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Publication
Experiências perinatais em Portugal em tempo de pandemia COVID-19
Advisor(s)
Abstract(s)
roblema: A pandemia COVID-19 tem mostrado ter tido um impacto profundo no bem-estar
psicossocial da mulher durante a gravidez, o parto e o pós-parto a nível global. Em Portugal as restrições
impostas no atendimento aos cuidados perinatais conduziram a uma mobilização social de contestação
sem precedentes, mostrando o descontentamento com as condições em que as mulheres e os seus bebés
estavam a ser acompanhados pelo sistema de saúde.
Objetivo: Este estudo propõe-se a explorar a experiência subjetiva da vivência da perinatalidade durante
o período de Pandemia COVID-19 em Portugal e perceber a acessibilidade e/ou recurso a cuidados de
saúde mental nesta fase.
Método: Foi utilizada uma metodologia qualitativa, através de entrevistas semi-estruturadas a sete
mulheres com experiência pessoal do ciclo perinatal em tempo de pandemia COVID-19. Os dados
recolhidos foram alvo de análise temática com recurso a software (MaxQDA).
Resultados: Foram desenvolvidos 3 temas: fatores protetores, fatores barreira, e experiência de parto.
Os fatores protetores com maior expressão, percebidos como facilitadores na experiência perinatal,
foram o sentimento de vivência das dinâmicas da família nuclear de forma segura e resguardada, o apoio
percebido do pai, o contacto com o bebé e a qualidade da relação com os prestadores de cuidados. Os
principais fatores barreira, percebidos como negativos na vivência perinatal, foram as mudanças nos
protocolos de prestação de cuidados perinatais, a incerteza quanto às consequências da infeção por
COVID-19, os desafios da reorganização da família nuclear, quadros de desconforto ou patologia
fisiológica, o afastamento social e a qualidade da interação com prestadores de cuidados. As restrições
protocolares no atendimento ao parto e a incerteza quanto às consequências do coronavírus levaram a
vários movimentos de ponderação e alteração no plano de parto e a escolha de intervenções durante o
parto. A nenhuma das mulheres foram sugeridos ou disponibilizados cuidados de saúde mental no
circuito de prestação de cuidados perinatais, revelando a fraca participação dos e/ou acessibilidade aos
cuidados especializados de saúde mental nos circuitos previstos para a prestação de cuidados nesta fase
de vida.
Conclusão: Este estudo fornece uma maior clareza acerca dos fatores que são valorizados por mulheres
portuguesas como facilitadores de uma vivência perinatal positiva. Sugere-se a inclusão dos
conhecimentos da área da saúde mental na construção de políticas de saúde e de protocolos de prestação
de cuidados perinatais, bem como a inclusão de técnicos de saúde mental, nomeadamente psicólogos,
de forma acessível nos circuitos previstos para o atendimento à mulher e às famílias durante o ciclo
gravídico-puerperal em Portugal.
ABSTRACT: Problem: The COVID-19 pandemic has been shown to have a profound impact on women's psychosocial well-being during pregnancy, childbirth and the postpartum period globally. In Portugal, the restrictionsimposed on perinatal care led to an unprecedented social mobilization of protest,showing dissatisfaction with the conditions in which women and their babies were being monitored by the health system. Objective: This study aims to explore the subjective experience of experiencing perinatality during the period of the COVID-19 Pandemic in Portugal and to understand the accessibility and/or use of mental health care at this stage. Method: A qualitative methodology, of thematic analysis, was used in approaching personal experience reports of the perinatal cycle during the COVID-19 pandemic. The analyzed data were collected through semi-structured interviews with seven women, with subsequent transcription. Results: Three central themes were identified: protective factors, barrier factors, and childbirth expirience. The factors perceived as facilitators in the perinatal experience with greater expression were the feeling of experiencing the dynamics of the nuclear family in a safe and protected way, the perceived support of the father, the contact with the baby and the quality of the relationship with the care providers. The main factors perceived as hindering the perinatal experience were changes in perinatal care protocols, uncertainty regarding the consequences of the COVID-19 infection, the challenges of reorganizing the nuclear family, conditions of discomfort or physiological pathology, social distancing and the quality of interaction with care providers. Protocol restrictions on childbirth care and uncertainty regarding the consequences of the coronavirus led to several movements of weighting and changing the birth plan and the choice of interventions during childbirth. None of the women were suggested or offered mental health care in the perinatal care circuit, revealing poor participation and/or accessibility to specialized mental health care in the Portuguese circuits provided for the provision of care at this stage of life. Conclusion This study provides initial insights into the factors that are valued by Portuguese women as facilitators of the perinatal experience. It is suggested the inclusion of knowledge in the area of mental health in the construction of health policies and protocols for the provision of perinatal care, as well as the inclusion of mental health technicians, namely psychologists, in an accessible way in the circuits provided for the care of women and families during pregnancy and childbirth in Portugal.
ABSTRACT: Problem: The COVID-19 pandemic has been shown to have a profound impact on women's psychosocial well-being during pregnancy, childbirth and the postpartum period globally. In Portugal, the restrictionsimposed on perinatal care led to an unprecedented social mobilization of protest,showing dissatisfaction with the conditions in which women and their babies were being monitored by the health system. Objective: This study aims to explore the subjective experience of experiencing perinatality during the period of the COVID-19 Pandemic in Portugal and to understand the accessibility and/or use of mental health care at this stage. Method: A qualitative methodology, of thematic analysis, was used in approaching personal experience reports of the perinatal cycle during the COVID-19 pandemic. The analyzed data were collected through semi-structured interviews with seven women, with subsequent transcription. Results: Three central themes were identified: protective factors, barrier factors, and childbirth expirience. The factors perceived as facilitators in the perinatal experience with greater expression were the feeling of experiencing the dynamics of the nuclear family in a safe and protected way, the perceived support of the father, the contact with the baby and the quality of the relationship with the care providers. The main factors perceived as hindering the perinatal experience were changes in perinatal care protocols, uncertainty regarding the consequences of the COVID-19 infection, the challenges of reorganizing the nuclear family, conditions of discomfort or physiological pathology, social distancing and the quality of interaction with care providers. Protocol restrictions on childbirth care and uncertainty regarding the consequences of the coronavirus led to several movements of weighting and changing the birth plan and the choice of interventions during childbirth. None of the women were suggested or offered mental health care in the perinatal care circuit, revealing poor participation and/or accessibility to specialized mental health care in the Portuguese circuits provided for the provision of care at this stage of life. Conclusion This study provides initial insights into the factors that are valued by Portuguese women as facilitators of the perinatal experience. It is suggested the inclusion of knowledge in the area of mental health in the construction of health policies and protocols for the provision of perinatal care, as well as the inclusion of mental health technicians, namely psychologists, in an accessible way in the circuits provided for the care of women and families during pregnancy and childbirth in Portugal.
Description
Dissertação de Mestrado apresentada no
Ispa - Instituto Universitário para obtenção de grau de Mestre na
especialidade de Psicologia Clínica
Keywords
Pandemia COVID-19 Período perinatal Análise temática COVID-19 pandemic Perinatal period Thematic analysis