Entre os rios e o bisturi: rotas de acesso, violação de direitos reprodutivos e vulnerabilidades de mulheres ribeirinhas esterilizadas em Nova Olinda do Norte, Amazonas

Abstract

Surgical sterilization, a contraceptive method with roots in eugenicist policies, continues to generate intense debates about sexual and reproductive health, especially in vulnerable contexts such as the Brazilian Amazon. In this region marked by socioeconomic and geographical inequalities, the practice reveals particularly complex contours. Historically marginalized, riverside women have been targeted by birth control policies, with their reproductive choices often limited by the intersection of gender, race, and social class. This intersectionality prevents them from accessing quality health information and services, significantly compromising their autonomy. Based on the narratives of riverside women, this research aimed to understand their perspectives on the sterilization process carried out in the public health network in the municipality of Nova Olinda do Norte, located in the interior of Amazonas. More specifically, we sought to: a) Describe the process of surgical sterilization from the perspective of riverside women users of the public health network in the interior of Amazonas, considering their experiences inside and outside the health services; b) To analyze the individual, social and institutional vulnerabilities of the surgical sterilization process from the perspective of riverside women. Data collection was carried out through narrative interviews with eleven riverside women, living in both urban and rural areas. The narratives were analyzed identifying patterns, similarities and differences in the experiences of the participants, thus, this dissertation is organized in two Studies: 1) The Sterilization Process of Amazonian Riverside Women: Access Routes, Influences and Uncertainties; 2) Sterilization of Riverside Women in the Interior of Amazonas: (Dis)paths of Vulnerability. The research shows that access to surgical sterilization by riverside women is permeated by a series of complex challenges, which encompass territorial, social and institutional aspects. Such challenges significantly compromise the reproductive autonomy of these women, since they expose them to situations of vulnerability, such as lack of adequate information, family pressure, and gender discrimination. The narratives present recurrent reports of women undergoing the procedure without prior consent and information, constituting a violation of their sexual and reproductive rights. Given this scenario, the research emphasizes the need for public policies that promote the sexual and reproductive health of riverside women, ensuring equitable access to quality services and the full exercise of their autonomy. The results obtained contribute to the deepening of the debate on reproductive justice and the importance of valuing the experiences and voices of women in contexts of social vulnerability.