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Escolas não debatem contracepção e responsabilidade ainda é das adolescentes

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Pesquisadora da Escola de enfermagem da USP analisa o comportamento dos adolescentes em relação a pílula do dia seguinte. Estudo revela desconhecimento dos alunos e despreparo das escolas.

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(7’48” / 1.79 Mb) - Uma pesquisa da Escola de Enfermagem da USP sobre a anticoncepção de emergência, mais conhecida como “pílula do dia seguinte”, chama atenção para a falta de preparo e de abertura das instituições de ensino nas discussões dos métodos contraceptivos.O estudo foi realizado em escolas públicas e particulares da cidade de Arujá (SP) e teve a participação de 705 jovens, entre 15 e 19 anos.

Apesar de 57,7% dos entrevistados já terem utilizado o medicamento, 72,6% deles nunca havia participado de palestra na escola que tratasse sobre a pílula. A pesquisa ainda aponta as dificuldades dos adolescentes no acesso ao medicamento através dos postos de saúde.

De acordo com a obstetriz Christiane Borges do Nascimento, autora do projeto, alguns profissionais de saúde não distribuem o medicamento aos jovens por acreditarem erroneamente que a pílula do dia seguinte é abortiva. Em entrevista à Radioagência NP, ela conta que algumas unidades exigem um termo assinado pelos responsáveis da adolescente ou que ela passe por uma consulta médica antes da liberação do medicamento.

Radioagência NP: Christiane, quais as principais dúvidas dos jovens em relação ao uso da pílula do dia seguinte?

Christiane Borges do Nascimento: As questões que tiveram maior desconhecimento foram em relação se em caso de vômito até duas horas da ingestão da pílula do dia seguinte se ele deve ingerir novamente a pílula do dia seguinte. Então, essa é uma questão muito mais clínica e específica. E a outra questão é em relação ao tempo de uso da pílula do dia seguinte. Hoje se sabe que a pílula do dia seguinte pode ser utilizada até cinco dias após a relação sexual desprotegida, porque antes o Ministério da Saúde preconizava que a pílula do dia seguinte poderia ser usada até 72h após a relação desprotegida e hoje já se sabe que ela pode ser usada até 5 dias.

Radioagência NP: Quais os riscos do uso indevido desse método contraceptivo?

CBN:O que se verifica é que quanto maior o uso da pílula do dia seguinte menor é a eficácia. Muitos adolescentes ainda acreditam que a pílula do dia seguinte pode ser usada todo mês, sendo que ela só deve ser utilizada em caso de emergência realmente. Então, em relação a risco não existe nenhuma comprovação científica, nenhuma evidência científica que comprove os malefícios da pílula do dia seguinte para a saúde, o que se sabe que quanto mais se utiliza menor é a eficácia, então ela não deve ser trocada por um outro método contraceptivo.

Radioagência NP: E qual a importância das escolas oferecerem espaços de debates e orientação sexual?

CBN: Eu verifiquei que muitos adolescentes tinham muitas dúvidas porque a escola não propicia aulas educativas sobre saúde sexual e reprodutiva, então existe muito desconhecimento de como usar os métodos contraceptivos, principalmente em relação a pílula do dia seguinte. Tem muito adolescente que acredita ainda que ela é abortiva, e ela não é abortiva. Então, quando eu fui nas escolas dar essas oficinas eu vi que tinha um despreparo muito grande. Os adolescentes relatavam quando eu fiz uma questão sobre quais as fontes de informação onde eles mais conheciam a pílula do dia seguinte eles relatavam que eram os amigos e as escolas. Eu via que as escolas era apenas um local onde ocorria a troca de informação, mas não que a escola propiciava informação.

O início da vida sexual ocorre, em média, por volta dos 15 anos de idade. Então, muitas escolas, principalmente as escolas privadas que eu fui fazer a pesquisa, muitas delas não aceitavam que eu ia lá fazer minha pesquisa, porque elas acreditavam que eu estava influenciando, incentivando os adolescentes ao início da vida sexual, mas já se sabe que o início da vida sexual ocorre na adolescência e você dar oficinas não é incentivar. É você dar informação, ajudar esses adolescentes para que eles tenham relacionamentos sexuais mais seguros, protegidos, e para evitar gravidezes não planejadas.

Radioagência NP: Em sua pesquisa você relata que a maioria dos entrevistados adquiriria a pílula do dia seguinte em farmácias. Ainda existe uma dificuldade dos postos de saúde disponibilizarem esse medicamento?

CBN: Existe ainda muita dificuldade. O adolescente quando vai no posto de saúde ainda encontra muito preconceito. Tem alguns postos de saúde que fazem a objeção de que o pai ou o responsável pelo adolescente assine um termo. Muitos profissionais de saúde acreditam erroneamente que a pílula do dia seguinte é abortiva e aí não distribui para o adolescente. Tem todo um trâmite para o adolescente conseguir essa pílula do dia seguinte. Ele tem que passar por uma consulta médica para pegar a receita e pegar a pílula do dia seguinte. E até ele conseguir marcar a consulta muitas vezes já passou desse período de cinco dias da relação sexual desprotegida. Quer dizer, ele fica completamente descoberto.

Radioagência NP: E essa discussão que existe da pílula do dia seguinte como um método abortivo, como você avalia isso?

CBN: Existem questões religiosas, questões políticas que acabam influenciando muito na opinião das pessoas. O que falta é esclarecimento sobre como realmente funciona, como é o mecanismo de ação da pílula do dia seguinte e isso muitas vezes não é divulgado pela mídia e acaba tendo essas informações erradas. Mas já se é comprovado que a pílula do dia seguinte não é abortiva. Primeiro que quando a pessoa toma a pílula do dia seguinte não ocorreu ainda a fecundação, então não tem como ela ser abortiva porque não existe na verdade um zigoto. O que a pílula do dia seguinte faz é alterar o muco vaginal, o PH da vagina, e o espermatozóide na verdade não consegue fecundar o óvulo.

Radioagência NP: Outro dado apresentado pela pesquisa é um maior conhecimento da pílula do dia seguinte entre as meninas. Como você avalia essa diferença?

CBN: O maior conhecimento da pílula do dia seguinte entre as mulheres a gente verifica também em relação a outros métodos contraceptivos, porque existe um encargo muito grande das mulheres em relação ao uso dos métodos contraceptivos. Então, essa responsabilidade de se evitar uma gravidez está muito mais sobre as mulheres do que sobre os homens. Essa preocupação e essa obrigação é muito mais imposta pela sociedade em relação ao papel feminino do que ao papel masculino.

De São Paulo, da Radioagência NP, Daniele Silveira.

20/06/13

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