O poder decisório da mulher no parto: as práticas discursivas dos profissionais e sua relação com a formação em obstetrícia

• Autor(a) principal: Mauadie, Rejane Araújo
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/11448
• topic: Natural Childbirth; Personal Autonomy; Obstetric Nursing; Education Nursing; Internship and residency; Obstetrics; Parto normal; Autonomia pessoal; Enfermagem obstétrica; Educação em enfermagem; Residência e internato; Obstetrícia; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

The women power of decision making during labor is influenced by medicalization, determined by the higher use of technologies and interventions, justified by the presumption of making it a safer process. This perspective has strengthened the medicalized model in obstetrics in which labor and birth are equivalent to diseases and in which labor and birth are not considered physiological events. Professional training can strengthen these conceptions and practices, and put women´s decision making in second places. Hence, the object of this research is women s power of decision making during labor on the discursive practices of nurses and doctors getting professional qualification in obstretrics. The objectives were to analyze the meanings attributed to the power of women´s decision making during labor on the discursive practices of nurses and doctors in professional training in obstetrics; and to discuss the possible relations between meanings that emerge from these practices and the obstetrics professional education. These discourses were taken from individual interviews with obstetrics resident nurses and doctors in a public maternity in the city of Rio de Janeiro, from April to June, 2017. The participants were eleven resident nurses and doctors. The discourse analysis method was based in Michel Foucault s genealogy, whom theoretical thought involves discourse, power and subjectivation that configured the fundamental foundation of this research. After applying such methodology, two categories were created: 1) Discourses of doctors and nurses controlling and monitoring: Obstetric Panopticon; 2) The limits of women´s decision making power through professional power-knowledge. Results have shown that women´s decision making power during labor is limited by a network of power based relations, represented by institutional power, medicalized assistance, bio-power, disciplinary power and professional knowledge. This network shows the biopolitics of medicalization in obstetrics assistance which clarifies the monitoring and control over women and their bodies. The discourses showed the convergence between the two models of assistance, medicalized and de-medicalized, as risks are pointed as a restriction of the possibility of normal and limiting of the noninvasive care. Further, antenatal care failure to inform about the physiology of pregnancy and labor were cited by both modes, which causes a stereotyped image of women, as uninformed, less cooperative and hysterical. The professional power-knowledge elucidates concepts about women as non-possessors of autonomy; with restricted decision-making power and exposed to professional s power-knowledge, seen as the possessors of knowledge or knowledge truth. Even if the discourses of physiological labor and birth defend women s autonomy giving more amplitude to women´s decision making in labor, these will not make a rupture on the discursive medicalized practices networks, as they concern on peripherical discourses, in other words, they are not considered as a knowledge truth. By Foucault's perspective, the power produces realities, therefore the few possibilities of the women´s decision making during labor revealed in this research relates to the no-power.