PREVALENCE AND FACTORS ASSOCIATED WITH OBSTETRIC VIOLENCE: A STUDY CONDUCTED AMONG PREGNANT WOMEN FROM THE PUBLIC HEALTHCARE SYSTEM IN CURITIBA

INTRODUCTION: Obstetric violence refers to actions and interventions directed at women during pregnancy, childbirth, or the postpartum period, as well as at their newborns, that undermine their autonomy and compromise their physical, emotional, or sexual integrity. Such practices may include physical or verbal abuse, aggressive treatments, and the performance of procedures without consent or evidence-based justification. AIMS: Analyze the prevalence and factors associated with obstetric violence among pregnant women in the public health system of Curitiba, Brazil. MATERIALS AND METHODS: This cross-sectional observational study was conducted within the Maternal and Child Health Cohort of Curitiba (COOSMIC), including 219 women with data collected during pregnancy and the immediate postpartum period. The dependent variable was constructed from six indicators of perceived obstetric violence, including episiotomy, verbal and physical aggression, ineffective communication/poor rapport with healthcare workers, discrimination, procedures done without consent, and absence of skin-to-skin contact with the newborn. Associations were tested using the Chi-square test with a 5% significance level. RESULTS: The prevalence of perceived obstetric violence was 52.2% when considering all six indicators and 44.3% when excluding lack of skin-to-skin contact. Significant associations with obstetric violence included maternal age (p = 0.036), previous diagnosis of anxiety (p = 0.007) and depression (p = 0.030), high-risk pregnancy (p = 0.039), complications during pregnancy (p = 0.017), emergency admissions (p = 0.041), waiting time over 30 minutes at hospital admission (p = 0.047), and delivery complications (p = 0.004). Excluding skin-to-skin contact, significant associations remained for anxiety (p = 0.003), depression (p = 0.019), and waiting time (p = 0.013). FINAL CONSIDERATIONS: Findings indicate a high prevalence of obstetric violence among women in the public health system, particularly among those with greater clinical and emotional vulnerability. The associations highlight the urgency of strengthening public policies and woman-centered care practices to ensure respectful, evidence-based, and qualified assistance during childbirth.

KEYWORDS: Obstetric Violence; Humanized Birth; Maternal Health; Unified Health System; Childbirth Care