Juliana Cristina dos Santos Monteiro

Amamentação e o seio feminino: uma análise sob a ótica da sexualidade e dos direitos reprodutivos

A pesar del conocimiento sobre el amamantamiento, reunido por cientificos y profesionales de la salud, a lo largo del siglo XX, el destete precoz persistio en este periodo como una causa importante para el aumento de la morbilidad y la mortalidad infantil. Desde el ano 1980, las politicas publicas en pro del amamantamiento empezaron a ser desarrolladas, principalmente en los paises de tercer mundo. Sin embargo, las mujeres principales actoras en el proceso del amamantamiento, muchas veces no son escuchadas en el momento de cumplir la funcion de amamantar. Este estudio aporta algunas reflexiones sobre el amamantamiento, enfocando la sexualidad y los derechos reproductivos de las mujeres en la cultura occidental. Esta dirigido a los profesionales de la Salud que trabajan con las mujeres en el ciclo gravido puerperal, para permitirles comprender y apoyar a las mujeres en sus decisiones sobre el proceso de amamantamiento.

Percepção das mulheres acerca do contato precoce e da amamentação em sala de parto

OBJETIVO: conocer y analizar las vivencias de las mujeres relacionadas al cuarto paso de la Iniciativa Hospital Amigo da Crianca, en una maternidad de Ribeirao Preto. METODOS: Fue utilizado el abordaje cualitativo. Los datos recolectados por medio de entrevistas semi-estructuradas fueron analizados a traves del analisis de contenido, modalidad tematica. RESULTADOS: Participaron 23 mujeres las cuales relataron que, aun estando en situacion inadecuada debido al cansancio y al dolor, aceptan con resignacion y entienden el momento como importante para el bebe. Ademas, recibir al nino por primera vez causa impacto y sorpresa. CONSIDERACIONES FINALES: La asistencia se muestra limitada a los aspectos practicos del cumplimiento del cuarto paso, sin considerar los reales sentimientos de las mujeres, siendo necesario el desarrollo de habilidades de comunicacion y empatia del profesional de salud.Objective: To describe women’s experiences with the fourth step of the Hospital Baby Friendly Initiative. Methods: A qualitative study was undertaken to collect data from 23 women admitted to a maternity hospital, in Ribeirao Preto, Brazil. Data were collected through semistructured interviews and submitted to content analysis. Results: Women stated that earlier contact and breastfeeding the newborn in the delivery room was very important for the newborn. In addition, women stated that receiving the newborn for the first time made them surprised and emotional. Final Considerations: There are several limitations in the application of the fourth step in clinical practice. Health care providers must be sensitive to women’s feelings, and must develop empathy and therapeutic communication.

Intimate partner violence against pregnant women: study about the repercussions on the obstetric and neonatal results

Este estudio tuvo como objetivos describir el proceso de traduccion y adaptacion cultural del instrumento Perceived Stigmatization Questionnaire (PSQ) y analizar la consistencia interna de los items en la etapa del pre-test. El PSQ fue desarrollado para la evaluacion de la percepcion de los comportamientos estigmatizantes de victimas de quemaduras. El proceso de adaptacion fue realizado de agosto del 2012 a febrero del 2013, incluyendo las etapas preconizadas en la literatura. Como parte de ese proceso, fue realizado el pre-test con 30 adultos victimas de quemaduras. Todos los participantes de esa etapa informaron comprender los items del instrumento y la escala de respuesta. No hubo sugerencias o cambios en la version probada. El valor del alfa de Cronbach en el pre-test fue de 0,87. La contribucion del estudio esta en la descripcion de la operacionalizacion de cada una de las etapas de ese proceso metodologico y demuestra la consistencia interna de los items en el pre-test.

Mental health of women who suffer intimate partner violence during pregnancy

Objective . To identify the relationship between intimate partner violence (IPV) during pregnancy and mental disorders in women in the pregnancy-puerperal cycle. Method . A review was conducted of papers published in Portuguese, English and Spanish regarding the study theme. The databases explored were PubMed, CINAHL, LILACS and PsycINFO. Results . The 17 included papers studied the relationship between IPV and: pre- and postpartum depression (41%); pregnancy anxiety (23%) and pregnancy posttraumatic stress disorder (12%). None of the studies investigated the association between IPV and suicidal ideation. Conclusion. IPV against women during the pregnancy-puerperal cycle causes negative impacts on mental health. Concrete actions shall be proposed regarding the prevention, identification and treatment of women exposed to IPV during their pregnancy period. Key words: spouse abuse; pregnancy; postpartum period; mental health; nursing. How to cite this article: Fonseca-Machado MO, Alves LC, Freitas PS, Monteiro JCS, Gomes-Sponholz F. Mental health of women who suffer intimate partner violence during pregnancy . Invest Educ Enferm. 2014;32(2):

Perfil da prática da amamentação em grupo de mães adolescentes

Objectives: To describe the breastfeeding experience among teenage mothers, to identify past breastfeeding experience, and to identify events / situations perceived as obstacles to their current breastfeeding. Methods: An exploratory study was conducted with 80 adolescent mothers in a low-risk maternity setting in Ribeirao Preto-SP. A structured data collection tool was administered three times (at hospital discharge, during consultation between 10-15 days postpartum, and by telephone one month after discharge). Descriptive statistics were used in the analyses of the resulting data. Results: Among those adolescents with previous breastfeeding experience, 38.5% breastfed longer than six months. There was a gradual reduction of breastfeeding in the population of teenage mothers in this study. Problems were identified that led to decreased breastfeeding, including: nipple trauma, and inadequate suckling at the breast by the infant, but at discharge the mothers were able to demonstrate understanding of how to properly breastfeed. Conclusions: The teenage mother needs support and attention, specific to her role as an adolescent breastfeeding mother, without preconceived ideas of her being unable to care for a child due to her age. Descriptors: Maternal and child health; Breast feeding; Pregnancy in adolescenceObjectives: To describe the breastfeeding experience among teenage mothers, to identify past breastfeeding experience, and to identify events / situations perceived as obstacles to their current breastfeeding. Methods: An exploratory study was conducted with 80 adolescent mothers in a low-risk maternity setting in Ribeirao Preto-SP. A structured data collection tool was administered three times (at hospital discharge, during consultation between 10-15 days postpartum, and by telephone one month after discharge). Descriptive statistics were used in the analyses of the resulting data. Results: Among those adolescents with previous breastfeeding experience, 38.5% breastfed longer than six months. There was a gradual reduction of breastfeeding in the population of teenage mothers in this study. Problems were identified that led to decreased breastfeeding, including: nipple trauma, and inadequate suckling at the breast by the infant, but at discharge the mothers were able to demonstrate understanding of how to properly breastfeed. Conclusions: The teenage mother needs support and attention, specific to her role as an adolescent breastfeeding mother, without preconceived ideas of her being unable to care for a child due to her age. Descriptors: Maternal and child health; Breast feeding; Pregnancy in adolescence

Breast feeding among Brazilian adolescents: practice and needs.

OBJECTIVES to characterise breast feeding practices among Brazilian adolescents and identify their breast feeding needs. METHODS the study was undertaken in Ribeirão Preto, Brazil in two stages. The first stage analysed data from the Second National Survey of Breast-feeding Prevalence, held in August 2008, which included 229 adolescent mothers. The second stage was a qualitative approach, and involved interviews with 10 adolescent mothers in a primary care unit. The data from the first stage were analysed in June 2010 based on descriptive statistics. The data obtained from the interviews were transcribed and organised using thematic content analysis. FINDINGS breast feeding was reported by 75% of the adolescent mothers. Of the 144 mothers with infants aged <180 days, 84% reported that they were breast feeding: 19% were breast feeding exclusively, 17% were breast feeding predominantly, 49% were providing complementary feeding, and 16% had weaned their infants. Analysis of the interviews led to the identification of three thematic units: concern for the childs health; breast feeding difficulties; and health team and family support. CONCLUSIONS the majority of the adolescent mothers presented conditions that were favourable to breast feeding (e.g. did not work outside the home, only had one child, breast fed in the first hour post partum). However, the practice of breast feeding still failed to meet the recommendations of the World Health Organization. The interviews led to identification of the breast feeding needs and demands of adolescent mothers, many of which were related to the needs of their infants. It is important to know what adolescent mothers think about breast feeding, in order to encourage the establishment of practices to keep breastfeeding as longer as possible in a satisfactory way for both mothers and infants.

Leite produzido e saciedade da criança na percepção da nutriz durante o aleitamento materno exclusivo

The aims of this study were to analyze maternal perceptions about the milk they produced and its relationship with the duration and experience of exclusive breastfeeding. The participants of this cross-sectional, descriptive-analytic study were 231 breastfeeding mothers who accompanied their less-than-4-month-old children in a Brazilian Public Health Care Clinic in Ribeirao Preto, Brazil. Data were analyzed using comparison among averages, Fishers exact test, and logistic regression, demonstrating that 71% of the participants claimed to produce good milk, perceiving the childs satisfaction after breastfeeding. Perception of milk was statistically significant when associated with child satisfaction. Breastfeeding mothers who perceive an unsatisfied child are 32 times more likely to have a bad perception of their milk. There was a significant difference between lactation intervals carried out by women who had and who did not have good perceptions of the breast milk. Child satisfaction was the indicator most used to evaluate milk. This study evidences the need to encourage womens capacity towards good milk production.The aims of this study were to analyze maternal perceptions about the milk they produced and its relationship with the duration and experience of exclusive breastfeeding. The participants of this cross-sectional, descriptive-analytic study were 231 breastfeeding mothers who accompanied their less-than-4-month-old children in a Brazilian Public Health Care Clinic in Ribeirao Preto, Brazil. Data were analyzed using comparison among averages, Fishers exact test, and logistic regression, demonstrating that 71% of the participants claimed to produce good milk, perceiving the childs satisfaction after breastfeeding. Perception of milk was statistically significant when associated with child satisfaction. Breastfeeding mothers who perceive an unsatisfied child are 32 times more likely to have a bad perception of their milk. There was a significant difference between lactation intervals carried out by women who had and who did not have good perceptions of the breast milk. Child satisfaction was the indicator most used to evaluate milk. This study evidences the need to encourage womens capacity towards good milk production. DESCRIPTORS: Breast feeding. Human milk. Maternal and child health.Los objetivos fueron analizar la percepcion materna sobre la leche producida y su relacion con la duracion y conduccion de la lactancia exclusiva. Estudio transversal, descriptivo analitico, com 231 nodrizas acompanando sus hijos menores de 4 meses en una Unidad de Salud en Ribeirao Preto, Brazil. Los datos fueron analizados mediante comparacion entre medias, test exacto de Fisher y regresion logistica. 71% de las participantes reportaron producir buena leche, percibiendo el nino satisfecho despues de mamar. La percepcion de la leche fue estadisticamente significativa cuando asociada a saciedad del nino. Las nodrizas que perciben el nino insatisfecho tienen 32 veces chance de mala percepcion sobre su leche. Hubo diferencia significativa entre intervalos de mamadas para mujeres que tenian o no buena percepcion sobre la leche. La satisfaccion del nino fue el indicador mas utilizado para evaluar la leche. Hay que estimular la capacidad de las mujeres para buena produccion de leche.

The experience of breastfeeding in a group of teenage mothers

Objectives: To describe the breastfeeding experience among teenage mothers, to identify past breastfeeding experience, and to identify events / situations perceived as obstacles to their current breastfeeding. Methods: An exploratory study was conducted with 80 adolescent mothers in a low-risk maternity setting in Ribeirao Preto-SP. A structured data collection tool was administered three times (at hospital discharge, during consultation between 10-15 days postpartum, and by telephone one month after discharge). Descriptive statistics were used in the analyses of the resulting data. Results: Among those adolescents with previous breastfeeding experience, 38.5% breastfed longer than six months. There was a gradual reduction of breastfeeding in the population of teenage mothers in this study. Problems were identified that led to decreased breastfeeding, including: nipple trauma, and inadequate suckling at the breast by the infant, but at discharge the mothers were able to demonstrate understanding of how to properly breastfeed. Conclusions: The teenage mother needs support and attention, specific to her role as an adolescent breastfeeding mother, without preconceived ideas of her being unable to care for a child due to her age. Descriptors: Maternal and child health; Breast feeding; Pregnancy in adolescenceObjectives: To describe the breastfeeding experience among teenage mothers, to identify past breastfeeding experience, and to identify events / situations perceived as obstacles to their current breastfeeding. Methods: An exploratory study was conducted with 80 adolescent mothers in a low-risk maternity setting in Ribeirao Preto-SP. A structured data collection tool was administered three times (at hospital discharge, during consultation between 10-15 days postpartum, and by telephone one month after discharge). Descriptive statistics were used in the analyses of the resulting data. Results: Among those adolescents with previous breastfeeding experience, 38.5% breastfed longer than six months. There was a gradual reduction of breastfeeding in the population of teenage mothers in this study. Problems were identified that led to decreased breastfeeding, including: nipple trauma, and inadequate suckling at the breast by the infant, but at discharge the mothers were able to demonstrate understanding of how to properly breastfeed. Conclusions: The teenage mother needs support and attention, specific to her role as an adolescent breastfeeding mother, without preconceived ideas of her being unable to care for a child due to her age. Descriptors: Maternal and child health; Breast feeding; Pregnancy in adolescence

Associação entre a analgesia epidural e o trauma perineal no parto vaginal

El objetivo de esto estudio fue analizar la asociacion entre la analgesia epidural y la laceracion perineal en mujeres sometidas al parto vaginal. Fue realizado un estudio descriptivo y transversal, para lo cual fueron investigados 109 prontuarios de mujeres asistidas durante el proceso de parturicion en una maternidad en Ribeirao Preto. Los datos fueron colectados en marzo y abril de 2003. Para analizar la correlacion entre las variables fue aplicado el Teste Chi-Cuadrado. Fue realizado parto normal en 91,7% (100) de las parturientes y en 8,2% (09) parto forceps. En el analisis de los datos, 74,3% de la muestra recibieron analgesia epidural, y de estas 26,5% tuvieron algun nivel de laceracion perineal y 9,1% perineo integro. No fue posible verificar la asociacion entre las variables aludidas. No fue verificado en esto estudio, significancia estadistica para afirmar que las condiciones del perineo despues del parto vaginal y el uso de analgesia epidural, estan asociadas (x²4GL= 3,1).

Intimate partner violence and anxiety disorders in pregnancy: the importance of vocational training of the nursing staff in facing them

Objetivos: identificar la relacion entre el trastorno de estres postraumatico, ansiedad estado-rasgo y la convivencia con pareja intima violenta durante el embarazo. Metodo: estudio observacional y transversal, desarrollado con 358 mujeres embarazadas. Fueran utilizados el Post-Traumatic Stress Disorder Checklist – Civilian Version, el Inventario de Ansiedad Estado-Rasgo y una version adaptada del instrumento utilizado por World Health Organization Multi-country Study on Women’s Health and Domestic Violence. Resultados: despues de ajustar el modelo de regresion logistica multiple, el comportamiento violento de las parejas, que se produjo durante el embarazo, se asocio con la indicacion de trastorno de estres postraumatico. Los modelos de regresion lineal multiple ajustados evidenciaron que las victimas de violencia, en el embarazo actual, tenian una puntuacion mas alta de sintomas de ansiedad estado-rasgo que las que no son o no fueran victimas de violencia. Conclusion: reconocer que la pareja intima violenta es factor de riesgo clinicamente relevante e identificable para la aparicion de los trastornos de ansiedad durante el embarazo y que puede ser un primer paso en la prevencion de esos problemas.Descriptores: Maltrato Conyugal; Ansiedad; Trastornos por Estres Postraumatico; Embarazo; Enfermeria; Salud Publica.855Objetivo: identificar a relacao entre transtorno de estresse pos-traumatico, ansiedade-traco e estado e violencia por parceiro intimo, durante a gestacao. Metodo: estudo observacional e transversal, desenvolvido com 358 gestantes. Foram utilizados o Post-Traumatic Stress Disorder Checklist – Civilian Version, o Inventario de Ansiedade Traco-Estado e uma versao adaptada do instrumento usado no World Health Organization Multi-country Study on Women’s Health and Domestic Violence. Resultados: apos se ajustar ao modelo de regressao logistica multipla, a violencia por parceiro intimo, ocorrida durante a gestacao, associou-se com o indicativo de transtorno de estresse pos-traumatico. Os modelos de regressao linear multipla ajustados evidenciaram que as vitimas de violencia, na atual gestacao, apresentaram maiores escores dos sintomas de ansiedadetraco e estado do que as nao vitimas. Conclusao: reconhecer a violencia por parceiro intimo como um fator de risco clinicamente relevante e identificavel, para a ocorrencia de transtornos ansiosos, durante a gestacao, pode ser um primeiro passo na prevencao desses problemas.Objective: to identify the relationship between posttraumatic stress disorder, trait and state anxiety, and intimate partner violence during pregnancy. Method: observational, cross-sectional study developed with 358 pregnant women. The Posttraumatic Stress Disorder Checklist - Civilian Version was used, as well as the State-Trait Anxiety Inventory and an adapted version of the instrument used in the World Health Organization Multi-country Study on Womens Health and Domestic Violence. Results: after adjusting to the multiple logistic regression model, intimate partner violence, occurred during pregnancy, was associated with the indication of posttraumatic stress disorder. The adjusted multiple linear regression models showed that the victims of violence, in the current pregnancy, had higher symptom scores of trait and state anxiety than non-victims. Conclusion: recognizing the intimate partner violence as a clinically relevant and identifiable risk factor for the occurrence of anxiety disorders during pregnancy can be a first step in the prevention thereof.