Um olhar para a mulher e suas necessidades de saúde no período puerperal a partir da integralidade do cuidado

Abstract

The experience of motherhood associated culturally and socially with the female condition has historically been present in different contexts. Our contemporary culture remains influenced by the social and historical construction of the female role, in relation to motherhood, characterized by the naturalization of the procreative function and motherhood as exclusive. Based on the hypothesis that many transformations caused by pregnancy and postpartum cause a state of important hormonal, physical, emotional and behavioral changes, that are experienced and linked to a set of expectations of the social role of women, it is relevant to understand the pregnancy and motherhood construction, articulating the biological, affective, cultural and social aspects through the perspective of Integrality of Health Care. Thus, the present research aimed to investigate the women’s health care needs in the puerperal period, considering the integrality of health care. This is an empirical, qualitative, descriptiveinterpretative study that investigated the universe of eight women who were in the puerperal period (from the 11th to the 60th postpartum day), attended by the Public Healthcare Service of a municipality in small inland in the state of SP. The instruments for data production included observations of the health care routine, recorded in a field diary, and semi-structured interviews, carried out in the context of home visits. The interviews were recorded, transcribed in full and analyzed based on thematic content analysis. The results produced five thematic categories: 1. Construction and reconstruction of the ways of being (mother); 2. Affective dimension and sexuality; 3. Care of the self; 4. Bond and support network; 5. Comprehensive health care: challenges and possibilities. These revealed the strength of social constructions on motherhood, the multiple health needs being secondary in order to a puerperal care centered on the baby's physiological well-being and the mother's reproductive functions, and a relationship between maternal experience and social context. In order to problematize and overcome this reductionist practice, as well contribute to broader and more comprehensive rearrangements in the provision of care to these women, we highlight some recommendations: i) carry out the puerperal appointment and home visit until the 10th postpartum day; ii) to create dialogic listening spaces, through information and communication technologies, for women, mothers of children served by the Happy Child Program, as possibilities of comprehensive care to be performed; iii) taking into account the dimension concerning in-service training, it is understood that the permanent education strategy, known as Practice Reflection (PR), may represent an important gain for local and regional health policy. Thereby, the present study brought elements to rethink public policies aimed at women, at the intersectoral level, as well has launched reflections on the care models in this stage of the life cycle and brought subsidies to the elaboration of puerperal care strategies under a new focus, which includes the professional’s respect to the values, desires and representation.