"Ser alguém na vida": uma análise sócio-antropológica da gravidez/maternidade na adolescência, em Belém do Pará, Brasil

Tendo como universo de análise um grupo de jovens de camadas populares de Belém do Pará, este estudo traz para debate a questão da gravidez/maternidade na adolescência com base em uma perspectiva sócio-antropológica. Objetivando uma compreensão dos significados culturais do evento nesse contexto, o estudo aponta que o mesmo não implica, para as meninas, a ruptura ou abandono de projetos de vida. Ao contrário, a gravidez/maternidade é valorizada por traduzir tanto mudanças de status social para as mesmas, quanto a afirmação de projetos de mobilidade social no futuro, justificando assim, a continuidade dos estudos diante das dificuldades que a situação impõe.

Maternidade para mães trabalhadoras: depressão pós-parto, stress, rede de apoio e conjugalidade

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Percepção de mães sobre vínculo e separação de seus bebês em uma unidade prisional feminina na cidade de São Paulo-SP

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Avaliação da qualidade da atenção ao parto nos colegiados de gestão regional Cuesta Botucatu e Vale do Jurumirim

The humanization of childbirth implies the understanding of this event as an important experience, and requires the redefinition of human relationships from the review of the assistance project, the understanding of pregnant women condition and human rights. To evaluate child birth assistance using a score that was developed by Botucatu Cuesta Regional Management and Jurumirim Valley Collegiates. This is an epidemiological, descriptive study that is inserted in the field of evaluation of services, programs or health projects. The data has been obtained by direct observation of deliveries, emphasizing the humane care. Results: Approximately one third of the women gave birth in a tertiary hospital (34.1%) and it was their first babies (33%).24.8% of the women received prenatal care in high-risk services. 67.1% of the births were normal, and 84.7% had no companions in the delivery room. In 47.1% of the cases the delivery was performed by obstetrician who used anesthesia in 44.7% and episiotomy in 48.2% of the deliveries. More than half of the newborns were attended by the pediatrician in the delivery room and had a delivery graph completed. Although the present study shows that 67.1% of the births were normal, caesarean rate can be considered excessive, as the WHO points out that c-sections above 15% are unlikely to be justifiable. It is important to emphasize that the Ministry of Health has to have a commitment with all women to promote safe motherhood, even in cases when the pregnancy involves a risk for both the mother and the fetus. It is noteworthy that the created score allowed us to assess variables related to the humanization of childbirth and only average and quite similar situations among the three services were evidenced. We hope that with this study, managers and professionals that work in this area can be subsidized in order to offer effective humane assistance and quality service in the delivery

Algumas reflexões sobre a condição da mulher brasileira da colônia às primeiras décadas do século XX

This article, about reflections on the condition of Brazilian women from the Colony to the first decades of the twentieth century, reveals the historical position of them and the attitudes and behaviors related to gender and sexuality. Subdued, it was treated as a sexual object, arousing all sorts of misogyny by men. Rebel, veiled or ostensibly, could serve their own desires. Throughout history, the Church and medical institutions which jointly accounted for, significantly, established the meaning and place of women. In Colony period, the woman is a ward from the Catholic ideology, but from the nineteenth century, after Independence, this power control arises to Medicine. The physician submits the religious discourse, naturalizing the status of women as one that breeds, namely the insertion of the medical issues of family scientifically legitimate colonial patriarchy. This is accentuated in the early twentieth century, when medicine consolidated setting standards and rules for marriage, to motherhood and family life. We note how the feminine universe was (and it is nowadays) ambivalent, with "one foot" in virtue and another in sin, with a tendency to contain and another to trespass. On the one hand we have the home and motherhood, validated in marriage, in which the woman is cared for and dependent on her husband. Reflecting on the motherhood of Virgin Mary, comes to the sacred dimension of the idealized woman saint by the Church. At the same time, however, feels the need for freedom, identity and independence, needing to give a voice to the desire to have their sexuality and all that it is due in full. The manifestation of the desire and the call for sexual satisfaction, and put in permanent conflict personal, psychological and social split between moral entrenched across generations and cultural transformations resulting from decades of the 20th Century.

A reincidência da gravidez na adolescência e a evasão escolar

Pós-graduação em Educação Escolar - FCLAR

Por dentro da história: mulheres operosas no mundo do comércio em Parnaíba (1930 a 1950)

Pós-graduação em História - FCLAS

Specifying the effects of religion on medical helpseeking: The case of infertility

Several recent studies have examined the connection between religion and medical service utilization. This relationship is complicated because religiosity may be associated with beliefs that either promote or hinder medical helpseeking. The current study uses structural equation modeling to examine the relationship between religion and fertility-related helpseeking using a probability sample of 2183 infertile women in the United States. We found that, although religiosity is not directly associated with helpseeking for infertility, it is indirectly associated through mediating variables that operate in opposing directions. More specifically, religiosity is associated with greater belief in the importance of motherhood, which in turn is associated with increased likelihood of helpseeking. Religiosity is also associated with greater ethical concerns about infertility treatment, which are associated with decreased likelihood of helpseeking. Additionally, the relationships are not linear throughout the helpseeking process. Thus, the influence of religiosity on infertility helpseeking is indirect and complex. These findings support the growing consensus that religiously-based behaviors and beliefs are associated with levels of health service utilization.

The Young Mother and the Labor Market

Introduction - The Centro de Orientacao ao Adolescente of Campinas (Southeastern Brazil) maintains a program to qualify economically disadvantaged adolescent students aged 15 to 18 years to enter the labor market. Objective - To understand life projects of teenagers who became mothers while participating in the program, in the period from 2003 to 2008, aiming to find the place of professional life in their life trajectory before and after motherhood. Method - Eight young mothers were interviewed, and a qualitative methodology was applied to the analysis of the interviews. Results - The trajectories of study and work were discontinued or adapted due to motherhood. Four young mothers completed high school and none had entered university. Three did not return to work and the rest had diverse work experiences. The reported difficulties to enter the labor market were: inadequate instruments to support the children's care, low income, lack of work experience, presence of small children and little educational background. Final Considerations - Teenage motherhood did not indicate the exclusion of educational or work projects but indicated adjustments and the need for a family and social support network. It was noted the need for public policies targeted at the inclusion of youths in the labor market and at support services such as nurseries. Also, the need for a change in gender relations was demonstrated, with greater equality of rights as a precondition for the inclusion of women, especially those who are mothers, in the labor market.

Repeat pregnancies among adolescents in a tertiary hospital in Brazil

Objective: to investigate factors associated with repeat pregnancies among adolescents in a tertiary hospital in the city of Sao Paulo, Brazil. Background: Teenage mothers present a high risk of repeat pregnancies during adolescence. Most of these pregnancies are unplanned. Methods: A cross-sectional study conducted in a tertiary hospital in Sao Paulo, Brazil. The study population included 745 first-time pregnancies and 170 two or more times pregnant teenagers hospitalised for childbirth. Logistic regression models were used to identify independent factors associated with repeat pregnancy in this population. Results: Older age at first pregnancy was associated with a decreased risk of repeat pregnancies (odds ratio and 95% confidence interval 0.78 (0.68-0.89)). Prenatal examinations (0.13 (0.05-0.32)), higher education (0.83 (0.76-0.91)) and higher monthly income (0.79 (0.67-0.95)) were also protective against repeat pregnancies. Those who used contraceptives (2.76 (1.80-4.21)) and lived with their partners (2.44 (1.53-3.88)) had an increased risk of becoming pregnant more than once. Conclusion: Preventive programmes aiming to avoid repeat pregnancies in adolescents should not be restricted to the transmission of information. Behavioural changes in family planning must include access not only to adequate information but also to adequate healthcare, contraceptive methods, education and training.

Hierarquias reprodutivas: maternidade e desigualdades no exercício de direitos humanos pelas mulheres

A partir da concepção contemporânea de direitos humanos, o texto discute os direitos reprodutivos e o exercício da maternidade. Após histórico e definição dos direitos reprodutivos e dos direitos sexuais, o artigo trata da maternidade voluntária, segura, socialmente amparada e prazerosa, para propor uma reflexão sobre 'hierarquias reprodutivas'. Defende-se que diferentes aspectos das mães - tal como raça, classe social, idade e parceria sexual - determinam a legitimidade e aceitação social destas maternidades, e, portanto, suas vivências. Quanto maior o número de aspectos 'negativos' presentes na mulher (ou casal) ao exercitar a maternidade e/ou a reprodução e cuidado com os filhos, mais próxima da base da pirâmide hierárquica estará e, ainda, maior dificuldade encontrará no exercício de seus direitos humanos. O texto conclui que são necessárias políticas públicas de suporte social à maternidade para as mulheres que assim escolham, indistintamente, visando promover o exercício de seus direitos humanos.

River-Like

I compose a poem in the same way I compose a photograph: shifting focus until I see only what is most beautiful or most terrible, warily choosing what will be in view and what will be left out, trying to find just the right amount of light or darkness. Art¿¿poetry, especially¿¿is a way for me to frame and illuminate experience. In this collection, I investigate experiences that dumbfound me, and the details of landscape become a vocabulary for discovery. The wheat fields of the Midwest are signifiers for loss and homesickness; a Pennsylvania forest is a catalyst for meditations on pregnancy and motherhood. Images of light and of water are abundant in these poems, and the speakers of my poems look to these elements for guidance and comfort with almost religious deference.

The door of the tomb is open: Participatory action research to assess the impact of strengthened community capacity on maternal health care in rural Mali

This participatory action-research project addressed the hypothesis that strengthened community and women's capacity for self-development will lead to action to address maternal health problems and the prevention of maternal morbidity and mortality in Mali. Research objectives were: (1) to undertake a comparative cross-sectional study of the association of community capacity with improved maternal health in rural areas of Sanando, Mali, where capacity building interventions have taken place in some villages but not in others. (2) to describe women's maternal health status, access to and use of maternal health services given their residence in program or comparison communities.^ The participatory action research project was an integrated qualitative and quantitative study using participatory rural appraisal exercises, semi-structured group interviews and a cross-sectional survey.^ Factors related to community capacity for self-development were identified: community harmony; an understanding of the benefits of self-development; dynamic leadership; and a structure to implement collective activities.^ A distinct difference between the program and comparison villages was the commitment to train and support traditional birth attendants (TBAs). The TBAs in the program villages work in the context of the wider, integrated self-development program and, 10 years after their initial training, the TBAs continue to practice.^ Many women experience labor and childbirth alone or are attended by an untrained relative in both program and comparison villages. Nevertheless a significant change is apparent, with more women in program villages than in comparison villages being assisted by the TBAs. The delivery practices of the TBAs reveal the positive impact of their training in the "three cleans" (clean hands of the assistant, clean delivery surface and clean cord-cutting). The findings of this study indicate a significant level of unmet need for child spacing methods in all villages.^ The training and support of TBAs in the program villages yielded significant improvements in their delivery practices, and resulting outcomes for women and infants. However, potential exists for further community action. Capacities for self-development have not yet been directed toward an action plan encompassing other Safe Motherhood interventions, including access to family planning services and emergency obstetric care services. ^

Improving the health and well-being of women at risk for neural tube defect recurrence

There is growing interest in providing women with internatal care, a package of healthcare and ancillary services that can improve their health during the period after the termination of one pregnancy but before the conception of the next pregnancy. Women who have had a pregnancy affected by a neural tube defect can especially benefit from internatal care because they are at increased risk for recurrence and improvements to their health during the inter-pregnancy period can prevent future negative birth outcomes. The dissertation provides three papers that inform the content of internatal care for women at risk for recurrence by examining descriptive epidemiology to develop an accurate risk profile of the population, assessing whether women at risk for recurrence would benefit from a psychosocial intervention, and determining how to improve health promotion efforts targeting folic acid use.^ Paper one identifies information relevant for developing risk profiles and conducting risk assessments. A number of investigations have found that the risk for neural tube defects differs between non-Hispanic Whites and Hispanics. To understand the risk difference, the descriptive epidemiology of spina bifida and anencephaly was examined for Hispanics and non-Hispanic Whites based on data from the Texas Birth Defects Registry for the years 1999 through 2004. Crude and adjusted birth prevalence ratios and corresponding 95% confidence intervals were calculated between descriptive epidemiologic characteristics and anencephaly and spina bifida for non-Hispanic Whites and for Hispanics. In both race/ethnic groups, anencephaly expressed an inverse relationship with maternal age and a positive linear relationship with parity. Both relationships were stronger in non-Hispanic Whites. Female infants had a higher risk for anencephaly in non-Hispanic Whites. Lower maternal education was associated with increased risk for spina bifida in Hispanics.^ Paper two assesses the need for a psychosocial intervention. For mothers who have children with spina bifida, the transition to motherhood can be stressful. This qualitative study explored the process of becoming a mother to a child with spina bifida focusing particularly on stress and coping in the immediate postnatal environment. Semi-structured interviews were conducted with six mothers who have children with spina bifida. Mothers were asked about their initial emotional and problem-based coping efforts, the quality and kind of support provided by health providers, and the characteristics of their meaning-based coping efforts; questions matched Transactional Model of Stress and Coping (TMSC) constructs. Analysis of the responses revealed a number of modifiable stress and coping transactions, the most salient being: health providers are in a position to address beliefs about self-causality and prevent mothers from experiencing the repercussions that stem from maintaining these beliefs. ^ Paper three identifies considerations when creating health promotion materials targeting folic acid use. A brochure was designed using concepts from the Precaution Adoption Process Model (PAPM). Three focus groups comprising 26 mothers of children with spina bifida evaluated the brochure. One focus group was conducted in Spanish-only, the other two focus groups were conducted in English and Spanish combined. Qualitative analysis of coded transcripts revealed that a brochure is a helpful adjunct. Questions about folic acid support the inclusion of an insert with basic information. There may be a need to develop different educational material for Hispanics so the importance of folic acid is provided in a situational context. Some participants blamed themselves for their pregnancy outcome which may affect their receptivity to messages in the brochure. The women's desire for photographs that affect their perception of threat and their identification with the second role model indicate they belong to PAPM Stage 2 and 3. Participants preferred colorful envelopes, high quality paper, intimidating photographs, simple words, conversational style sentences, and positive messages.^ These papers develop the content of risk assessment, psychosocial intervention, and health promotion components of internatal care as they apply to women at risk for recurrence. The findings provided evidence for considering parity and maternal age when assessing nutritional risk. The two dissimilarities between the two race/ethnic groups, infant sex and maternal education lent support to creating separate risk profiles. Interviews with mothers of children with spina bifida revealed the existence of unmet needs-suggesting that a psychosocial intervention provided as part of internatal care can strengthen and support women's well-being. Segmenting the audience according to race/ethnicity and PAPM stage can improve the relevance of print materials promoting folic acid use.^

A systematic review of literature to compare the fertility desires among HIV positive women and cancer survivors

Background. Decision-making on reproductive issues is influenced by an interplay of individual, familial, medical, religious and socio-cultural factors. Women with chronic medical illnesses such an HIV infection and cancers are often fraught with decisional conflicts about child-bearing. With increase in the incidence of these illnesses as well as improvement in survival rates, there is a need to pay due attention to the issue of reproductive decision-making. Examining the prevalence and determinants of fertility desires in the two groups in a comparative manner would help bring to light perception of the medical community and the society in general on the two illnesses and the issue of motherhood. ^ Methods. Systematic literature search was undertaken using databases such as MEDLINE (PubMED), MEDLINE (Ovid), PsycInfo and Web of Science. Articles published in English and English language abstracts for foreign articles were included. Studies that explore ‘fertility desires’ as the outcome variable were included. Quantitative studies which have assessed the prevalence of fertility desires as well as qualitative studies which have provided a descriptive understanding of factors governing reproductive desires were included in the review. ^ Results. A total of 34 articles (29 studies examining HIV and 5 studies examining cancer in relation to fertility desires). Variables such as age, stage of illness, support of spouse and family, perception of the medical community and one’s own view of motherhood were key determinants among both groups. ^ Conclusion. There is a need for uniform, systematic research in this field. It is important that health care workers acknowledge these decisional conflicts, include them as part of the medical care of these patients and provide guidance with the right balance of information, practicality and compassion.^