being readmitted postpartum, and a higher mortality rate, when compared to white women.(AU)

Insights into fear: A phenomenological study of Black mothers.

AIM: The aim of the study was to explore the lived experience of stress as described by Black childbearing women. DESIGN: A phenomenological approach was used. METHODS: Seven mothers who met inclusion criteria participated in both individual and group interviews between August 2018 and August 2019. Each session was audio recorded and professionally transcribed. Consistent with van Manen's phenomenological approach, three rounds of reflective transcript analysis were conducted over several months. RESULTS: Several stress themes were identified from the data. However, the most pervasive theme was the fear of having a son and keeping him safe. In this paper, the themes of Living in Fear and Living with Fear are detailed. CONCLUSION: Previous research has found that Black populations in America fear for their safety. This study identified a pervasive and profound fear for their children, specifically sons who are at a higher risk of being killed in normal daily activities. Mothers also expressed fears about their responsibility to keep them safe by providing the right tools. IMPACT: Although scientists have long studied poor pregnancy outcomes for Black American women, the disparity persists. This study sought to identify stressors acknowledged by Black mothers themselves. For the first time, Black mothers stated that their primary stress is fear for their children's lives. The role this fear has in adverse pregnancy outcomes, if any, is yet to be determined.

Factors Associated With Violence Against Women and Facial Trauma of a Representative Sample of the Brazilian Population: Results of a Retrospective Study.

STUDY DESIGN: Violence against women is a challenge in public health. It involves women of all ages, socioeconomic statuses, cultures, and religions. OBJECTIVE: The objective of this study was to perform an epidemiological survey of facial trauma among women who experienced physical aggression by an intimate partner. METHODS: Electronic medical records from a public tertiary referral hospital for trauma in the Brazilian state of Espírito Santo were analyzed between 2013 and 2018. RESULTS: Patients were most commonly between 20 and 29 years of age (33.9%), and 50% of the patients were of mixed race. When separated by days of the week, facial trauma was most commonly inflicted on Sundays (24.2%) and on Saturdays (22.6%). Of the 62 women included in the study, 47 had facial fractures, and 7 had more than 1 concomitant fracture. Forty of the total fractures (72.7%) were on the middle and upper thirds of the face, while 15 fractures (27.3%) were on the lower third of the face. The most commonly observed signs and symptoms of these injuries were edema (56.5%), periorbital ecchymosis (35.5%), deviated nasal dorsum (22.6%), and hematoma (16.1%). CONCLUSIONS: Facial trauma may be considered an important marker of attempted femicide. Health care professionals must be aware of and attentive to this correlation, since many cases of attempted femicide go unnoticed or are attributed to another etiology.

The sustainability-peace nexus in crisis contexts: how the Rohingya escaped the ethnic violence in Myanmar, but are trapped into environmental challenges in Bangladesh.

Because of ethnic and cultural violence in Myanmar, approximately a million Rohingya fled to neighboring Bangladesh starting from August 2017, in what the UN has called a "textbook example of ethnic cleansing". Those arriving in Bangladesh were able to escape decade-long ethnic violence in Myanmar, but the Rohingya's immediate destination, Cox's Bazar district is one of the most climate-vulnerable and disaster-prone areas in Bangladesh. Currently, they have been subjected to extreme rainfalls, landslides, and flashfloods. With the COVID-19 pandemic, they continue to face fear and further marginalization in resource-constrained Bangladesh, as well as increased vulnerability due to tropical cyclones, flashfloods, and landslides. The Rohingya in southeast Bangladesh are now at the epicenter of a humanitarian and sustainability crisis. However, their situation is not entirely unique. Millions of displaced, stateless or refugees around the world are facing multi-dimensional crises in various complex geopolitical, and climatic situations. Using the theoretical lens of political ecology and critical development studies, this paper analyzes the sustainability-peace nexus for millions of Rohingya in Myanmar and in Bangladesh. This paper is based on information from various sources, including three ethnographic field visits in recent years, which helped to get local insights into the current sustainability challenges in this humanitarian context. The core arguments of this paper suggest that sustainability-peace nexus will especially be compromised in climate-vulnerable resource-constrained conditions. To overcome this challenge, decolonizing Rohingya solutions would be critical, by engaging the Rohingya in the process of development and meaningful change, which can affect their lives, livelihoods, and wellbeing. Even though this paper has a specific geographical focus, the insights are relevant in parts of the world facing similar social, economic, political, and environmental challenges.

Underprivileged Women Impacted by Ethnic Violence: Deconstructing Lives.

Though the city of Karachi in Pakistan is a nucleus of ethnic violence, only a limited number of studies have been conducted on the predicament of underprivileged women during ongoing conflicts. There has been negligible focus on how the women are coping in the post violence milieu. Voices of disadvantaged women remain unheard in patriarchal societies, particularly in developing and underdeveloped countries. The objective of this qualitative study is to provide voice to underprivileged women impacted by ethnic violence and to comprehend post violence conditions under which they are surviving. This research accentuates the relevance of studying gender dimension of violence (GDV) from women's perspectives. Findings from five focus group interviews with 24 participants highlight the harrowing tales of poverty, despair, physical and psychological distress with which the women are coping. Individual, semi structured interviews were conducted with two female workers from local Non-Governmental Organizations (NGOs) to examine measures for rehabilitation of the women. Data from NGO workers underscores the inertia of government in this respect and recommendations include endeavors of governmental and non-governmental organizations to provide healthcare, education and vocational training to the impacted women.

Desafios do processo gestacional de mulheres negras: uma revisão narrativa / Challenges in the gestational process of black women: hia narrative review

Esta revisão narrativa procura discutir aspectos concernentes ao processo gestacional de mulheres negras, quais sejam: se existem diferenças de tratamento entre mulheres brancas e negras durante a gravidez e nos momentos do parto e pós-parto, como essas diferenças são influenciadas pelos aspectos fisiológicos de cada grupo étnico e como isso afeta as taxas de morbimortalidade. Para esta revisão, quatro bases de dados foram usadas (SciELO, LILACS, PubMed e MEDLINE) e 23 artigos foram lidos na íntegra, depois de selecionados por data de publicação, língua, país da pesquisa e análise dos títulos e resumos. Como principais resultados, os autores encontraram diferenças claras entre mulheres brancas e negras quanto ao acesso à saúde, sendo as negras mais propensas a usar os sistemas públicos e ter menos consultas pré-natal. Também foi observado que as mulheres negras reportaram maus-tratos mais vezes, tinham maiores chances de serem proibidas de ter um acompanhante durante o parto e recebiam menos anestesia para episiotomias. As características fisiológicas também foram apontadas várias vezes. Nesse sentido, altas taxas de anemia ferropriva e hipertensão durante a gravidez foram mais comuns entre as negras. Além disso, em se tratando de taxas de morbimortalidade, mulheres negras tinham uma chance consideravelmente maior de serem readmitidas pós-parto e maiores taxas de mortalidade, quando comparadas com mulheres brancas.(AU)

This review aims to discuss aspects related to the gestational process of black women, namely: if there is a difference in how black and white women are treated throughout pregnancy, partum and postpartum moments, how this difference is influenced by the physiological aspects of each ethnical group and how it affects their morbidity and mortality rates. For this review, four databases were used (SciELO, LILACS, PubMed and MEDLINE) and 23 articles were fully read, after being selected by publishing date, language, country of research, title and abstract analysis. The authors found as the main results clear differences between black women's and white women's access to health care, as black women are more likely to use public health care systems and have fewer prenatal appointments. It was also noticed that black women reported maltreatment more frequently, had a higher chance of being prohibited from keeping a companion during labor and suffering from less local anesthesia for episiotomy. The physiological characteristics were also pointed out several times, with high rates of iron deficiency anemia and hypertension during pregnancy being more common among black women. Moreover, when it comes to morbidity and mortality rates, black women had an extremely higher chance of being readmitted postpartum, and a higher mortality rate, when compared to white women.(AU)

Ethnic Violence and Birth Outcomes: Evidence From Exposure to the 1992 Conflict in Kenya.

This study is an examination of the effect of intrauterine exposure to electoral violence on child birth weight, an outcome that has long-term effects on an individual's education, income, and health in later life. We consider the electoral violence that resulted from the introduction of multiparty democracy in Kenya as an exogenous source of shock, using a difference-in-differences method and a mother fixed-effects model. We find that prenatal exposure to the violence increased the probabilities of low birth weight and a child being of very small size at birth by 19 and 6 percentage points, respectively. Violence exposure in the first trimester of pregnancy decreased birth weight by 271 grams and increased the probabilities of low birth weight and very small size at birth by 18 and 4 percentage points, respectively. The results reaffirm the significance of the nine months in utero as one of the most critical periods in life that shapes future health, economic, and educational trajectories.

Enfrentamento da violência e Atenção Primária à Saúde: a visão dos usuários do SUS/BH / Coping with violence and Primary Health Care: the view of SUS/BH users

A violência se mostra como uma agrura de abrangência mundial, que acomete desde países inteiros a pequenos aglomerados. A fereza desse problema tende a culminar em sérias consequências tanto para a vida privada, quanto para o setor público e, justo por isso, o assunto pode ser destacado como uma importante vertente que demanda atenção e estudo, a fim de possibilitar um novo olhar que permita "novos fazeres", culminando em ações de promoção da saúde e prevenção da violência. As formas para enfrentamento da violência e as visões sobre o próprio ato são bastante numerosas entre os diferentes grupos de uma sociedade. Assim, tomando por palco primeiro o contexto brasileiro e, então, elevando ao cerne o modo como se organiza o município de Belo Horizonte/MG para o enfrentamento da violência, é que se buscou entender esse fenômeno sob a perspectiva dos usuários das unidades básicas de saúde. Para o desenvolvimento desta dissertação foi realizado um estudo exploratório, descritivo com abordagem quantitativa. Os dados analisados foram gerados pela pesquisa intitulada Programa de Promoção da Saúde e Prevenção da Violência na Atenção Básica da Saúde coordenada pelo Departamento de Medicina Preventiva Social da UFMG, aplicada com os usuários das Unidades Básicas de Saúde de Belo Horizonte no ano de 2017, cujo instrumento foi um questionário semiestruturado com 310 questões em que foram definidas como variáveis independentes algumas características pessoais, sociofamiliares e situações de violência na área de abrangência da unidade, e como variável dependente o enfrentamento da violência. Esse estudo trouxe como avanço a proposição do Indicador de Percepção e Enfrentamento da Violência que ajuda a compreender a questão mesmo com as limitações de referencial teórico encontrado na literatura. Os sujeitos do estudo foram 1.125 entrevistados selecionados nas nove regionais de saúde de BH, e os critérios de inclusão foram residir no local há mais de 06 meses, ter 16 anos ou mais e ter sido atendido na unidade de saúde pelo menos uma vez antes da entrevista. Com relação à percepção do enfrentamento da violência desses entrevistados, os resultados apontaram de forma resumida, as seguintes relações: As mulheres que sofreram violência tiveram percepção mais heterogênea e mais alta que os homens na mesma condição, já os indivíduos com renda inferior a um salário mínimo tiveram percepção mais alta que aqueles com maiores salários, os pertencentes à faixa etária de 55 a 64 anos apresentaram percepção mais alta que as demais faixas etárias e indivíduos com baixos níveis de escolaridade dispuseram de uma percepção mais baixa do enfrentamento da violência em relação àqueles com maior escolaridade. A maioria dos entrevistados acredita que a violência pode ser evitada, e reconhece o papel essencial das Unidades Básicas de Saúde e do município na prevenção e enfrentamento da violência, contudo, não reconhecem as práticas do poder público que estão voltadas para esse enfrentamento. Esse estudo permitiu correlacionar as características dos indivíduos estudados e o enfrentamento da violência com as políticas adotadas pelo município e o impacto que exercem sobre eles.

Violence is a worldwide issue, which affects from whole countries to small communities, causing serious consequences for both individuals and the public sector. Given its impact, this subject should be an important aspect for public awareness and research, changing perspectives and allowing "New actions" to be taken, resulting in new public health polices and prevention actions against violence. Views and actions against violence varies for different groups in society. Hence, taking into account how actions against violence are managed in Brazil, and more specific in the city of Belo Horizonte, this study aims to understand violence by the lens of the public cared for the primary care of the Unified Health System. In this dissertation, an exploratory, descriptive study with a quantitative approach was carried out. The data analyzed on the study was based on a field research entitled Program of Health Promotion and Violence Prevention in Primary Health Care, coordinated by the department of Preventive Medicine of the Federal University of Minas Gerais, the research was conducted on to the public cared for the primary care of the Unified Health System in Belo Horizonte in 2017. The field research consists of a semi-structured questionnaire with 310 questions in which some personal, social and family characteristics, as well as situations of violence in the area covered by the primary care unit, were defined as independent variables, and the coping with violence as a dependent variable. The study proposes a new Indicator of the Perception and Copping of violence that helps to understand the issues even after taking into account the theoretical limitations find in the literature. The interviewees were 1,125 people selected from nine different districts of Belo Horizonte. The criteria for the interviewees were: live in the same place for more than 06 months, to be 16 years old or older and to have been seen at the primary care unit at least once before the interview. According to the data analyzed, the interviewees' perception of violence, can be summarized as follows: Women who suffered violence had higher, more heterogeneous perception than men in the same condition, while individuals with income below minimum wage had a higher perception than those with higher earnings. Those belonging to the age group of 55 to 64 years old had a higher perception than other age groups. Individuals with lower degree of education had a lower perception of coping with violence than those with higher education. Most participants believed that violence can be avoided, and recognize the essential role of primary care of the Unified Health System and the public polices in preventing and coping with violence, however, they do not identify the policies of the government that are focused on this issue. This study made it possible to correlate the characteristics of the population and coping with violence with the policies adopted by the city and the impact they have on the sampled population.

Shaking the tyrant's bloody robe.

Group violence, despite much study, remains enigmatic. Its forms are numerous, its proximate causes myriad, and the interrelation of its forms and proximate causes poorly understood. We review its evolution, including preadaptations and selected propensities, and its putative environmental and psychological triggers. We then reconsider one of its forms, ethnoreligious violence, in light of recent discoveries in the behavioral and brain sciences. We find ethnoreligious violence to be characterized by identity fusion and by manipulation of religious traditions, symbols, and systems. We conclude by examining the confluence of causes and characteristics before and during Yugoslavia's wars of disintegration.