A credibilidade do testemunho da criança vítima de abuso sexual no contexto judiciário

Violência sexual contra crianças não é um evento incomum; no entanto, há a dificuldade de denúncia, pois, além do estabelecimento da relação de dominação que o agressor exerce sobre a vítima, a maneira como tal fato é recebido pela sociedade e como é encaminhado pelas instituições judiciárias responsáveis também é determinante para as omissões. Inserida no universo dos interrogatórios, muitas vezes, a criança causa confusão ao desmentir o que havia falado antes, reforçando possíveis preconceitos em relação a si mesma. O presente trabalho traz a análise das relações entre a infância e a instituição judiciária, com principal enfoque no sistema de comunicação e de notificação dos crimes sexuais contra a criança e as consequentes intervenções profissionais que buscam a validação, ou não, de seu testemunho. Para tanto, foram pesquisados 51 processos judiciais, dos quais foram selecionados dois casos exemplares. Este trabalho evidencia a possibilidade de preservar a criança da revitimização causada pela multiplicidade de interrogatórios, sem deixar de cumprir as normas jurídicas necessárias. A fragilidade da palavra da criança está na forma como é acolhida pelos adultos, desde a revelação na família até a denúncia aos órgãos oficiais, revelando a urgência de alterações nos procedimentos judiciais relacionados a essa problemática

Monitoramento de fungos anemófilos e de leveduras em unidade hospitalar

OBJETIVO: Monitorar e caracterizar fungos anemófilos e leveduras de fontes bióticas e abióticas de uma unidade hospitalar. MÉTODOS: As coletas foram realizadas mensalmente e em dois períodos, do centro cirúrgico e unidades de terapia intensiva adulto e neonatal em hospital de Araraquara, Estado de São Paulo. Para coleta de fungos anemófilos foi utilizado amostrador tipo Andersen de simples estágio. A pesquisa de leveduras foi feita das mãos e de orofaringe de profissionais de saúde, bem como de superfícies de leitos e de maçanetas das áreas críticas. RESULTADOS: Foram recuperados do centro cirúrgico 32 gêneros de fungos anemófilos e 31 das unidades de terapia intensiva. Os gêneros mais freqüentemente isolados foram Cladophialophora spp., Fusarium spp., Penicillium spp., Chrysosporium spp. e Aspergillus spp. Durante o período de estudo, houve reforma e implantação de uma unidade dentro do hospital, que coincidiu com o aumento na contagem de colônias de Cladophialophora spp., Aspergillus spp. e Fusarium spp. Leveduras foram encontradas em 39,4% dos profissionais de saúde (16,7% das amostras dos espaços interdigitais, 12,1% do leito subungueal e 10,6% da orofaringe) e, em 44% das amostras do mobiliário, com predomínio do gênero Candida (C. albicans, C. guilliermondii, C. parapsilosis e C. lusitaniae) seguido por Trichosporon spp. CONCLUSÕES: Observou-se número relativamente elevado de fungos anemófilos (potencialmente patogênicos) em áreas especiais e níveis expressivos de leveduras em fontes bióticas e abióticas. O monitoramento microbiológico ambiental deve ser realizado, principalmente em salas especiais com pacientes imunocomprometidos, sujeitos à exposição de patógenos do meio ambiente, assim como, advindos de profissionais de saúde.

A criança e o brinquedo-TV: análise sobre o discurso publicitário direcionado para a infância na Rede Globo de Televisão

Esta investigación es un análisis del contexto actual que rodea a la publicidad brasileña, más concretamente, la publicidad discurso televisivo dirigido a los niños en Brasil. Análisis de los documentos se basa en la revisión retórica (Leach, 2004) (SODRE, 2006) A partir de la primera supuesta inadecuación de algunos de sus contenidos al público para que se comunican. También investiga las posibilidades de regulación y la educación del consumidor y el papel de los medios de comunicación en la sociedad mediante la movilización exigiendo el cumplimiento y la mejora de la legislación vigente, evitando los posibles abusos y distorsiones de las secciones generales de la ley. Hemos llevado a cabo por separado se analiza en los niños y sus conceptualizaciones y la función social, abordando también el juguete y el acto de jugar hoy y su sede histórica en un intento de crear una fundación que apoya el análisis de la relación entre la infancia y la publicidad y el consumo, basado en obras de Roger Silverstone, Kapferer, Leontiev y Walter Benjamin. También se hicieron inferencias basadas en estudios de Pablo Del Río, sobre las posibles consecuencias psicológicas del consumo de medios por los niños, sin embargo, en arvorarmos llevar a cabo investigaciones en el estudio de la recepción. Se enfrentarán, tanto en acciones a favor de la aprobación de la Ley 5.921/2001 N º Suplente sugiere que la prohibición de la publicidad infantil en todo el país, los enfoques ampliamente "integrado" y por lo tanto, favorables a la continuidad de la actividad publicitaria en el país bajo la acción de la CONAR de autorregulación, lo que demuestra sin embargo, la viabilidad de ambas propuestas. Tambien relativa a el CONAR se llevó a cabo un estudio sobre su Consejo Asesor, dando a entender su composición y características. Por último, se estudian las posibilidades y el concepto de la educación para el consumo de los medios de comunicación, a partir de la utilización de los recursos de los propios medios de comunicación, como una propuesta para un cambio de paradigma en el mercado de la publicidad en Brasil. En conclusión, vemos que a partir del análisis de la publicidad comercial de los niños atendidos por la Red Globo de Televisión, en una muestra de 170 inserciones, todavía existen graves lagunas, pero que los desequilibrios se pueden resolver con medidas relativamente sencillas que incluyan campañas de educación y la exigencia de adecuación de los pocos grandes anunciantes que violan la ley. Afortunadamente, una nueva entrega de los anunciantes mostró la responsabilidad social en sus acciones

Fisioterapia respiratória em crianças com pneumonia: revisão sistemática

Introduction: Pneumonia is an inflammatory lung disease and it is the greatest cause of deaths in children younger than five years of age worldwide. Chest physiotherapy is widely used in the treatment of pneumonia because it can help to eliminate inflammatory exudates and tracheobronchial secretions, remove airway obstructions, reduce airway resistance, enhance gas exchange and reduce the work of breathing. Thus, chest physiotherapy may contribute to patient recovery as an adjuvant treatment even though its indication remains controversial. Objectives: To assess the effectiveness of chest physiotherapy in relation to time until clinical resolution in children (from birth up to 18 years old) of either gender with any type of pneumonia. Methods: We searched CENTRAL 2013, Issue 4; MEDLINE (1946 to May week 4, 2013); EMBASE (1974 to May 2013); CINAHL (1981 to May 2013); LILACS (1982 to May 2013); Web of Science (1950 to May 2013); and PEDro (1950 to May 2013). We consulted the ClinicalTrials.gov and the WHO ICTRP registers to identify planned, ongoing and unpublished trials. We consulted the reference lists of relevant articles found by the electronic searches for additional studies. We included randomised controlled trials (RCTs) that compared chest physiotherapy of any type with no chest physiotherapy in children with pneumonia. Two review authors independently selected the studies to be included in the review, assessed trial quality and extracted data. Results: Three RCTs involving 255 inpatient children are included in the review. They addressed conventional chest physiotherapy, positive expiratory pressure and continuous positive airway pressure. The following outcomes were measured: duration of hospital stay, time to clinical resolution (observing the following parameters: fever, chest indrawing, nasal flaring, tachypnoea and peripheral oxygen saturation levels), change in adventitious sounds, change in chest X-ray and duration of cough in days. Two of the included studies found a significant improvement in respiratory rate and oxygen saturation whereas the other included study failed to show that standardised respiratory physiotherapy and positive expiratory pressure decrease the time to clinical resolution and the duration of hospital stay. No adverse effects related to the interventions were xvi described. Due to the different characteristics of the trials, such as the duration of treatment, levels of severity, types of pneumonia and the techniques used in children with pneumonia, as well as differences in their statistical presentation, we were not able to pool data. Two included studies had an overall low risk of bias whereas one included study had an overall unclear risk of bias. Conclusion: Our review does not provide conclusive evidence to justify the use of chest physiotherapy in children with pneumonia due to a lack of data. The number of included studies is small and they differed in their statistical presentation

Gestão de estoques: uma proposta de reposição contínua para material médico hospitalar e medicamentos em um hospital universitário federal do estado do Rio Grande do Norte

The inventory management in hospitals is of paramount importance, since the supply materials and drugs interruption can cause irreparable damage to human lives while excess inventories involves immobilization of capital. Hospitals should use techniques of inventory management to perform replenishment in shorter and shorter intervals, in order to reduce inventories and fixed assets and meet citizens requirements properly. The inventory management can be an even bigger problem for public hospitals, which have restrictions on the use of resources and decisionmaking structure more bureaucratized. Currently the University Hospital Onofre Lopes (HUOL) uses a periodic replacement policy for hospital medical supplies and medicines, which involves one moment surplus stock replenishment, the next out of stock items. This study aims to propose a system for continuous replenishment through order point for inventory of medical supplies and medicines to the hospital HUOL. Therefore, a literature review of Federal University Hospitals Management, Logistics, Inventory Management and Replenishment System in Hospitals was performed, emphasizing the demand forecast, classification or ABC curve and order point system. And also, policies of inventory management and the current proposal were described, dealing with profile of the mentioned institution, the current policy of inventory management and simulation for continuous replenishment order point. For the simulation, the sample consisted of 102 and 44 items of medical and hospital drugs, respectively, selected using the ABC classification of inventory, prioritizing items of Class A, which contains the most relevant items in added value, representing 80 % of the financial value in 2012 fiscal year. Considering that it is a public organization, subject to the laws, we performed two simulations: the first, following the signs for inventory management of Instruction No. 205 (IN 205 ), from Secretary of Public Administration of the Presidency ( SEDAP / PR ), and the second, based on the literature specializing in inventory management hospital. The results of two simulations were compared to the current policy of replenishment system. Among these results are: an indication that the system for continuous replenishment reorder point based on IN 205 provides lower levels of safety stock and maximum stock, enables a 17% reduction in the amount spent for the full replenishment of inventories, in other words, decreasing capital assets, as well as reduction in stock quantity, also the simulation made from the literature has indicated parameters that prevent the application of this technique to all items of the sample. Hence, a change in inventory management of HUOL, with the application of the continuous replenishment according to IN 205, provides a significant reduction in acquisition costs of medical and hospital medicine

A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care

Avaliação e monitoramento de políticas públicas: criação de um modelo sistêmico aplicado ao Instituto de Assistência Técnica e Extensão Rural do Rio Grande do Norte (EMATER-RN)

The nature of this thesis is interventionist and aims to create an alternative on how to control and evaluate the public policies implementation developed at the Institute for Technical Assistance and Rural Extension of Rio Grande do Norte State. The cenarium takes place in a public institution , classified as a municipality that belongs to the Rio Grande do Norte government and adopts the design science research methodology , where it generates a set of artifacts that guide the development of a computerized information system . To ensure the decisions, the literature was reviewed aiming to bring and highlight concepts that will be used as base to build the intervention. The use of an effective methodology called Iconix systems analysis , provides a software development process in a short time . As a result of many artifacts created by the methodology there is a software computer able of running on the Internet environment with G2C behavior, it is suggested as a management tool for monitoring artifacts generated by the various methods. Moreover, it reveals barriers faced in the public companies environment such as lack of infrastructure , the strength of the workforce and the executives behavior

A criança e a cidade: as transformações da infância numa Natal moderna

The first years of the twentieth century in Natal is characterized by several urban interventions that aim was to change the feature of the city basically rural to another that was in line with cities as models of modernity and civilization. In this case all individuals would have to play important social roles, which included men, women and especially children. It was in this atmosphere of bright future that the children were taken as key parts of an idealized society. Some processes were essential in triggering changes in natal s childhood, among them, operated within the families, that this historic moment in public life sought other possibilities of existence, the school education and the construction of which would be the model for urban education the School Groups, propagators of science as mediators of all knowledge, and finally, the medical interventions that disseminating health and hygiene practices has enabled not only the conservation of child life, but also the possibility of building their individuality in a body healthy. If these processes on the one hand tried to crystallize an ideal image of a child making a child identity directly linked to education and the "body hygiene" on the other, giving specific reflexive autonomy to children, providing them see the world through eyes of subject.

O tratamento odontológico sob o olhar da criança :um estudo de representações sociais

Oral health measures directed to children are characterized by the lack of policies that consider the individual and his biopsychosocial aspects. As a consequence, it can be observed that a child´s dental experience has normally been prejudged as unpleasant and threatening. Thus, this study is aimed at investigating dental treatment from the child´s viewpoint using the theory of social representations for theoretical/methodological support. This theory was selected for being able to build practical knowledge surrounding the interrelations between social actors, the phenomenon and the world around them. The investigation was performed at the Professor José Fernandes Machado State School, located in the Ponta Negra district of Natal-RN-Brazil. The participants consisted of 30 children from the public elementary school system in the 6-10 year age group, who had undergone dental treatment within the previous year or were being treated at the time of data collection. An in-depth interview and story drawing within a theme were used as collection instruments. Thematic Content Analysis (Bardin, 2002) was used to analyze the material collected in the interviews, whereas for story drawing within a theme, in addition to content analysis, the data were also analyzed by the Coutinho model (2001). The two instruments demonstrated similarity of content as well as complementarity and contained categories associated to the model for dental treatment in children, the description of the dental office environment., the perception of the image of the dentist, as well as psychological and behavioral manifestations. The results enable us to understand determinate reactions of the children in relation to dental treatment, which has been characterized by its technical-curative approach, where the motive for seeking treatment, the manner in which it is performed and the relation of the dentist with the child are all in evidence. Thus, this study intends not only to reveal the viewpoint of children faced with dental treatment, but also to contribute to a dental practice directed towards them, in this way instilling in the professionals who attend them a more concrete awareness of the needs, anxieties and feelings of these young patients

Impacto do Programa de Saúde da Família sobre indicadores de saúde bucal na população de Natal -RN

The aim of this study was to assess the impact of the Family Health Program (FHP) on a number of oral health indicators in the population of Natal, Brazil. The study is characterized as a quasi-random community intervention trial. The intervention is represented by the implementation of an Oral Health Team (OHT) in the FHP prior to the study. A total of 15 sectors covered by the FHP with OHT were randomly drawn and paired with another 15 sectors, based on socioeconomic criteria, not covered by the teams. A few sectors were lost over the course of the study, resulting in a final number of 22 sectors, 11 covered and 11 not covered. We divided the non-covered areas into two conditions, one in which we considered areas that had some type of assistance program such as the Community Agents Program (CAP), FHP without OHT, BHU (Basic Health Unit) or no assistance, and the other, in which we considered areas that had only BHU or no assistance. Community Health Agents (CHAs) and Dental Office Assistants (DOAs) applied a questionnaire-interview to the most qualified individual of the household and the data obtained per household were transformed into the individual data of 7186 persons. The results show no statistical difference between the oral health outcomes analyzed in the areas covered by OHT in the FHP and in non-covered areas that have some type of assistance program, with a number of indicators showing better conditions in the non-covered areas. When we considered the association between covered and non-covered areas under the second condition, we found a statistical difference in the coverage indicators. Better conditions were found in covered areas for indicators such as I have not been to the dentist in the last year with p < 0.001 and OR of 1.64 and I had no access to dental care with p < 0.001 and OR of 2.22. However, the results show no impact of FHP with OHT on preventive action indicators under both non-covered conditions. This can be clearly seen when we analyze the toothache variable, which showed no significant difference between covered and non-covered areas. This variable is one of the most sensitive when assessing oral health programs, with p of 0.430 under condition 1 and p of 0.038 under condition 2, with CI = 0.70-0.90. In the analysis of health indicators in children where the proportion of deaths in children under age 1, the rate of hospitalization for ARI (Acute Respiratory Infections) in those under age 5 and the proportion of individuals born underweight were considered, a better condition was found in all the outcomes for areas with FHP. Therefore, we can conclude that oral health in the FHP has little effect on oral health indicators, even though the strategy improves the general health conditions of the population, as, for example child health

A ação do psicólogo na assistência social: interiorização da profissão e combate a pobreza

A pobreza, como uma das manifestações da questão social , é elemento constitutivo do padrão de desenvolvimento capitalista, extremamente desigual, em que convivem acumulação e miséria. Nas últimas décadas, sob a égide do ideário neoliberal, verifica-se um incremento em políticas de combate à pobreza no Brasil, de caráter focalizado e compensatório, tanto por meio de ações diretas de transferência de renda, quanto pelo fortalecimento de serviços e programas voltados às populações pobres, com a estruturação do Sistema Único de Assistência Social, hierarquizado em Proteção Social Básica e Especial. A participação do psicólogo nas equipes profissionais do CRAS constitui um importante elemento para a discussão da inserção desse profissional no campo das políticas sociais no Brasil, considerando os limites estruturais postos pelo caráter compensatório dessas políticas, e a construção de estratégias que possam resultar em uma mudança efetiva nas condições de vida das camadas mais pobres da sociedade. Aliado a isso, por meio do ingresso na política de assistência social, um número significativo de profissionais psicólogos passa a atuar em cidades pequenas e médias, fora dos tradicionais centros urbanos, constituindo um movimento de interiorização da profissão . O objetivo do presente trabalho é analisar a ação profissional do psicólogo na assistência social no contexto nas políticas de combate à pobreza em municípios do interior do Rio Grande do Norte. Realizou-se entrevistas semiestruturadas com psicólogos atuantes nos CRAS de 17 municípios de pequeno e médio porte do estado. As informações foram sistematizadas com auxílio do software QDA Miner v. 3.2. A perspectiva defendida neste trabalho refere-se à funcionalidade das práticas psicológicas no contexto das políticas de combate à pobreza brasileiras na atualidade, ao reforçar os ideais neoliberais de naturalização da questão social e responsabilização dos indivíduos pela sua condição social, além de, em grande parte, desconsiderar as particularidades e singularidades que marcam os territórios de ação. Todavia, é possível depreender alguns modos de ação profissional que estão na contramão dos mais frequentemente encontrados nesse campo. Esses modos se revelam no cotidiano do CRAS como formas diferentes de compreensão do saber fazer profissional, resultados de um posicionamento político e de uma formação profissional que buscam romper com o tradicionalismo e conservadorismo da Psicologia e do campo da assistência social

Maternidade na adolescência: significados e repercussões

From evidence of an existing divergence of opinion among professionals and adolescents using the prenatal and delivery services at a Public Health Unit, aimed to study meanings and consequences of adolescent motherhood among 26 adolescent mothers living in Felipe Camarão, low income district of Natal, capital do Estado do Rio Grande do Norte. Living in a peripheral neighbourhood with a high rate of adolescent mothers in relation to the total new-born, those girls, with offspring among 8 and 12 months age, during interview and focus groups, expressed a different appreciation of their experience than the hegemonic idea among professionals that considers pregnancy and motherhood as unwanted or undesired. With age among 15 and 20 years old, having 53,8% initiated sexual activity before being 15 years old, revealed that the pregnancy was desired in 73,1% of cases, but showing at the same time a social context marked by strong gender oppression and lack of opportunities as consequence of social class deprivation. Life projects, almost always limited to the constitution of a traditional nuclear family, with a purveyor father and care giver mother, appears with very limited possibilities: 46,2% already lived with her partner before becoming pregnant and for 50% of the participants, the birth of the child did not provoke changes in plans and projects. Lack of economical recourses and precarious public services available, together with an idealized maternity role seems to produce extra apprehension among those girls, resulting in frustration and disillusion. As a fact, 92,3% of those adolescents would recommend other adolescent to postpone the maternity project

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

O Psicólogo no campo do Bem-Estar: cartografias de práticas na saúde e assistência social

The study focuses on the psychology and Social Well-being Policy encounters. The objective is to understand how the psychologists in the health services of Natal, RN, specifically in the Basic Health Units and social assistance, experience their daily practices. The methodology included observation and interviews of 13 psychologists regarding their daily activities and forms of practice in these services. We utilized an interview protocol directed at the affective memory and the professional life history of these technicians. Field notes were used to produce a cartography of the encounter intensities experienced by the researcher in the investigated context. The data analysis enabled the construction of the following analytic axes: 1) Work processes and proximity/ distancing points between these fields; 2) Forms of government and life management in the well-being context; 3) Experiments of self in the daily services. The first axis showed the precariousness of working conditions (remuneration issues, lack of structure, of training and autonomy for the activities). In the second axis the identified care forms produced in these fields indicated an adherence to the production of ideal subjects characterized as autonomous, productive, healthy and aware of own rights . These were considered normative insofar as they express attempts to break with the established patterns. In the third axis, many technicians experienced constraint with the daily activities because they found themselves in contexts that were adverse to the habitual forms of action. This situation provoked two distinct forms of positioning: a) action expressed by compassion, pity and resentment; b) investment in the practices themselves, so as to overcome its limits and to respond innovatively to the difficulties and/or challenges that these contexts provoke

Do útero à adoção: a experiência de mulheres férteis que adotaram uma criança

Even with all changes and ruptures related to the social roles that woman had performed, the literature had confirmed that the motherhood still configures it like one of the main roles that she hopes to play in some moment of her life. When the woman did not get pregnant or take ahead a pregnancy, some women find in adoption an alternative to play this role. This research aimed to understand the experience of being mother for adoption in the case of fertile women, but whose partner is infertile. Supported by existential-phenomenological theory, used it the narrative, how methodological instrument. Participated five women, whose adoption process followed the legal ways in the Youngness and Infancy Judgeship of Natal/RN. The results showed that in the selfish training, the woman to see herself how whose role principal is to generate children, although, she think that is natural her participation in others activities go out home too. In male infertile case is a tendency that the woman strikes the infertile status too. The adoption is an alternative to fulfill her desire of being a mother and, meanwhile, please her husband and guarantee the continuity of her love relationship. Through motherly care, the woman discover herself as a mother, what brings a new meaning for her live, independent of to generate a child. Though, exit frustration, sometimes, in association with suffering, on account of the pregnancy and childbirth absence. The end of the research suggests reflections that to become fulfilled herself as mother, the woman does not need, necessarily, to generate a child, being the maternity one of the uncountable possibilities that are shown, and that she can choose, or not, accomplish it