A humanização no parto e no nascimento: os saberes e as práticas no contexto de uma maternidade pública brasileira
The practice of medicine related to the gestational processes tend to be organized according to the context and the place of work, being thus dependent of the conditions both social and economical, and of the physical structure and the functionality of the services. The high mortality rate in this p...
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Formato: | doctoralThesis |
Idioma: | por |
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Universidade Federal do Rio Grande do Norte
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Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/17585 |
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Resumo: | The practice of medicine related to the gestational processes tend to be organized
according to the context and the place of work, being thus dependent of the conditions
both social and economical, and of the physical structure and the functionality of the
services. The high mortality rate in this process has diminished, since 1986, the study
made by the World Health Organization (WHO) as to the technical aspects and the
social inequalities that influence this situation in different geographical contexts. This
culminated recommendations that proposed the reorientation of the dynamical practice
of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000,
the suggestions of the OMS, emphasizing the humanization as the main reason for these
actions. However, this discussion tends to not consider the problems caused by the
social inequalities and the epidemiological and social conditionings that define the
actions of the Unified Health System (Sistema Único de Saúde SUS). In this area, this
research seeks to analyze the practices, cares taken, and the universal symbol that
promotes and rewards the assistance to the birth of children by the SUS. Besides the
analysis of the public documents that deal with this subject, an ethnographic study was
developed in a maternity in Natal/RN, considered a model of humanization after
receiving the Galba de Araújo prize in 2002. In this stage, the methodological strategies
were observed, and the focus of the individual interviews with workers and users of this
service. In the analysis of the data, it became evident that the different professional
workers and women who gave birth, tend to show concern of the standards the delimit
production and reproduction of the practice of medicine, as they favor the absence of a
critical posture of the actions destined to the population. Besides this, if became evident
that the institutional difficulties associated to the economical, cultural, and political
problems also difficult the involvement and the reflection of the workers in favor of
assisting changes of the process. There is also a utilization of a perspective prescriptive
of humanization in the everyday life of the social workers, without reflection of its
meaning. Some workers present, in their statements, a preoccupation with the social and
economical aspects that affect the practice of medicine, and with the limitations of the
humanization discourse that disarticulates the necessities of those involved in the
process of formation, and soon tend to return to the discussion of humanization while a
kind practice characterized by the minimization of the interventionist actions. Now the
users of the system show themselves before the dynamic of the services, submitting
themselves to what is offered while assistance, without questioning and/or reflecting
about their usual shortages. Therefore, to think of changes in the know and do of the
practice of medicine destined to the birth of children implies reflection on the quotidian
production of these practices and of the social contexts that influence the process of
assistance in the practice of medicine. Herein it would be possible to predict the
appropriation, by different workers concerning their exasperations and necessities,
making them active in the pursuit of their rights as citizens |
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