Crenças de gestantes usuárias de álcool e outras drogas no contexto da saúde mental

Abstract

The consumption of psychoactive substances has been increasing among women in Brazil, especially among younger women, which presents significant risks, especially during pregnancy. The consumption of these substances during pregnancy can result in obstetric complications and negative impacts on the development of the fetus. This study sought to fill a gap in knowledge by focusing on the universe of meanings of pregnant women who use alcohol and other drugs, aiming to contribute to public health policies for this population, promoting maternal and child health and the healthy development of babies. The general objective of this study was to analyze pregnant women's perceptions of their experience of using alcohol and other drugs during pregnancy and the impacts of this consumption on their lives and mental health at this time, through their beliefs. The specific objectives were to understand the emotions and feelings of pregnant women related to these experiences, as well as their coping strategies, from their perspective. This is a qualitative, exploratory study with pregnant women at any stage of pregnancy who self-reported as consumers of psychoactive substances and who attended a public maternity hospital in a city in the interior of São Paulo. A sociodemographic and health questionnaire was applied and a semi-structured interview was conducted individually and audio-recorded. The data were analyzed using Clarke and Braun's Reflective Thematic Analysis (RTA) and interpreted according to the theoretical basis of Cognitive Behavioral Therapy (CBT), developed by Aaron T. Beck, which offered a conceptual framework to understand beliefs and their impact on the mental health of pregnant women. The study was analyzed and approved by the Human Research Ethics Committee of a federal university in the interior of São Paulo, with the substantiated opinion no. 6,618,645 in the year 2024. The results highlighted that pregnant women expressed general negative beliefs, that is, of lack of love, helplessness and/or worthlessness, mainly arising from situations experienced during childhood and adolescence, as well as beliefs related to the experience of using alcohol and other drugs during pregnancy, which seem to underlie and influence this consumption, impacting the lives and mental health of these women. The participants in this study experienced ambivalent and conflicting feelings related to the use of psychoactive substances during pregnancy, as well as the search for abstinence during pregnancy. The feelings involved anxiety and stress during abstinence and in the process of reducing the pattern of psychoactive substance use, guilt when using drugs and also sadness for not using them. The motivational factors for pregnant women to decide to reduce or stop using drugs consisted of the pregnancy itself and concern for the baby's health. The coping strategies used by pregnant women when deciding to reduce or abstain from drugs during pregnancy involved eating fruits and sweets, focusing on their own and their children's physical health, waiting for the craving to pass, avoiding places and environments that could generate “triggers” for use, as well as the presence of family support. This study provided a space to listen to the narrative of the experiences of pregnant women. This fact can contribute to the practice of health professionals, helping them to better understand how they perceive themselves, the world and others, and how these perceptions can influence their emotions and addictive behaviors. Such information can reinforce the importance of these professionals delving into the universe of senses and meanings of this population so that, in fact, a more assertive intervention in health is possible. As perspectives for future research, studies involving several meetings with pregnant women who experience the use of psychoactive substances during pregnancy are recommended, in order to capture experiences that offer a greater understanding of the perceptive universe of this population. Prospective studies or clinical approach research based on cognitive-behavioral theory with pregnant women who experience the use of such substances are also suggested, in order to monitor intervention processes in this therapeutic line.