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Preprint en Portugués | SciELO Preprints | ID: pps-1625


The present narrative review synthesized scientific evidence regarding gender and race inequality in the COVID-19 pandemic, focusing on women's productive/reproductive work, gender-based violence, and the access to sexual and reproductive health services (SRHS). The results demonstrated that the effective control of the pandemic and the preservation of rights should consider social inequality. Besides the direct effects of SARS-CoV-2, the literature discusses that access barriers to SRHS can lead to an increase of unintended pregnancies, unsafe abortions, and maternal mortality. Also, the social distancing has led several women to stay confined with their aggressors, which hinders the access to reporting services, incurring in the increase of gender-based violence and severe outcomes to health. As the main responsible for the care, women are more prone to get the virus in both professional and domestic spheres. The conciliation between work and family has become more difficult for them during the pandemic. Literature naturalizes gender, race, and social class differences, emphasizing risk factors. An intersectional research plan is needed to support the information of public policies that incorporate human rights and embrace the needs of the most vulnerable groups to the COVID-19.

Esta revisão narrativa sintetizou evidências científicas sobre desigualdades de gênero e raça na pandemia da COVID-19, enfocando o trabalho produtivo/reprodutivo das mulheres, a violência de gênero e o acesso aos serviços de saúde sexual e reprodutiva (SSR). Os resultados confirmam que as desigualdades sociais devem ser consideradas para o efetivo controle da pandemia e a preservação de direitos. Para além dos efeitos diretos do SARS-CoV-2, discute-se que barreiras de acesso a serviços de SSR podem ocasionar o aumento de gravidezes não-pretendidas, abortos inseguros e mortalidade materna. O distanciamento social tem obrigado muitas mulheres a permanecer confinadas com seus agressores e dificultado o acesso a serviços de denúncia, incorrendo no aumento da violência de gênero e em desfechos graves à saúde. Como principais responsáveis pelo cuidado, as mulheres estão mais expostas a adoecer nas esferas profissional e doméstica. A conciliação trabalho-família tornou-se mais difícil para elas durante a pandemia. A literatura naturaliza as diferenças de gênero, raça e classe, com ênfase em fatores de risco. Uma agenda de pesquisa com abordagem interseccional é necessária para embasar a formulação de políticas que incorporem os direitos humanos e atendam às necessidades dos grupos mais vulneráveis à COVID-19.

Artículo en Inglés | MEDLINE | ID: mdl-33439462


Women face difficulties in accessing post-abortion care, as hierarchical care operates under discrimination mechanisms that condemn women in abortion. In addition, it is the Black and Brown women who are more subject to unsafe abortions and need hospitalization to complete the termination of pregnancy or treat associated complications. This study aimed at identifying factors associated with the institutional barriers in access to health services for women who underwent abortion by race/color. The survey encompassed 2640 users admitted to public hospitals in Salvador, Recife, and São Luís. Differences among covariables according to race/color (Black, Brown, and White women) were analyzed and tested for statistical significance using Pearson's χ2 test. The regression analysis initially included variables that may express the technical criteria of priority in care (time of pregnancy when abortion occurred and conditions of arrival), then the sociodemographic characteristics, and, lastly, the type of abortion declared. Black women faced more institutional difficulties (27.7% vs 19.5% in White women and 18.7% in Brown women), such as waiting to be attended and getting a bed. The association between being Black women and institutional barriers remained, even after adjustments in the regression model. Institutional racism limits access to health services and timely care for Black women, acting as a performative mechanism, legitimizing and generating exclusionary behaviors. The results demonstrate that the intersection between racial discrimination and abortion stigma redouble institutional barriers that are denominated intersectional discrimination.