Autonomia reprodutiva de mulheres com doença falciforme no centro-norte baiano

Abstract

Reproductive rights, as a feminist achievement, is a fundamental conception of reproductive rights and requires the right to exercise freedom. Socioeconomic and cultural issues, intertwined in unequal gender relations, influence the actions and have repercussions on the health and quality of life of many women, specifically those who are socially disadvantaged, such as women with sickle cell disease (SCD), who live with racism, sexism and difficulties in accessing health services. This research had the general objective of analyzing the reproductive autonomy of women with sickle cell disease at the Municipal Reference Center for People with SCD, in Feira de Santana-BA and specifically: to characterize women with SCD according to sociodemographic and sexual and reproductive health aspects; to identify the level of reproductive autonomy of women with SCD through the Reproductive Autonomy Scale for the three subscales: decision-making, absence of coercion and communication; To verify the association between sociodemographic and sexual and reproductive health characteristics with reproductive autonomy in women with SCD treated at a Municipal Reference Center for People with SCD, in Feira de Santana-BA. This is a cross-sectional epidemiological study, with a quantitative approach, carried out in Feira de Santana, with 168 women aged between 18 and 49 years, with a confirmed diagnosis of SCD. Data collection was carried out through a structured interview between July and November 2024. Data were processed using the SPSS for Windows statistical package (version 25.0). For analysis, descriptive statistical procedures were used to express the results in terms of absolute and relative frequencies, means, standard deviations, minimum and maximum values, and interquartile ranges. Data normality was measured using the nonparametric Mann-Whitney test and for the analysis of variables with three or more groups, the Kruskal-Wallis test was used. The statistical significance level was set at p ≤ 0.05 for all analyses performed. The results of the study showed that the majority of women were single, black, Catholic, did not work, had an income of up to one minimum wage, and had more than 11 years of education. Most women had menarche before the age of 14, had had sexual intercourse in the last 12 months, had not participated in a family planning group in the last 12 months, and were already pregnant. The average total reproductive autonomy score was 2.52. Associations were found between dimensions of reproductive autonomy and sociodemographic variables. "Absence of Coercion" was related to age, "Decision Making" to marital status and income, and "Communication" to place of residence and distance to Feira de Santana. "Total Reproductive Autonomy" was associated with religion. Furthermore, "Decision Making" and "Communication" were associated with sexual activity in the last 12 months, while "Total Reproductive Autonomy" and "Communication" were related to contraceptive use. "Decision Making" and "Absence of Coercion" were also associated with pregnancy history. Therefore, it is important to consider sociodemographic factors and reproductive health dimensions in promoting reproductive autonomy, highlighting the need for targeted interventions that can empower these women in making decisions about their health and sexual life.