BÁRBARA FIGUEIREDO (**)

RAQUEL COSTA (**)

ALEXANDRA PACHECO (**)

RESUMO

Neste artigo os autores começam por fazer uma breve explanação da diversidade cultural na concepção do parto e das consequências que advêm desta diversidade, quer em termos dos métodos utilizados, quer em termos da experiência de parto proporcionada à mulher. Seguidamente, apresentam uma revisão teórica e empírica dos estudos que investigam a experiência de parto, tal como é geralmente descrita pela mulher, nomeadamente, os acontecimentos tidos como mais significativos durante o gravidez e parto. Finalmente, analisam alguns dos factores susceptíveis de influenciar a experiência de parto, o comportamento neonatal e o estabelecimento da relação mãe-bebé, dando particular atenção ao suporte emocional durante o parto, ao tipo de parto, à preparação e participação no parto e à dor associada ao parto. São ainda propostas algumas sugestões de intervenção, no âmbito da Psicologia da Saúde, no sentido de promover e beneficiar positivamente a experiência de parto da mulher.

Palavras-chave: Experiência de parto, tipo de parto, dor, analgesia epidural, comportamento neonatal.

ABSTRACT

In this article, the authors present a brief explanation of cultural diversity concerning childbirth and it's consequences regarding methods of delivery and women's experiences. They also present a conceptual and empiric framework, attending to the studies about childbirth experience as it is usually described by women, namely, the most important events regarding pregnancy and labor. Finally, they analyse some variables that might influence childbirth experience, neonatal behaviour and mother-infant relationship, such as: preparation for labour and delivery, emotional support, participation and pain during labour and delivery as well as method of delivery. Some Health Psychology suggestions of intervention are given, to promote and benefit positively the childbirth experience.

Key words: Childbirth experience, method of delivery, pain, epidural anaesthesia, neonatal behaviour.

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

REFERÊNCIAS BIBLIOGRÁFICAS

Alfasi, G. (1985). Mother-infant feeding interactions in preterm and full-term infants. Infant Behaviour Development, 8 (2), 167-180.         [ Links ]

Algom, D., & Lubel, S. (1994). Psychophysics in the field: perception and memory for labor pain. Perception & Psychophysics, 55 (2), 133-141.         [ Links ]

Bradley, C. F., Ross, S. E., & Warnyca, J. (1983). A prospective study of mother's attitudes and feelings following cesarean and vaginal births. Birth, 10, 79-83.         [ Links ]

Brazelton, T. B. (1981). On becoming a father. New York: Delacort Press.         [ Links ]

Chestnut, D. H. (1999). Effects on the progress of labor and method of delivery. In D. H. Chestnut (Ed.), Obstetric anesthesia - Principles and practice (pp. 386-407). St. Louis, Missouri: Mosby, Inc.         [ Links ]

Clement, S., Wilson, J., & Sikorski, J. (1999). The development of an intrapartum intervention score based on women's experiences. Journal of Reproductive and Infant Psychology, 17 (1), 53-62.         [ Links ]

Copstick, S., Taylor, K., Hayes, R., & Morris, N. (1999). The relation of time of day to childbirth. Journal of Reproductive and Infant Psychology, 4, 13-22.         [ Links ]

Cranley, M. S., Hedhal, K. J., & Pegg, S. H. (1983). Women's perceptions of vaginal and cesarean deliveries. Nursing Research, 32 (1), 10-15.         [ Links ]

Crawford, J. W. (1982). Mother-infant interaction in premature and full-term infants. Child Development, 53, 957-962.         [ Links ]

Cummins, L. H., Scrimshaw, S. C. M., & Engle, P. L. (1988). Views of cesarean birth among primiparous women of Mexican origin in Los Angeles. Birth, 15, 164-170.         [ Links ]

DeVries, F. G., Wellemans-Camus, M., & Candeur-Meyrant, S. (1993). Influence du climat institutionnel entourant la naissance sur les comportements et les interactions précoces entre la mère et son bébé. Enfance, 1 (2), 85-98.         [ Links ]

DiMatteo, M. R., Morton, S. C., Lepper, H. S., Damush, T. M., Carney, M. F., Pearson, M., & Kahn, K. L.(1996). Cesarean childbirth and psychosocial outcomes: A meta-analysis. Health Psychology, 15 (4), 303-324.         [ Links ]

Direcção Geral de Saúde (2001). Plano nacional de luta contra a dor. Aprovado por Despacho Ministerial de 26 de Março de 2001.         [ Links ]

Field, T. M., & Windmayer, S. M. (1980). Developmental follow-up of infants delivered by cesarean section and general anesthesia. Infant Behaviour Development, 3, 253-264.         [ Links ]

Figueiredo, B. (2000). Psicopatologia do desenvolvimento na maternidade. In I. Soares (org.), Trajectórias (in)adaptadas de desenvolvimento (pp. 347-380). Coimbra: Quarteto Editora.         [ Links ]

Figueiredo, B. (2001). Mães e bebés. Lisboa: Fundação Calouste Gulbenkian e Fundação para a Ciência e a Tecnologia.         [ Links ]

Figueiredo, B., & Alegre, C. (in press). Motherhood experiences of portuguese women. In J. Cox, M. Marks, & M. Oates (Eds.). Transcultural Study of Postpartum Depression. Cambridge Press.         [ Links ]

Fisher, J. R. W., Stanley, R. O., & Burrows, G. D. (1990). Psychosocial adjustment to cesarean delivery: A review of the evidence. Journal of Psychossomatic Obstetrics and Gynaecology, 11, 91-106.         [ Links ]

Fraser, C. M. (1983). Selected perinatal procedures. Scientific basis for use and psychosocial effects: A literature review. Acta Obstetrica et Gynecologica Scandinavica, 117, 1-39.         [ Links ]

Gainer, M., & Van Bonn, P. (1977). Two factors affecting the cesarean delivered mother: father's presence at the delivery and postpartum teaching. Ann Arbor, University of Michigan (tese de mestrado não publicada).         [ Links ]

Garel, M., Lelong, N., & Kaminski, M. (1987). Psychological consequences of caesarean childbirth in primíparas. Journal of Psychosomatic Obstetrics and Gynaecology, 6 (3), 197-209.         [ Links ]

Garel, M., Lelong, N., & Kaminski, M. (1988). Follow-up study of psychological consequences of caesarean childbirth. Early Human Development, 16 (2-3), 271-282.         [ Links ]

Glosten, B. (1999). Epidural and spinal analgesia/anesthesia. In D. H. Chestnut (Ed.), Obstetric anesthesia - Principles and practice (pp. 360-385). St. Louis, Missouri: Mosby.         [ Links ]

Gottlieb, S. E., & Barrett, D. E. (1986). Effects of unanticipated caesarean section on mothers, infants, and their interaction in the first month of live. Journal of Developmental and Behavioral Pediatrics, 7 (3), 180-185.         [ Links ]

Hwang, C. P. (1987). Cesarean childbirth in Sweden: Effects on the mother and father infant relationship. Infant Mental Health Journal, 8 (2), 91-99.         [ Links ]

Klaus, M., & Kennell, J. (1976). Maternal-infant bonding. Saint Louis: The C. V. Mosby Company.         [ Links ]

Lee, R. E. (1995). Women look at their experience of pregnancy. Infant Mental Health Journal, 16 (3), 192-205.         [ Links ]

Leventhal, E. A., Leventhal, H., Shacham, S., & Easterling, D. (1989). Active coping reduces reports of pain from childbirth. Journal of Consulting and Clinical Psychology, 57 (3), 365-371.         [ Links ]

Lozoff, B., Jordan, B., & Malone, S. (1988). Childbirth in cross-cultural perspective. Marriage and Family Review, 12 (3-4), 35-60.         [ Links ]

Manning, M. M., & Wright, T. L. (1983). Self-efficacy expectancies, outcome expectancies, and the persistence of pain control in childbirth. Journal of Personality and Social Psychology, 45 (2), 421-431.         [ Links ]

Marut, J. S., & Mercer, R. T. (1979). Comparison of primíparas - perceptions of vaginal and cesarean births. Nursing Research, 28 (5), 260-266.         [ Links ]

Matthews, A. E. B. (1964). Reflections on the pain of labour. Nurs Mirror, 118, 550-554.         [ Links ]

Muhlen, L., Pryke, M., & Wade, K. (1986). Effects of type of birth and anaesthetic on neonatal behavioural assessment scale scores. Australian Psychologist, 21 (2), 253-270.         [ Links ]

Nieland, M., & Roger, D. (1993). Emotion control and analgesia in labour. Personality and Individual Differences, 14 (6), 841-843.         [ Links ]

Niven, C. (1988). Labour pain: Long-term recall and consequences. Journal of Reproductive and Infant Psychology, 6, 83-87.         [ Links ]

O'Hara, M. W., Varner, M. W., & Johnson, S. R. (1986). Assessing stressful life events associated with childbearing: The peripartum events scale. Journal of Reproductive and Infant Psychology, 4, 85-98.         [ Links ]

Oakley, A. (1983). Social consequences of obstetric technology: The importance of measuring "soft" outcomes. Birth, 10 (2), 99-108.         [ Links ]

Paech, M. J. (1991). The King Edward Memorial Hospital 1000 mother survey of methods of pain relief in labour. Anaesth Int Care, 19, 393-399.         [ Links ]

Pederson, F. A., Zaslow, M. J., Cain, R. L., & Anderson, B. J. (1981). Cesarean childbirth: Psychological implications for mothers and fathers. Infant Mental Health Journal, 2, 257-263.         [ Links ]

Pedro, J. C. G. (1982). Influência no comportamento do recém-nascido do contacto precoce com a mãe: Contributo para a interpretação clínica da interacção da díade. Lisboa: Fundação Calouste Gulbenkian.         [ Links ]

Raskin, V. D., Richman, J. A., & Gaine, C. (1990). Patterns of depressive symptoms in expectant and new parents. American Journal of Psychiatry, 147 (5), 658-660.         [ Links ]

Robson, K. M., & Kumar, R. (1980). Delay onset of maternal affection after childbirth. British Journal of Psychiatry, 136, 347-353.         [ Links ]

Rofé, Y., & Lewin, I. (1980). Affiliation in an unavoidable stressful situation: an examination of the utility theory. British Journal of Social Psychology, 25 (2), 118-128.         [ Links ]

Taylor, A., Adams, D., Doré, C., Kumar, R., & Glover, V. (in press). Mother-baby bonding: Correlations with early mood and methods of delivery.         [ Links ]

Thune-Larsen, K. B., & Moller-Pedersen, K. (1988). Childbirth experience and postpartum emotional disturbance. Journal of Reproductive and Infant Psychology, 6 (4), 229-240.         [ Links ]

Tulman, L. J. (1986). Initial handling of newborn infants by vaginally and cesarean-delivered mothers. Nursing Research, 35, 296-300.         [ Links ]

Walker, N. C., & O'Brien, B. (1999). The relationship between method of pain management during labor and birth outcomes. Clinical Nursing Research, 8 (2), 119-134.         [ Links ]

Wideman, M. V., & Singer, J. E (1984). The role of psychological mechanisms in preparation for childbirth. American Psychologist, 39 (12), 1357-1371.         [ Links ]

Windstrom, A. M., et al. (1990). Short-term effects of early suckling and touch of the nipple on maternal behaviour. Early Human Development, 21 (3), 153-163.         [ Links ]

(*) Este estudo foi desenvolvido com o apoio do Serviço de Saúde e Desenvolvimento Humano da Fundação Calouste Gulbenkian.

(**)Departamento de Psicologia da Universidade do Minho. Maternidade Júlio Dinis (Porto).