Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê.
Ano de defesa: | 2019 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Católica de Pernambuco
|
Programa de Pós-Graduação: |
Doutorado em Psicologia Clínica
|
Departamento: |
Departamento de Pós-Graduação
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://tede2.unicap.br:8080/handle/tede/1138 |
Resumo: | This study consists of some research that focus on the constitution of the mother and preterm baby relationship while in a hospital environment. Facing the complexities which are natural to maternity, during the birth of a preterm baby, two factors are observed: hospitalization and prematurity. This birth is categorized by the early separation of baby and mother. The baby is not able to survive on their own and the maternal care given is not enough to allow this survival. Breastfeeding, as part of the process that constitutes the relation between baby and mother, becomes another challenging factor, since the physiological immaturity of the baby, as they are not able to breastfeed directly from the mother when they are born. Breast milk is considered the best food for them and, to be fed early, the mother needs to be milked. However, studies point out difficulties among mothers in the milk production, in the milking process and in breastfeeding. Facing this complex scenario, the purpose of this research was to analyze how the relationship between preterm mother-infant, involving breastfeeding in the hospital context, is constituted. In an attempt to respond to the proposition, we chose Psychoanalysis and the method of observation of the mother-baby relationship of Esther Bick as the theoretical-methodological references. Three mothers and their infants were observed during the three-month period of hospitalization in Recife-PE. As a result, we realize that not only is the new baby a premature one. We reflect that the mother is also premature and needs time to prepare for the arrival of a child who has been crossed by the unexpected and who, at birth, demanded specific hospital care. The hospital, as an institution, becomes an essential element for the survival of the baby. However, this may represent a protective structure, as well as an obstacle between mother and child. In several moments of the observations, the team positioned themselves in an imperative and authoritarian way, with actions based on the medical and institutional power. In this position, what prevailed was the normative dimension of the institution. These acts enhanced the erasure of maternal singularities and their children, as well as ignored the maternal knowledge that was built in the exchange with the baby. The observed mothers, despite their contingencies, were able to appropriate their children and exercise their role in particular. They also have been successful in establishing and maintaining breastfeeding. They revealed to us that regardless the ways the milk was offered, what really mattered was the quality of a pleasurable relationship established in that context. This research therefore points out the need to recognize that in hospital admission, not only a special care is given to the preterm infant in search of their survival, but also a particular relationship between mother and child takes place, legitimized by maternal knowledge in the exercise of its function. In this sense, recognition of these aspects, ethical posture, reception and technical and psychic support, detached from the imperatives of duty and moral judgments, contribute to the process of humanizing the baby and can even collaborate with the goals determined by the hospital protocols. |
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Queiroz, Edilene Freire dehttp://lattes.cnpq.br/5286223909194547Portella, Rafaella Botelho Cursino2019-09-12T22:36:52Z2019-06-27PORTELLA, Rafaella Botelho Cursino. Prematuridade e hospitalização : possibilidades e atravessamentos na constituição da relação mãe-bebê . 2019. 160 f. Tese (Doutorado) - Universidade Católica de Pernambuco. Pró-reitoria Acadêmica. Coordenação Geral de Pós-graduação. Doutorado em Psicologia clínica, 2019.http://tede2.unicap.br:8080/handle/tede/1138This study consists of some research that focus on the constitution of the mother and preterm baby relationship while in a hospital environment. Facing the complexities which are natural to maternity, during the birth of a preterm baby, two factors are observed: hospitalization and prematurity. This birth is categorized by the early separation of baby and mother. The baby is not able to survive on their own and the maternal care given is not enough to allow this survival. Breastfeeding, as part of the process that constitutes the relation between baby and mother, becomes another challenging factor, since the physiological immaturity of the baby, as they are not able to breastfeed directly from the mother when they are born. Breast milk is considered the best food for them and, to be fed early, the mother needs to be milked. However, studies point out difficulties among mothers in the milk production, in the milking process and in breastfeeding. Facing this complex scenario, the purpose of this research was to analyze how the relationship between preterm mother-infant, involving breastfeeding in the hospital context, is constituted. In an attempt to respond to the proposition, we chose Psychoanalysis and the method of observation of the mother-baby relationship of Esther Bick as the theoretical-methodological references. Three mothers and their infants were observed during the three-month period of hospitalization in Recife-PE. As a result, we realize that not only is the new baby a premature one. We reflect that the mother is also premature and needs time to prepare for the arrival of a child who has been crossed by the unexpected and who, at birth, demanded specific hospital care. The hospital, as an institution, becomes an essential element for the survival of the baby. However, this may represent a protective structure, as well as an obstacle between mother and child. In several moments of the observations, the team positioned themselves in an imperative and authoritarian way, with actions based on the medical and institutional power. In this position, what prevailed was the normative dimension of the institution. These acts enhanced the erasure of maternal singularities and their children, as well as ignored the maternal knowledge that was built in the exchange with the baby. The observed mothers, despite their contingencies, were able to appropriate their children and exercise their role in particular. They also have been successful in establishing and maintaining breastfeeding. They revealed to us that regardless the ways the milk was offered, what really mattered was the quality of a pleasurable relationship established in that context. This research therefore points out the need to recognize that in hospital admission, not only a special care is given to the preterm infant in search of their survival, but also a particular relationship between mother and child takes place, legitimized by maternal knowledge in the exercise of its function. In this sense, recognition of these aspects, ethical posture, reception and technical and psychic support, detached from the imperatives of duty and moral judgments, contribute to the process of humanizing the baby and can even collaborate with the goals determined by the hospital protocols.Este estudo consiste em uma pesquisa que enfoca a temática da constituição da relação mãe-bebê pré-termo no contexto hospitalar. Diante das complexidades inerentes à maternidade, no nascimento de um bebê pré-termo entram em jogo outros dois fatores: a hospitalização e a prematuridade. Esse nascimento é caracterizado pela separação prematura entre o bebê e sua mãe. O filho não dispõe em si mesmo da capacidade de sobreviver e os cuidados maternos por si só não são suficientes para permiti-lo. Inserida no processo de constituição da relação entre mãe e filho, a amamentação torna-se outro fator desafiador, pois, diante de sua condição de imaturidade fisiológica, o recém-nascido pré-termo não pode se alimentar diretamente no seio materno ao nascer. O leite materno é considerado o melhor alimento para ele e, para ser alimentado precocemente, é preciso que a mãe o ordenhe. No entanto, estudos apontam dificuldades das mães na produção do leite, no processo da ordenha e na amamentação. Frente ao complexo cenário, a proposição desta pesquisa foi analisar como se constitui a relação entre mãe-bebê pré-termo, envolvendo a amamentação no contexto hospitalar. Na tentativa de responder à proposição, optamos pela Psicanálise e pelo método de observação da relação mãe-bebê de Esther Bick como os referenciais teórico-metodológicos. Foram observadas, ao longo de três meses, três mães e seus bebês no período de internamento hospitalar, no Recife-PE. Como resultados, percebemos que não só o bebê nasce antes do tempo. Refletimos que a mãe também é prematura e precisa de um tempo para elaborar a chegada de um filho que veio atravessado pelo inesperado e que, ao nascer, demandou cuidados específicos do hospital. A instituição hospitalar torna-se um elemento imprescindível para a sobrevivência do bebê. No entanto, esta pode representar tanto uma estrutura de proteção como se colocar como obstáculos entre mãe e filho. Em diversos momentos observados, a equipe se posicionou de modo imperativo e autoritário, com posturas baseadas no poder médico e institucional. Nesse posicionamento, o que prevalecia era a dimensão normativa da instituição. Essa posição potencializou o apagamento das singularidades maternas e de seus filhos, assim como ignorou o saber materno que se construiu na troca com o bebê. As mães observadas, apesar das contingências, conseguiram construir um saber sobre seus filhos e exercer, de modo particular, sua função. Obtiveram, também, sucesso no estabelecimento da amamentação ao longo do internamento hospitalar. Revelaram-nos que independentemente do modo como o leite foi ofertado o importante foi a qualidade da relação prazerosa estabelecida nesse contexto. Esta pesquisa alerta, portanto, para a necessidade de reconhecer que no internamento hospitalar não se presta apenas cuidados ao bebê pré-termo em busca de sua sobrevivência, mas também se constitui uma relação particular entre mãe e filho, legitimada pelo saber materno no exercício de sua função. Nesse sentido, o reconhecimento desses aspectos, a postura ética, de acolhimento e de sustentação técnica e psíquica, descolada dos imperativos do dever e dos julgamentos morais, contribui para o processo de humanização do bebê e pode, inclusive, colaborar com as metas determinadas pelos protocolos hospitalares.Submitted by Biblioteca Central (biblioteca@unicap.br) on 2019-09-12T22:36:51Z No. of bitstreams: 2 rafaella_botelho_cursino_portella.pdf: 1411035 bytes, checksum: d7756547f5d6f2d11e012fe31c6b7bf9 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2019-09-12T22:36:52Z (GMT). No. of bitstreams: 2 rafaella_botelho_cursino_portella.pdf: 1411035 bytes, checksum: d7756547f5d6f2d11e012fe31c6b7bf9 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2019-06-27application/pdfporUniversidade Católica de PernambucoDoutorado em Psicologia ClínicaUNICAPBrasilDepartamento de Pós-Graduaçãohttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessMãe e lactentePsicanálisePsicopatologiaPrematurosAmamentaçãoTesesThesesMother and infantPsychoanalysisPsychopathologyPrematureBreast-feedingCIENCIAS HUMANAS::PSICOLOGIAPrematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis-1750668812972093704500500600-88540523682731408353411867255817377423reponame:Biblioteca Digital de Teses e Dissertações da UNICAPinstname:Universidade Católica de Pernambuco (UNICAP)instacron:UNICAPORIGINALrafaella_botelho_cursino_portella.pdfrafaella_botelho_cursino_portella.pdfapplication/pdf1411035http://tede2.unicap.br:8080/handle/tede/bitstream/tede/1138/5/rafaella_botelho_cursino_portella.pdfd7756547f5d6f2d11e012fe31c6b7bf9MD55CC-LICENSElicense_urllicense_urltext/plain; charset=utf-849http://tede2.unicap.br:8080/handle/tede/bitstream/tede/1138/2/license_url4afdbb8c545fd630ea7db775da747b2fMD52license_textlicense_texttext/html; charset=utf-80http://tede2.unicap.br:8080/handle/tede/bitstream/tede/1138/3/license_textd41d8cd98f00b204e9800998ecf8427eMD53license_rdflicense_rdfapplication/rdf+xml; charset=utf-80http://tede2.unicap.br:8080/handle/tede/bitstream/tede/1138/4/license_rdfd41d8cd98f00b204e9800998ecf8427eMD54LICENSElicense.txtlicense.txttext/plain; charset=utf-82170http://tede2.unicap.br:8080/handle/tede/bitstream/tede/1138/1/license.txt5d71329502a0e313f28be890c62f4ad8MD51tede/11382019-09-12 19:36:52.399oai:tede2.unicap.br:tede/1138Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.unicap.br:8080/http://tede2.unicap.br:8080/oai/requestbiblioteca@unicap.br||biblioteca@unicap.bropendoar:46462019-09-12T22:36:52Biblioteca Digital de Teses e Dissertações da UNICAP - Universidade Católica de Pernambuco (UNICAP)false |
dc.title.por.fl_str_mv |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. |
title |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. |
spellingShingle |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. Portella, Rafaella Botelho Cursino Mãe e lactente Psicanálise Psicopatologia Prematuros Amamentação Teses Theses Mother and infant Psychoanalysis Psychopathology Premature Breast-feeding CIENCIAS HUMANAS::PSICOLOGIA |
title_short |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. |
title_full |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. |
title_fullStr |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. |
title_full_unstemmed |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. |
title_sort |
Prematuridade e hospitalização: possibilidades e atravessamentos na constituição da relação mãe-bebê. |
author |
Portella, Rafaella Botelho Cursino |
author_facet |
Portella, Rafaella Botelho Cursino |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Queiroz, Edilene Freire de |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5286223909194547 |
dc.contributor.author.fl_str_mv |
Portella, Rafaella Botelho Cursino |
contributor_str_mv |
Queiroz, Edilene Freire de |
dc.subject.por.fl_str_mv |
Mãe e lactente Psicanálise Psicopatologia Prematuros Amamentação Teses |
topic |
Mãe e lactente Psicanálise Psicopatologia Prematuros Amamentação Teses Theses Mother and infant Psychoanalysis Psychopathology Premature Breast-feeding CIENCIAS HUMANAS::PSICOLOGIA |
dc.subject.eng.fl_str_mv |
Theses Mother and infant Psychoanalysis Psychopathology Premature Breast-feeding |
dc.subject.cnpq.fl_str_mv |
CIENCIAS HUMANAS::PSICOLOGIA |
description |
This study consists of some research that focus on the constitution of the mother and preterm baby relationship while in a hospital environment. Facing the complexities which are natural to maternity, during the birth of a preterm baby, two factors are observed: hospitalization and prematurity. This birth is categorized by the early separation of baby and mother. The baby is not able to survive on their own and the maternal care given is not enough to allow this survival. Breastfeeding, as part of the process that constitutes the relation between baby and mother, becomes another challenging factor, since the physiological immaturity of the baby, as they are not able to breastfeed directly from the mother when they are born. Breast milk is considered the best food for them and, to be fed early, the mother needs to be milked. However, studies point out difficulties among mothers in the milk production, in the milking process and in breastfeeding. Facing this complex scenario, the purpose of this research was to analyze how the relationship between preterm mother-infant, involving breastfeeding in the hospital context, is constituted. In an attempt to respond to the proposition, we chose Psychoanalysis and the method of observation of the mother-baby relationship of Esther Bick as the theoretical-methodological references. Three mothers and their infants were observed during the three-month period of hospitalization in Recife-PE. As a result, we realize that not only is the new baby a premature one. We reflect that the mother is also premature and needs time to prepare for the arrival of a child who has been crossed by the unexpected and who, at birth, demanded specific hospital care. The hospital, as an institution, becomes an essential element for the survival of the baby. However, this may represent a protective structure, as well as an obstacle between mother and child. In several moments of the observations, the team positioned themselves in an imperative and authoritarian way, with actions based on the medical and institutional power. In this position, what prevailed was the normative dimension of the institution. These acts enhanced the erasure of maternal singularities and their children, as well as ignored the maternal knowledge that was built in the exchange with the baby. The observed mothers, despite their contingencies, were able to appropriate their children and exercise their role in particular. They also have been successful in establishing and maintaining breastfeeding. They revealed to us that regardless the ways the milk was offered, what really mattered was the quality of a pleasurable relationship established in that context. This research therefore points out the need to recognize that in hospital admission, not only a special care is given to the preterm infant in search of their survival, but also a particular relationship between mother and child takes place, legitimized by maternal knowledge in the exercise of its function. In this sense, recognition of these aspects, ethical posture, reception and technical and psychic support, detached from the imperatives of duty and moral judgments, contribute to the process of humanizing the baby and can even collaborate with the goals determined by the hospital protocols. |
publishDate |
2019 |
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2019-09-12T22:36:52Z |
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2019-06-27 |
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PORTELLA, Rafaella Botelho Cursino. Prematuridade e hospitalização : possibilidades e atravessamentos na constituição da relação mãe-bebê . 2019. 160 f. Tese (Doutorado) - Universidade Católica de Pernambuco. Pró-reitoria Acadêmica. Coordenação Geral de Pós-graduação. Doutorado em Psicologia clínica, 2019. |
dc.identifier.uri.fl_str_mv |
http://tede2.unicap.br:8080/handle/tede/1138 |
identifier_str_mv |
PORTELLA, Rafaella Botelho Cursino. Prematuridade e hospitalização : possibilidades e atravessamentos na constituição da relação mãe-bebê . 2019. 160 f. Tese (Doutorado) - Universidade Católica de Pernambuco. Pró-reitoria Acadêmica. Coordenação Geral de Pós-graduação. Doutorado em Psicologia clínica, 2019. |
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http://tede2.unicap.br:8080/handle/tede/1138 |
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