Ação política no enfrentamento da violência obstétrica em Manaus - Am

Abstract

The construction of this thesis was born out of the interest in continuing research into health care for pregnant women in the Amazon and the search for the eradication of obstetric violence through activism in Manaus, Amazonas. We sought to discuss the effects on official public health policies through mapping the repertoires of political action mobilized by a social movement - Humaniza Coletivo Feminista - which has been fighting for 10 years for sexual and reproductive security (reproductive justice), abortion assistance safe, humanized birth, combating obstetric violence and improvements in the quality of health services provided to Amazonian women during pregnancy and postpartum in the state of Amazonas. The main forms of articulation with representatives of public bodies in the health, judiciary and educational systems of the government of Amazonas were highlighted. This is qualitative field research, participant observation with ethnographic inspirations, highlighting some official documents produced by Humaniza and field notes. Document analysis was carried out by sharing the collective's Google Drive®. Interviews were carried out with seven activists, between June 2023 and April 2024, via the Zoom® video platform using a semi-structured script as an instrument. The qualitative analysis was guided by the interpretative theory of Clifford Geertz (1973) and the documentary analysis was based on the narratives of Ferreira and Lowenkron (2020). The results highlighted Humaniza's main repertoires of political action (or discursive fields of action): (1) partnership and confrontation with state actions inside and outside the State Committee to Combat Obstetric Violence in Amazonas, (2) assistance legal as amicus curiae in cases of judicialization of health in the context of obstetric violence and violation of rights, (3) strengthen relationships of influence with public bodies and institutions of the state aiming at greater political visibility and (4) promote inspections in maternity hospitals in Manaus and the interior of the state, engagement on social networks and public demonstrations in partnership with public universities and other social movements to disseminate information, create spaces for speech and reflection with civil society on the scenario of obstetric violence and precarious care women's health in Manaus and the region. It is concluded that in Amazonas, obstetric violence is a public health problem that encompasses the violation of human and women's rights. Faced with this reality, Humaniza activists maintain a dubious relationship with the state, oscillating between moments of partnerships and confrontations, in order to change the violent scenario that permeates obstetric care for Amazonian women. Therefore, this investigation supports the thesis that feminist political activism in Amazonas, through the Humaniza collective, has demonstrated to be an effective instrument to confront obstetric violence and promote the restructuring of public health policies, based on the mapping of action strategies policy, it is observed that the collective's intervention not only denounces violent practices, but also puts pressure on the health system and public authorities to adopt measures that value the autonomy of women in the pregnancy-puerperal cycle. The initiative for institutional changes promotes the improvement of the quality of obstetric health care, highlighting the fundamental role of coordination between organized civil society and the state in the protection of sexual and reproductive rights in the Amazon