School health-care team members' reflections of their promotion of sexual and reproductive health and rights (SRHR): Important but neglected.

OBJECTIVE: Young people are prioritized regarding the promotion and safeguarding of sexual and reproductive health and rights - SRHR. In Sweden, the school is seen as an important arena with members of the school health-care or SHC team as vital actors in this work. This study explored SRHR-related work in SHC teams in Sweden. METHODS: Within an explorative qualitative design, structured interviews were conducted with 33 nurses, counsellors, SHC unit managers and headmasters. Reflexive thematic analysis was applied, and two main themes found. RESULTS: SHC team members see SRHR as an urgent topic, but address it only 'when necessary', not systematically - and they experience a shortage of guidance and cooperation regarding SRHR-related work. Even in a country with agreement on the importance of SRHR for all and on providing holistic comprehensive sex education in schools, young people are left to chance - i.e., to the SRHR competence in the professionals they meet. CONCLUSION: SHC team members in Sweden see SRHR as an urgent topic but do not address it systematically. Moreover, they experience a shortage of guidance for their work. To avoid any professional stress of conscience and for equitable school health care regarding SRHR to be realized, research-informed policy needs to underline systematic, comparable and proactive practice.

The Urban Environment and Disparities in Sexual and Reproductive Health Outcomes in the Global South: a Scoping Review.

By 2050, the Global South will contain three-quarters of the world's urban inhabitants, yet no standardized categorizations of urban areas exist. This makes it challenging to compare sub-groups within cities. Sexual and reproductive health and rights (SRHR) are a critical component of ensuring that populations are healthy and productive, yet SRHR outcomes within and across urban settings vary significantly. A scoping review of the literature (2010-2022) was conducted to describe the current body of evidence on SRHR in urban settings in the Global South, understand disparities, and highlight promising approaches to improving urban SRHR outcomes. A total of 115 studies were identified, most from Kenya (30 articles; 26%), Nigeria (15; 13%), and India (16; 14%), focusing on family planning (56; 49%) and HIV/STIs (43; 37%). Findings suggest significant variation in access to services, and challenges such as gender inequality, safety, and precarious circumstances in employment and housing. Many of the studies (n = 84; 80%) focus on individual-level risks and do not consider how neighborhood environments, concentrated poverty, and social exclusion shape behaviors and norms related to SRHR. Research gaps in uniformly categorizing urban areas and key aspects of the urban environment make it challenging to understand the heterogeneity of urban environments, populations, and SRHR outcomes and compare across studies. Findings from this review may inform the development of holistic programs and policies targeting structural barriers to SRHR in urban environments to ensure services are inclusive, equitably available and accessible, and direct future research to fill identified gaps.

Reimagining young people's rights in South Asia: Learnings from #FlawsInLaws.

While the criminal justice system is an essential pillar in ensuring human rights for young people, especially their sexual and reproductive health and rights (SRHR), laws and regulations are often overused or misused regarding rights related to gender and sexuality. Sometimes this is explicit, but other times it works in less overt ways to undermine young people's rights. Therefore, in 2019, CREA joined with seven partners in South Asia to launch a campaign focusing on the impact of criminalisation of young people's sexuality - rethink young people's freedoms, reimagine their rights, and help them to realise their futures. Legal and policy advocacy has often promoted reform in a way that empowers the state to legislate on aspects of sexuality, including sexual identity, conduct, expression and reproduction - sometimes expanding rights protections, but sometimes putting rights at risk. Through the campaign, the partners sought to highlight the disconnected law and policy structures about young people and their sexuality (including criminalisation, lack of comprehensive sexuality education and lacune in SRHR services), envisioning arights-affirming environment for young people and the communities that support them. We contestedthe tendency to advocate for rights' recognition through distinct, issue-based initiatives rather than a holistic, intersectional approach.

Indigenous Women's Resistance of Colonial Policies, Practices, and Reproductive Coercion.

This analysis of urban Indigenous women's experiences on the Homeland of the Métis and Treaty One (Winnipeg, Manitoba, Canada), Treaty Four (Regina, Saskatchewan, Canada), and Treaty Six (Saskatoon, Saskatchewan, Canada) territories illustrates that Indigenous women have recently experienced coercion when interacting with healthcare and social service providers in various settings. Drawing on analysis of media, study conversations, and policies, this collaborative, action-oriented project with 32 women and Two-Spirit collaborators demonstrated a pattern of healthcare and other service providers subjecting Indigenous women to coercive practices related to tubal ligations, long-term contraceptives, and abortions. We foreground techniques Indigenous women use to assert their rights within contexts of reproductive coercion, including acts of refusal, negotiation, and sharing community knowledge. By recognizing how colonial relations shape Indigenous women's experiences, decision-makers and service providers can take action to transform institutional cultures so Indigenous women can navigate their reproductive decision-making with safety and dignity.

Lineamientos técnicos para la provisión de condones masculinos, femeninos y lubricantes a base de agua en el Sistema Nacional Integrado de Salud / Technical guidelines for the provision of condoms male, female and water-based lubricants in the National Integrated Health System

Los presentes lineamientos técnicos han sido elaborados en función de garantizar la cobertura y el acceso universal en salud. Sin embargo, la prevención de ITS/VIH, en particular en los grupos de población clave y vulnerable, se ve impactada por el estigma y discriminación, desigualdad en materia de género, violencia, falta de poder de decisión de las comunidades y vulneraciones de los derechos humanos, derechos sexuales y derechos reproductivos. Es debido a lo anterior, que se han identificado acciones necesarias plasmadas en este documento, para superar dichas barreras de acceso en estos grupos de población

These technical guidelines have been prepared in order to guarantee the coverage and universal access in health. However, STI/HIV prevention, particularly in groups of key and vulnerable population, is impacted by stigma and discrimination, inequality in of gender, violence, lack of decision-making power of the communities and violations of the rights human rights, sexual rights and reproductive rights. It is due to the above, that they have been identified necessary actions embodied in this document, to overcome these barriers of access in these population groups

A call for action that cannot go to voicemail: Research activism to urgently improve Indigenous perinatal health and wellbeing.

In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of successful community-driven programs making a difference and call on all peoples to support and resource Indigenous-led perinatal health services by providing practical actions for individuals and different groups.

The politest form of racism: sexual and reproductive health and rights paradigm in Canada.

The Canadian national identity is often understood as what it is not; American. Inundation with American history, news, and culture around race and racism imbues Canadians with a false impression of egalitarianism, resulting in a lack of critical national reflection. While this is true in instances, the cruel reality of inequity, injustice and racism is rampant within the Canadian sexual and reproductive health and rights realm. Indeed, the inequitable health outcomes for Black, Indigenous and people of color (BIPOC) are rooted in policy, research, health promotion and patient care. Built by colonial settlers, many of the systems currently in place have yet to embark on the necessary process of addressing the colonial, racist, and ableist structures perpetuating inequities in health outcomes. The mere fact that Canada sees itself as better than America in terms of race relations is an excuse to overlook its decades of racial and cultural discrimination against Indigenous and Black people. While this commentary may not be ground-breaking for BIPOC communities who have remained vocal about these issues at a grassroots level for decades, there exists a gap in the Canadian literature in exploring these difficult and often underlying dynamics of racism. In this commentary series, the authors aim to promote strategies addressing systemic racism and incorporating a reproductive justice framework in an attempt to reduce health inequities among Indigenous, Black and racialized communities in Canada.

Revisiting the Role of Health Care Proxies in Reproductive Choice.

In an effort to protect patients' reproductive rights, many states prohibit health care proxies from serving as surrogate decision makers for pregnancy termination in patients who lack capacity. We explore the case of a 24-year-old developmentally delayed woman with intractable seizures and complex psychosocial needs who was found to be pregnant. Her older sister was her health care proxy and declared that an abortion would be in her best interest, medically and socially; the patient herself lacked capacity to make this decision. Legally, her sister's judgment alone was insufficient to move forward with the procedure. Here we describe our multidisciplinary medical, ethical, and legal review of this case and how, despite agreeing with the patient's sister, legal barriers hindered our ability to obtain an abortion for this patient. Her situation illustrates the unintended consequences of our current approach to surrogate decision making in pregnancy termination. It highlights the need to reconsider the role of health care proxies in reproductive-choice decisions and emphasizes the value of a holistic evaluation of patients' social circumstances.

"O escuro das cores, na pele afrodescendente, herdeira das dores": dimensões do racismo no contexto de assistência ao parto / "The dark of colors, in the afro-descendant skin, heir of pain": dimensions of racism in the context of childbirth care

Resumo Partindo de uma pesquisa mais ampla sobre as vivências de mulheres negras na assistência ao período gestacional e parto, este artigo aborda alguns aspectos do racismo na rotina de atenção à mulher negra durante este ciclo. Trata-se de uma pesquisa empírica de abordagem qualitativa com mulheres e mães que se autodeclaram negras e antirracistas. Nas narrativas, os pontos apresentados envolviam, na sua maioria, estereótipos associados ao corpo negro construídos sob um imaginário social racista. Nas relações interpessoais, discursos permeados por estereótipos racistas desumanizam a mulher negra, gerando barreiras na sua saúde reprodutiva.

Abstract Starting from a broader research on the experiences of black women in assisting the gestational period and childbirth, this article addresses some aspects of racism in the routine of care for black women during this cycle. This is an empirical research with a qualitative approach with women and mothers who declare themselves black and anti-racist. In the narratives, the points presented involved, for the most part, stereotypes associated with the black body constructed under a racist social imaginary. In interpersonal relationships, speeches permeated by racist stereotypes dehumanize black women, creating barriers in their reproductive health.

Contribución científica y académica de estudios sobre sexualidad juvenil realizados en una facultad de enfermería de Colombia / Scientific and Academic Contribution of Studies on Youth Sexuality Conducted in a Colombian Nursing School / Contribuição científica e acadêmica de estudos sobre sexualidade juvenil realizados em uma escola de enfermagem na Colômbia

Introducción: el objetivo de esta investigación fue describir la contribución científica y académica de los estudios en torno a la sexualidad juvenil realizados entre los años 2014 y 2018 en una facultad de enfermería de Colombia. Metodología: Se realizó un estudio de revisión documental, a través del cual se seleccionaron y analizaron 14 productos derivados de investigación docente y de estudiantes que cursaron un posgrado. El análisis se realizó mediante una evaluación crítica y analítica de los resultados reportados en los estudios seleccionados, lo que permitió presentar el estado actual de desarrollo del conocimiento, sus tendencias y avances con una visión global y contextualizada. Resultados: los estudios revisados tienden a profundizar en componentes psicosociales de la sexualidad juvenil con visión holística, lo que explica el predominio de enfoques cualitativos, que, a su vez, son coherentes con la educación y la formación en enfermería y psicología, profesiones que han liderado dichas investigaciones. Conclusiones: en los estudios revisados, predomina el tema del embarazo adolescente desde diferentes perspectivas. Esta prelación es explicable por tratarse de una de las problemáticas más frecuentes en este grupo poblacional y con mayores consecuencias psicosociales ya que suele alterar su calidad de vida presente y futura. Con menor frecuencia, se estudian otros aspectos de la sexualidad juvenil y se inician acercamientos a la educación virtual para la prevención y el manejo de las situaciones que más afectan la sexualidad en esta etapa.

Introduction: This research aims to describe the scientific and academic contribution of studies on youth sexuality conducted between 2014 and 2018 in a Colombian nursing school. Methods: A document review study was carried out in which 14 research products of teachers and graduated students were selected and analyzed. The analysis involved a critical and analytical evaluation of the results reported in the selected studies, making it possible to present the current state, development, trends, and advances of knowledge under a global and contextualized vision. Results: The reviewed studies tend to delve into psychosocial components of youth sexuality using a holistic view, which explains the predominance of qualitative approaches that, in turn, are consistent with education and training in nursing and psychology, two subject fields that have led these pieces of research. Conclusions: In the reviewed studies, the topic of adolescent pregnancy addressed from different perspectives predominates. This preference can be explained by the fact that pregnancy in adolescence is one of the most frequent problems in this population and one with the greatest psychosocial consequences since it tends to alter teenagers' present and future quality of life. Other aspects of youth sexuality are less frequently studied, and approaches to virtual education are initially tried to prevent and manage situations that most affect sexuality at this stage.

Introdução: objetivou-se descrever a contribuição científica e acadêmica de estudos sobre sexualidade juvenil realizados entre 2014 e 2018 em uma escola de enfermagem na Colômbia. Metodologia: Foi realizado um estudo de revisão documental, por meio do qual foram selecionados e analisados 14 produtos derivados de pesquisa docente e de alunos de pós-graduação. A análise realizou-se mediante uma avaliação crítica e analítica dos resultados reportados nos estudos selecionados, o que permitiu apresentar o estado atual do desenvolvimento do conhecimento, suas tendências e avanços com uma visão global e contextualizada. Resultados: os estudos revisados vontalm-se a aprofundar os componentes psicossociais da sexualidade juvenil com uma visão holística, o que explica o predomínio de abordagens qualitativas, que, por sua vez, são consistentes com a educação e a formação em enfermagem e a psicologia, profissões que têm encabeçado tais pesquisas. Conclusões: nos estudos revisados predomina a questão da gravidez na adolescência desde diferentes perspectivas. Essa escolha pode ser explicada por ser um dos problemas mais frequentes nesse grupo populacional e de maiores consequências psicossociais, pois tende a alterar sua qualidade de vida presente e futura. Com menos frequência, outros aspectos da sexualidade juvenil são estudados e abordagens de educação virtual são iniciadas para a prevenção e gerenciamento das situações que mais afetam a sexualidade nesta etapa

How COVID-19 Highlights an Ongoing Pandemic of Neglect and Oppression When It Comes to Women's Reproductive Rights.

The coronavirus disease-19 (COVID-19) pandemic has exposed an underlying pandemic of neglect affecting women's reproductive rights, particularly in the provision of abortion services and maternity care. The systemic neglect in the Australian context has resulted in a rise in demand for the services provided by privately practising midwives (PPMs) that is not matched by systemic support for, nor recognition of, women choosing to birth at home. As a result, PPMs are unable to meet the rise in demand, which in itself reflects decades of limited State support for the choice to birth at home and opposition by incumbent stakeholders in the provision of maternity care to healthy women with low-risk pregnancies. We discuss the historical backdrop to these currently erupting issues, along with the real reasons for the opposition to PPMs in Australia. Finally, we offer solutions to this ongoing issue.

Community-informed models of perinatal and reproductive health services provision: A justice-centered paradigm toward equity among Black birthing communities.

Perinatal health outcomes in the United States continue to worsen, with the greatest burden of inequity falling on Black birthing communities. Despite transdisciplinary literature citing structural racism as a root cause of inequity, interventions continue to be mostly physician-centered models of perinatal and reproductive healthcare (PRH). These models prioritize individual, biomedical risk identification and stratification as solutions to achieving equity, without adequately addressing the social and structural determinants of health. The objective of this review is to: (1) examine the association between the impact of structural and obstetric racism and patient-centered access to PRH, (2) define and apply reproductive justice (RJ) as a framework to combat structural and obstetric racism in PRH, and (3) describe and demonstrate how to use an RJ lens to critically analyze physician-led and community-informed PRH models. We conclude with recommendations for building a PRH workforce whose capacity is aligned with racial equity. Institutional alignment with a RJ praxis creates opportunities for advancing PRH workforce diversification and development and improving PRH experiences and outcomes for our patients, communities, and workforce.

La enfermedad normal: Aspectos históricos y políticos de la medicalización del parto / The normal disease: Historical and political aspects of the medicalization of childbirth / A enfermidade normal: Aspectos históricos e políticos da medicalização do parto

Resumen Este artículo indaga sobre la construcción del saber y la práctica médica en ginecobstetricia. Se centra específicamente en las transformaciones de los significados sociales y médicos sobre el cuerpo gestante y parturiente que se dieron desde finales del siglo XIX y en el transcurso del siglo XX, y que posibilitan el proceso de medicalización, patologización y hospitalización del parto. Así mismo, se exploran los efectos que tiene el modelo médico tecnocrático de atención al binomio embarazo/parto, en cuanto a la experiencia de dichos procesos en las mujeres. El artículo concluye en la necesidad de profundizar en los elementos del paradigma médico, la formación de los profesionales y las condiciones laborales del sector de la salud, que intervienen en la problemática de la deshumanización de la atención del parto.

Abstract This article investigates the construction of medical knowledge and practice in gynecology and obstetrics. Specifically, it focuses on the transformations of social and medical meanings in the pregnant body that occurred since the end of the 19th century and during the 20th century, and which make possible the process of medicalization, pathologization and hospitalization of childbirth. Likewise, the effects that the technocratic medical model of care for the pregnancy / childbirth binomial has in terms of the experience of these processes in women are explored; concluding on the need to deepen the elements of the medical paradigm, the training of health professionals and the working conditions in the health sector that intervene in the problem of dehumanization of care.

Resumo Este artigo investiga a construção do conhecimento e da prática médica em ginecologia e obstetrícia. Especificamente, concentra-se nas transformações dos significados sociais e médicos no corpo gestante ocorridas desde o final do século XIX e durante o século XX, e que possibilitam o processo de medicalização, patologização e hospitalização do parto. Da mesma forma, são explorados os efeitos que o modelo médico tecnocrático de atenção ao binômio gravidez / parto tem em termos da experiência desses processos em mulheres; concluindo sobre a necessidade de aprofundar os elementos do paradigma médico, a formação dos profissionais de saúde e as condições de trabalho no setor da saúde que intervêm no problema da desumanização da assistência.

Prioritizing the sexual and reproductive health and rights of adolescent girls and young women within HIV treatment and care services in emergency settings: a girl-centered agenda.

BACKGROUND: Extensive documentation exists on a range of negative sexual and reproductive health outcomes and rights violations occurring during humanitarian emergencies. We explore two central questions: Do existing policies, services, and research adequately address the SRH rights, priorities and HIV risks of adolescent girls and young women in emergency settings? What are the missed opportunities for holistically addressing the vulnerabilities experienced by those living with HIV during rapid onset disasters and long term, protracted emergencies? Authors review considerations informing real-time decision making, and highlight missed opportunities to apply a gendered lens in the delivery of AGYW-centered SRHR/HIV services. METHODS: A scoping review identified studies on HIV intervention and outcomes in emergency settings, published in the peer-reviewed literature (2002-2017). This exercise was complemented with a desk review of normative guidance, frameworks, and implementation guidelines on HIV and SRH in emergency responses, and by consultations with subject matter experts. RESULTS: The existing frameworks and guidance pay scant attention to the sexual reproductive health and rights of young women living with HIV (WLHIV), focusing mainly on prevention of mother to child transmission (PMTCT), antiretroviral therapy (ART), HIV testing services, and linkage to treatment services. Applying a gendered sexual and reproductive health lens to the response offers opportunities to identify critical implementation questions, and highlight promising practices, to better tailor current services for AGYW. CONCLUSIONS: A plurality of competing needs crowds out dedicated time and space to effectively integrate HIV and sexual and reproductive health interventions in emergency settings. Political will is required to advance multi-sectoral cooperation, through joint planning, rights-informed learning and integrative responses, and to promote creative solutions for ART continuation, drug supply and HIV testing, treatment and care. Recent advancements in policy and practice would suggest that a more AGYW-centered response is feasible.

Child marriage of female Syrian refugees in Jordan and Lebanon: a literature review.

BACKGROUND: The Syrian conflict has resulted in major humanitarian crises. The risk is particularly high amongst female children who face additional gendered risks, such as harassment and sexual violence, including a rise in prevalence of child marriage. Despite the importance of this topic, current literature remains relatively scarce. OBJECTIVES: This study aims to explore the social and healthcare repercussions of Syrian refugee child marriages in Jordan and Lebanon. METHODS: A systematic review of the literature was carried out to gather evidence, from a total of eight articles. Data analysis was conducted using the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. RESULTS: The findings of this research identify tradition, honour, economics, fear, and protection-related factors as drivers of child marriage of refugees in Jordan and Lebanon. These motives overlap with findings regarding access to reproductive health and reproductive rights. The lack of autonomy of the child to give informed consent is augmented in the context of protracted violence and displacement. CONCLUSION: There is a need for a holistic approach to provide safe spaces, education, and protection to young girls and their families to reduce their acceptance of child marriage.

Atenção integral à saúde da população LGBT: Experiência de educação em saúde com agentes comunitários na atenção básica / Integral health care of LGBT population: Health education experience with community agents in basic attention / Atención integral la salud de la población LGBT: Experiencia de educación en salud con agentes comunitarios en la atención básica

Objetivo: Relatar uma experiência de educação em saúde com agentes comunitários de saúde acerca da saúde da população LGBT na atenção básica. Métodos: Foi realizada uma ação de educação continuada por meio do estudo de casos escolhidos pelos agentes de saúde dentro de suas microáreas de atuação seguida de discussão em grupo e reflexão sobre as práticas vigentes. Resultados: Foram discutidos três casos apresentados pelos agentes de saúde que abordavam as temáticas de: (1) a escola e o preconceito; (2) a importância do apoio familiar e social; e (3) o papel da estratégia saúde da família e da educação em saúde. Percebeu-se que o tema permanece excluído das grandes discussões, sobretudo nas escolas médicas e na atenção básica, que é o primeiro contato do usuário com o Sistema Único de Saúde. Dessa forma, estratégias que objetivem discutir as peculiaridades da prevenção, promoção e assistência à saúde desses grupos devem ser estimuladas e reproduzidas tendo em vista uma melhor qualidade do atendimento a fim de captar esses pacientes em um ambiente favorável a práticas integrativas com respeito à diversidade sexual. Conclusão: Conclui-se que a atividade educacional realizada foi de extrema importância para desmistificar mitos e preconceitos envolvendo a saúde LGBT no cenário da atenção básica. Observou-se que após a atividade educacional os ACS se mostraram mais confiantes e sensibilizados sobre as temáticas abordadas e mudaram concepções no sentido de respeitar as decisões dos pacientes e realizar abordagem adequada para o acolhimento a esses usuários.

Objective: To report a health education experience with community health agents about the health of the LGBT population in basic care. Methods: A continuous education action was carried out by means of the study of cases chosen by health agents within their micro-areas of action followed by group discussion and reflection on current practices. Results: Three cases presented by the health agents that dealt with the themes of: (1) school and prejudice; (2) the importance of family and social support; and (3) the role of family health strategy and health education. It was noticed that the theme remains excluded from the great discussions, especially in medical schools and primary care, the first contact with the Brazilian health system (SUS), thus strategies that aim to discuss the peculiarities of prevention, promotion and health care of these groups should be stimulated and reproduced with a view to a better quality of care in order to capture these patients in an environment favorable to integrative practices with respect to sexual diversity. Conclusion: It was concluded that the educational activity performed was extremely important to demystify myths and prejudices involving LGBT health in the primary care setting. It was observed that after the educational activity the CHAs were more confident and sensitized on the topics addressed and changed conceptions in order to respect the decisions of the patients and to carry out an appropriate approach to the reception of these users.

Objetivo: Informar una experiencia de educación en salud con agentes comunitarios de salud acerca de la salud de la población LGBT en la atención básica. Métodos: Se realizó una acción de educación continuada por medio del estudio de casos escogidos por los agentes de salud dentro de sus microáreas de actuación seguido de discusión en grupo y reflexión sobre las prácticas vigentes. Resultados: Hemos discutido tres casos presentados por los funcionarios de salud que abordaron los siguientes temas: (1) la escuela y el prejuicio; (2) la importancia del apoyo familiar y social; y (3) el papel de la estrategia sanitaria de la familia y de la educación en salud. Se percibió que el tema permanece excluido de las grandes discusiones, sobre todo en las escuelas médicas. Estrategias que objetiven discutir las peculiaridades de la promoción y asistencia a la salud de esos grupos deben ser estimuladas teniendo en vista una mejor calidad de la atención a fin de captar esos pacientes en un ambiente favorable a prácticas integrativas con respecto a la diversidad sexual. Conclusión: Se concluye que la actividad educativa realizada fue de extrema importancia para desmitificar mitos y prejuicios involucrando la salud LGBT en el escenario de la atención básica. Se observó que después de la actividad educativa los ACS se mostraron más confiados y sensibilizados sobre las temáticas abordadas y cambiaron concepciones en el sentido de respetar las decisiones de los pacientes y realizar un abordaje adecuado para la acogida a esos usuarios.

Regulating Traditional Mexican Midwifery: Practices of Control, Strategies of Resistance.

The institutionalization of Mexican midwifery has a long history. Despite global recommendations moving away from training traditional midwives, training courses still continue. Based on fieldwork in the State of Chiapas, I argue that while ongoing trainings offered to traditional midwives in Mexico aim at teaching them best practices, they also limit midwives' autonomy and keep poor women's reproductive behaviors under control. I demonstrate how midwives and medical personnel mobilize discourses of reproductive risk, women's rights and indigenous cultural rights to reinforce or contest mechanisms of reproductive governance.

O saber de puérperas sobre violência obstétrica / The knowledge of pueperal women on obstetric violence

Objetivo: analisar os saberes de puérperas sobre violência obstétrica. Método: trata-se de um estudo qualitativo, descritivo, exploratório, desenvolvido em uma maternidade pública. Entrevistaram-se 17 puérperas e a coleta dos dados foi realizada por meio de entrevista guiada por roteiro semiestruturado. Analisaram-se os dados de acordo com a Análise de Conteúdo. Resultados: emergiram-se, a partir das falas das participantes, três categorias analíticas, a saber: "(Des) Conhecimento de puérperas sobre violência obstétrica"; "Experiência da violência obstétrica no parto" e "Estratégias de prevenção da violência obstétrica". Conclusão: ressalta-se que é de grande importância o conhecimento das puérperas sobre a violência obstétrica para poderem identificar e/ou intervir, caso a prática ocorra.(AU)

Objective: to analyze the knowledge of postpartum women about obstetric violence. Method: this is a qualitative, descriptive, exploratory study, developed in a public maternity hospital. Seventeen puerperal women were interviewed and data were collected through interviews guided by a semi-structured script. Data was analyzed according to Content Analysis. Results: emerged from the participants' statements, three analytical categories, namely: "(Lack of) Knowledge of puerperal women about obstetric violence"; "Experience of obstetric violence in childbirth" and "Strategies for preventing obstetric violence". Conclusion: it is emphasized that it is of great importance the knowledge of postpartum women about obstetric violence to be able to identify and / or intervene if the practice occurs.(AU)

Objetivo: analizar el conocimiento de las mujeres posparto sobre la violencia obstétrica. Método: estudio exploratorio cualitativo, descriptivo, desarrollado en una maternidad pública. Diecisiete mujeres posparto fueron entrevistadas y se recopilaron datos a través de entrevistas guiadas por un guión semiestructurado. Los datos se analizaron según el Análisis de Contenido. Resultados: surgieron de las declaraciones de los participantes, tres categorías analíticas, a saber: "(Des) conocimiento de las mujeres posparto sobre la violencia obstétrica"; "Experiencia de violencia obstétrica en el parto" y "Estrategias para prevenir la violencia obstétrica". Conclusión: se enfatiza que es de gran importancia el conocimiento de las mujeres posparto sobre la violencia obstétrica para poder identificar y/o intervenir, si ocurre la práctica.(AU)