RESUMO
OBJECTIVES: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.
RESUMO
OBJECTIVE: To study the association between first and last caesarian sections with tubal sterilization; to determine length of reproductive life after the first delivery. METHODS: From February to October 2001 in a university hospital, interviews were carried out with 653 women having had at least two pregnancies. Of these women, 172 had a first caesarian section; 294 had a last caesarian section. Variables were social demographic characteristics, obstetric history and characteristics of the first and last deliveries and tubal sterilization. Bivariate analysis was performed, followed by multiple regression analysis calculating the adjusted odds ratio. Women who had undergone tubal sterilization were divided into age groups of 25 to 44 and >45 years in a percentile distribution. The Wilcoxon test was used to analyze age at tubal sterilization and length of reproductive life after the last delivery. The study was approved by the Ethics Committee. RESULTS: Of these women, 89% completed<8 years of school education and 78% were Caucasian. On multiple regression analysis, there was an association between the first and last caesarian section (OR=15.28, 95%CI 8.54 to 27.36), having a partner (OR=3.87, CI95% 1.63 to 9.17) and giving birth in the '70s, '80s or '90s (OR=4.43, 95%CI 1.37 to 14.27), (OR=6.11, 95%CI 1.47 to 25.47) and (OR=6.67, 95%CI 1.21 to 40.26), respectively. The last caesarian section was associated with intrapartum tubal sterilization (OR=14.09, 95%CI 7.37 to 26.97), giving birth in the '70s, '80s or '90s (OR=1.81, 95%CI 1.06 to 3.09), (OR=5.53, 95%CI 3.18 to 9.61) and (OR=5.90, 95%CI 3.03 to 11.48), respectively, family income of >5 minimum wages (OR=2.41, 95%CI 1.42 to 4.08) and age at first delivery>25 years (OR=1.80, 95%CI 1.01 to 3.22). Mean age at sterilization was 29.0 and 33.2 years in women aged 25 to 44 years and >45 years, respectively (p<0.001). The duration of the reproductive period after the first delivery was 9.0 and 11.4 years for the same groups (p<0.001). CONCLUSION: The first caesarian section was associated with the last caesarian section. The last caesarian section was associated with intrapartum tubal sterilization. Age at sterilization was lower and the reproductive period was shorter among younger women.