Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Även tryckt utgåva. Härtill 4 uppsatser.

This thesis explores the relationships between self-esteem and socio-economic factors and characteristics of maternity group home program participation. Self-esteem is used sometimes as the independent variable and sometimes as the dependent variable in this study. A sample of 268 women was used representing the data available in an administrative database on women admitted to the Villa Rosa program for the period from May 1998 to February 2009, after removing cases with too much of the self-esteem measure missing. Methods of analysis included; paired samples t-tests, independent samples t-tests, analysis of variance, repeated measures analysis of variance, standard multiple regression, sequential multiple regression, and multinomial logistic regression. Attempts were made to control for the influence of the several factors. The main findings of the research included: 1) Ethnicity was not found to be significantly related to discharge self-esteem. 2) Self-esteem of residents was found to be significantly healthier at discharge from the program than at intake to the program. 3) Self-esteem was not found to be significantly different between women who participated in a post-natal semi-independent living component of the program and those who did not when controlling for control variables. When the control variable of length of time in the program was removed self-esteem was found to be significantly healthier for women who participated in the post-natal semi-independent living component of the program than those who did not. 4) A significant difference was not found between the discharge self-esteem of women who reported as living with a disability at intake, and women who did not. 5) Self-esteem at discharge was found to be healthier with an increased number of days spent at Villa Rosa. 6) Less healthy intake self-esteem was associated with plans not to breastfeed. 7) More supportive attitudes of social support network as measured at intake were shown to be linked to healthier self-esteem at discharge. 8) Experiences of abuse were not shown to be significantly related to discharge self-esteem. Both support received from the significant findings, and a lack of support from insignificant findings, were found for several self-esteem theories.

This thesis explores the relationships between self-esteem and socio-economic factors and characteristics of maternity group home program participation. Self-esteem is used sometimes as the independent variable and sometimes as the dependent variable in this study. A sample of 268 women was used representing the data available in an administrative database on women admitted to the Villa Rosa program for the period from May 1998 to February 2009, after removing cases with too much of the self-esteem measure missing. Methods of analysis included; paired samples t-tests, independent samples t-tests, analysis of variance, repeated measures analysis of variance, standard multiple regression, sequential multiple regression, and multinomial logistic regression. Attempts were made to control for the influence of the several factors. The main findings of the research included: 1) Ethnicity was not found to be significantly related to discharge self-esteem. 2) Self-esteem of residents was found to be significantly healthier at discharge from the program than at intake to the program. 3) Self-esteem was not found to be significantly different between women who participated in a post-natal semi-independent living component of the program and those who did not when controlling for control variables. When the control variable of length of time in the program was removed self-esteem was found to be significantly healthier for women who participated in the post-natal semi-independent living component of the program than those who did not. 4) A significant difference was not found between the discharge self-esteem of women who reported as living with a disability at intake, and women who did not. 5) Self-esteem at discharge was found to be healthier with an increased number of days spent at Villa Rosa. 6) Less healthy intake self-esteem was associated with plans not to breastfeed. 7) More supportive attitudes of social support network as measured at intake were shown to be linked to healthier self-esteem at discharge. 8) Experiences of abuse were not shown to be significantly related to discharge self-esteem. Both support received from the significant findings, and a lack of support from insignificant findings, were found for several self-esteem theories.

Objective: to evaluate the risk of obstetric and perinatal outcomes in teenage pregnancy in comparison with adult pregnancy. Methods: retrospective cohort study of 67.693 pregnant women attended in a public hospital in Lima between 2000 and 2010. Obstetric and perinatal outcomes were evaluated. The adolescent group was divided in late adolescents (15-20 years), and early adolescents (<15 years) and was compared among the adult group (20-35 years). Adjusted odds ratios were calculated by education, civil status, prenatal care, previous pregnancies, parity, and pre-gesta-tional BMI. Results: higher risk of cesarean (OR=1,28; CI95%=1,07-1,53) and puerperal infection (OR=1,72; CI95%=1,17-2,53) was found in teenager under 15 years old; as well as higher risk of episiotomy (OR=1,34; CI95%=1,29-1,40) in late teenagers. In addition, this study identified a lower risk of teenage pregnancy for preeclampsia (OR=0,90; CI95%=0,85-0,97), 2nd half-pregnancy bleeding (OR=0,80; CI95%=0,71-0,92), premature rupture of membranes(OR=0,83; CI95%=0,79-0,87), preterm labor (OR=0,87; CI95%=0,80-0,94) and vaginal tearing (OR=0,86; CI95%=0,79-0,93). Conclusion: pregnancy behaves as a risk factor for some obstetric outcomes in the adolescent group, especially in the youngest ones. In addition to maternal age, there are other factors that constitute the need to form multidisciplinary teams to reduce obstetric outcomes in this population. / diego.maticorena@gmail.com / Objetivos: analizar el riesgo de complicaciones obstétricas y perinatales en adolescentes embarazadas en un hospital de Lima, Perú. Métodos: estudio de cohorte retrospectiva de 67.693 gestantes atendidas en el período 2000-2010. Se evaluó complicaciones obstétricas y perinatales. Las adolescentes se clasificaron en tardías (15-19 años) y tempranas (< 15 años) y se compararon con las adultas (20-35 años). Se calculó OR ajustados por educación, estado civil, control prenatal, gestaciones previas, paridad e IMC pregestacional. Resultados: se encontró mayor riesgo de cesárea (OR=1,28; IC95%=1,07-1,53) e infección puerperal (OR=1,72; IC95%=1,17-2,53) en las adolescentes menores de 15 años, así como mayor riesgo (OR=1,34; IC95%=1,29-1,40)de episiotomía en las adolescentes tardías. Asimismo, se identificó un menor riesgo del embarazo adolescente para preeclampsia (OR=0,90; IC95%=0,85-0,97), hemorragia de la 2da mitad del embarazo (OR=0,80; IC95%=0,71-0,92), ruptura prematura de membranas (OR=0,83; IC95%=0,79-0,87), amenaza de parto pretérmino (OR=0,87; IC95%=0,80-0,94) y desgarro vaginal (OR= 0,86; IC95%=0,79-0,93). Conclusión: el embarazo se comporta como factor de riesgo para ciertas complicaciones obstétricas en la población adolescente, especialmente en las adolescentes tempranas. Existen además otros factores, que sumados a la edad materna, constituyen la necesidad de formar equipos multidis-ciplinarios para reducir complicaciones obstétricas en esta población. / Revisión por pares

Made available in DSpace on 2015-07-22T20:49:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-04-29 / Trata-se de um estudo qualitativo com base na abordagem das Representações Sociais, que teve por objetivo conhecer as representações de adolescentes acerca do estar grávida e as subjetividades emergentes deste processo no ambiente da escola. Os sujeitos deste estudo constituíram-se por dois grupos: o primeiro grupo formado por adolescentes e jovens do sexo feminino que estiveram grávidas, com idade delimitada na faixa etária de 10 a 19 anos; o segundo, por adolescentes e jovens de ambos os sexos que fizeram parte do grupo da adolescente na escola. Foi realizado junto ao campo de ação do Projeto de Extensão Universitária “Corporalidade e Promoção da Saúde” da Universidade Federal de São Paulo, que é desenvolvido em três escolas de ensino fundamental e médio e na Unidade Básica de Saúde de referência, situadas na região de Santo Eduardo, município de Embu, São Paulo. Os instrumentos utilizados para coleta dos dados foram a técnica de entrevista individual e a do grupo focal. Optamos pela utilização da técnica de análise de dados das Representações Sociais para tratamento dos dados desvelados pelos discursos dos sujeitos, e a interpretação dos mesmos foi realizada com base nos pressupostos winnicottianos. O Núcleo Central delimitado foi o estar grávida no ambiente escolar, no qual emergiram os seguintes Núcleos Periféricos: A representação do estar grávida; A repercussão da gravidez no ambiente escolar na visão da adolescente; A representação da família segundo a adolescente; A repercussão da gravidez na adolescente segundo o grupo; A relação do grupo com a adolescente grávida. Identificamos que o estar grávida em ambiente escolar apresenta representações e subjetividades no âmbito psicossocial, envolve questões relativas ao relacionamento da adolescente grávida com sua família, com os professores, com a escola e repercute na sua relação com o grupo. / TEDE

Orientador: João Luiz Carvalho Pinto e Silva / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T17:18:23Z (GMT). No. of bitstreams: 1 EspejoCarvacho_IngriddeLourdes_D.pdf: 310301 bytes, checksum: ecf2c9b4bc1df26da82cdcdcd868f818 (MD5) Previous issue date: 2005 / Resumo: Para o Brasil, assim como para outros países, o índice crescente de gravidez na adolescência representa um problema social e de saúde pública devido às repercussões orgânicas, psicológicas e sociais que a gravidez acarreta nesta faixa etária. São vários e complexos os fatores etiológicos envolvidos no fenômeno. Entre eles, a literatura aponta a desinformação das adolescentes sobre o funcionamento do corpo e a falta de acesso aos serviços de saúde, onde as adolescentes são alvo de ações educativas e preventivas apropriadas. Este estudo de corte transversal teve como objetivos verificar o uso de métodos anticoncepcionais e a intenção reprodutiva, avaliar o conhecimento sobre o aparelho genital feminino e alguns aspectos da fisiologia da reprodução, bem como o acesso aos serviços de saúde entre adolescentes gestantes atendidas em uma unidade básica de saúde do Município de Indaiatuba, através de metodologia quantitativa. Foram entrevistadas individualmente 200 adolescentes primigestas no momento de sua primeira consulta de pré-natal, aplicando-se um questionário (pré-testado) com perguntas abertas e fechadas relativas às características sociodemográficas das adolescentes, intenção reprodutiva, uso de métodos anticoncepcionais na primeira relação sexual e antes de engravidar, identificação, localização e função dos órgãos genitais femininos, barreiras de acessos geográfico, econômico, administrativo, psicossocial e à informação, ao serviço de saúde. Na análise descritiva univariada dos dados foram utilizados a distribuição de freqüência absoluta e índices percentuais; na análise bivariada foi aplicado teste qui-quadrado de Pearson ou exato de Fisher, e, na multivariada, regressão logística para analisar a associação entre as características sociodemográficas e reprodutivas e o conhecimento e acesso a serviços de saúde. O conhecimento das adolescentes foi avaliado através da elaboração de três indicadores: anatomia, fisiologia dos órgãos genitais e fisiologia da reprodução, e o acesso ao serviço de saúde através de cinco indicadores de acessos: geográfico, econômico, administrativo, psicossocial e à informação. Concluiu-se que o uso de métodos anticoncepcionais é descontínuo e que a gravidez não foi programada na maioria dos casos. O conhecimento sobre os órgãos genitais femininos foi insatisfatório, principalmente os conceitos fisiológicos da reprodução. A idade e escolaridade das adolescentes, a religião, idade dos parceiros, a diferença de idade do casal e o vínculo com o parceiro após a gravidez associaram-se aos indicadores de conhecimento. Entre as barreiras de acesso ao serviço de saúde foram consideradas significativas apenas as barreiras de natureza psicossocial. A escolaridade, o trabalho, a idade dos parceiros e o vínculo com o parceiro associaram-se com o acesso ao serviço de saúde em suas diversas dimensões. Há a necessidade de novas estratégias para facilitar o acesso ao serviço de saúde pelas adolescentes e que minimizem as barreiras de gênero, respeitem a autonomia das adolescentes e considerem as características e o vínculo com seus parceiros / Abstract: In Brazil, as in other countries, high adolescent pregnancy rates represent a significant social and public health problem due to the organic, psychological and social repercussions of pregnancy in this age group. Several complex etiological factors are involved in this phenomenon. Of these, previous studies have reported misinformation regarding the functioning of the adolescent¿s own body and difficult access to health services where appropriate educational information is provided and preventive actions are implemented. The objective of this cross-sectional study was to assess the prior use of contraceptive methods, reproductive intentions, and the knowledge among pregnant adolescents seeking healthcare at a basic health center in the municipality of Indaiatuba with respect to the female genital organs, some aspects of reproductive physiology and the adolescents¿ perception of healthcare access. Quantitative methodology was used in the data analysis. Two hundred primigravidae were interviewed individually at the time of their first prenatal consultation. A pre-tested questionnaire was applied, containing both open and closed questions regarding the sociodemographic characteristics of the adolescents, their reproductive intentions, use of contraceptive methods during first sexual intercourse and prior to becoming pregnant, identification, localization and function of the female genital organs, geographical, economical, administrative and psychosocial barriers, as well as information barriers to health services. Absolute frequency distribution and percent index were used in the univariate descriptive data analysis. Pearson¿s chi-squared test or Fisher¿s exact test were used in the bivariate descriptive analysis, and logistic regression was used in the multivariate analysis to analyze the association between sociodemographic and reproductive characteristics and knowledge and access to health services. The adolescents¿ knowledge was evaluated by elaborating three indicators: anatomy, physiology of the genital organs and reproductive physiology. Access to health services was evaluated in 5 categories: geographic, economic, administrative, information and psychosocial. Our results show that use of contraceptive methods is sporadic and in most cases the pregnancy was not planned. Knowledge regarding the female genital organs is insufficient, principally with respect to concepts of reproductive physiology. The age and education level of the adolescents, religion, age of partners, age difference within the couple, and the bond with partner after the pregnancy were associated with indicators of knowledge. The only barriers to access to health services that were considered significant were those of a psychosocial nature. Education level, age of partner, bond with partner and employment were, in their individual dimensions, associated with access to health services. There is a need for new strategies to make access to health services easier for adolescents, minimizing gender barriers, respecting the autonomy of the adolescents and taking the characteristics of their partners and the relationship between the adolescents and their partners into consideration / Doutorado / Ciencias Biomedicas / Doutor em Tocoginecologia

Este trabalho apresenta uma pesquisa com adolescentes grávidas e mães de um primeiro bebê (até cinco meses após o parto), usuárias de um serviço público de pré-natal de Santos (SP). O estudo investiga a percepção das adolescentes sobre si mesmas e sobre suas vidas, usando referências psicanalíticas e trabalhando com três instrumentos de pesquisa - questionários, desenhos de auto-retrato e entrevistas em profundidade. Resultados de 82 questionários com adolescentes grávidas indicaram dificuldades com a educação formal anterior à gravidez, figuras maternas valorizadas e figuras paternas avaliadas negativamente, e gravidez em geral aceita e ocorrida numa relação de namoro. A análise de 150 desenhos de auto-retrato de adoescentes grávidas destacou: sinais de ambivalência, auto-imagens não muito prejudicadas, tendência de se retratar num momento mais próximo ao presente, auto-retratos anteriores à gravidez com menos sinais de conflito, desenhos estando grávida com sinais de ansiedade, e auto-retratos posteriores ao parto com indícios compensatórios. A análise de entrevistas em profundidade com 10 adolescentes mães apontou: gravidez relacionada a conquistas de benefícios sociais, grande valorização das figuras maternas e ataques às figuras paternas e aos pais dos bebês (antes mais idealizados), indícios de busca de engravidar, vida sexual sem maiores impedimentos e com algum conhecimento sobre métodos contraceptivos, queixas de perdas quanto a passeios, relação com a escola tendendo a manter a trajetória anterior à gravidez, e relação cuidadosa com o bebê. Para as adolescentes pesquisadas, pertencentes a segmentos mais pobres de população urbana, a gravidez não pareceu percebida de forma negativa e associou-se a alguns ganhos sociais, durante a gestação e os primeiros meses do bebê. / This work presents a research with adolescents in the first pregnancy and becoming mothers, until five months after delivery, using a specialized public service, offered by the city of Santos, SP, Brazil. The study investigates the self perception of the adolescents, using psychoanalytical references and working with three instruments of research: questionnaires, self portrait drawings and interviews in depth. The results of the 82 questionnaires with pregnant adolescents indicated difficulties with formal education prior to the pregnancy, valorized mother figures, negatively evaluated father figures, no objection to the pregnancy and that it has occurred during the dates with the boyfriends. The analysis of 150 self portraits from pregnant adolescents pointed out to signals of ambivalence, self image not much damaged, tendency to make a self portrait in a moment close to the present, self portraits prior to the pregnancy with few signals of conflicts, portraits of pregnants indicating signals of anguish and self portraits prior to the delivery with compensatory evidence. The analysis of the interviews in depth with 10 adolescents mothers indicated pregnancy related to social benefits, great increasing in the mother figures, as well as aggression to the father figures and to the fathers of the babies (better idealized before), indication of provoked pregnancy, fair knowledge about contraceptive methods, sexual life with few obstacles, some complaints about not going out anymore, same relationship with the studies as they had prior to the pregnancy and a careful relationship with the babies. The pregnancy does not seem perceived in a negative way for these adolescents, belonging to the poorer segments of the urban population, rather it can be related to social benefits, during the period of pregnancy and in the beginning months of the baby’s life.

A relação mãe-filho é um dos elementos fundadores do psiquismo humano e é por meio desta que a criança apreende o mundo a sua volta. São muitas as variáveis que interferem nessa relação como, por exemplo, a experiência pessoal, os legados inter e transgeracionais, as condições históricas, sociais, e econômicas. Tendo em vista a fragilidade dos laços afetivos nos dias atuais e a dificuldade no estabelecimento de vínculos que propiciem o sentimento de confiança, segurança e estabilidade, este trabalho tem como objetivo verificar como três jovens mães, que vivenciaram diversos tipos de violências em suas trajetórias, desempenham a função materna. As participantes encontravam-se em um abrigo para jovens mães no município de São Paulo. Foram realizados cinco encontros com cada dupla (mãe e filho) com cerca de uma hora de duração, onde foram explorados conteúdos a respeito da relação da adolescente com sua mãe e a família, a experiência com a gestação e a maternidade, a experiência com as diversas formas de violência e o vínculo com o filho. Foi empregado o método de pesquisa psicanalítico e, portanto, além da comunicação verbal foram analisados aspectos transferenciais e contratransferenciais. Os conteúdos encontrados articulam-se com as idéias de Winnicott. Por meio desse estudo concluiu-se que o sentimento de abandono e vazio causado pela a ausência de uma relação genuína de afeto é transmitido entre as gerações na relação mãe-filho, tendo muitas vezes como consequência a violência. Esta, por sua vez, interrompe o processo de amadurecimento emocional e a conquista de um sentimento de preocupação real com outro. A possibilidade de restaurar laços e dar continuidade ao processo de integração depende em grande parte da sustentação e do apoio (holding) oferecido a essas jovens mães. Nos três casos analisados, observamos que ainda há esperança, segundo a conceituação de Winnicott, de reencontrar uma experiência de afeto significativa, por meio da qual se constitua um sentimento autêntico de preocupação e comprometimento com o próximo / The mother-son relationship is one of the founding elements of the human psyche and it is through this that the child perceives the world around him/her. There are many variables that affect this relationship, for example, personal experience, the inter-and transgenerational legacy and the historical, social, and economic conditions. Given the fragility of the affective bonds today and the difficulty in establishing links that give the feeling of trust, security and stability, this study aims to determine how three young mothers, who experienced several types of violence in their lives, play the maternal role. The participants were in a shelter for young mothers in São Paulo city. Five meetings were conducted with each pair (mother and son) for about one hour, when the relationship between the teenager with her mother and family, her experience with pregnancy and motherhood, her experience with various forms of violence and the bond with her child, were exploited. The psychoanalytic research method was employed and transference and countertransference aspects, which go beyond the verbal communication, were therefore analyzed. The content found can be linked with the Winnicotts ideas. In this study we concluded that the feeling of abandonment and emptiness caused by the absence of a genuine affection is transmitted between generations in the mother-child relationship and frequently has the violence as consequence. The violence stops the process of emotional maturation and the achievement of a sense of real concern to another person. The possibility of restoring ties and continuing the integration process depends largely on the support and assistance (holding) offered to these young mothers. In these three cases, we observed that there is still hope, according to Winnicott\'s concept, to find a meaningful experience of affection, through which it constitutes a genuine feeling of concern and commitment to the other person

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The birth of a new member in the family can cause changes in the routine of this group, requiring an adjustment in the lives of all family members involved in this situation. The changes are related not only to family dynamics, but also to the development of new roles and identities. Currently, some grandparents play the role of caregivers, offering moral, financial and emotional support to children and grandchildren. This dissertation deals with this theme, and is composed by two articles. The first study is a critical integrative review aimed to investigate the scientific publications on the topic of grandparents, published from 2005 to 2015. A search of national studies was performed on the SciELO and PEPSIC databases. They selected 14 articles. It was found that grandparents are important sources of emotional support, and affection both for children and for their grandchildren, particularly in contexts of teenage pregnancy, grandchildren with disabilities and breastfeeding. The second study aims to know how was the process of becoming a grandmother in the context of adolescent pregnancy. The participants were 12 women in the age group of 29-55 years. Information was collected in Health Basic Units of a city in Rio Grande do Sul through semi-structured interviews and incomplete sentences game. The analysis was based on the theoretical model of Grounded Theory (DFT). Becoming a grandmother was found to be characterized by negative (fear, anger, sadness) and positive feelings (happiness). Participants report that they never imagined becoming a grandmother at this time of their lives. Some grandparents consider that being a grandmother is to be the second mother of the child. It highlights the need for development of public policies that address this audience, and the inclusion of their participation in health promotion activities. / O nascimento de um novo membro na família pode provocar mudanças na rotina das pessoas que a compõem, o que torna necessário um ajustamento na vida de todos os familiares envolvidos nesta situação. As mudanças não se relacionam somente a dinâmica familiar, mas também a elaboração de novos papéis e identidades. Atualmente, alguns avós desempenham função de cuidadores, oferecendo apoio afetivo, moral, financeiro e suporte emocional aos filhos e netos. Essa dissertação trata desse tema, sendo composta por dois artigos. O primeiro estudo busca realizar uma revisão integrativa de literatura com o objetivo de investigar as publicações científicas sobre o tema avós , publicadas no período de 2005 e 2015. Foi realizada uma busca de estudos nacionais nas bases de dados SciELO e PePsic. Foram selecionados 14 artigos. Constatou-se que os avós são fontes importantes de suporte emocional, carinho e afeto tanto para os filhos como para os netos, isso é particularmente estudado nos contextos de gravidez na adolescência, netos com deficiência e aleitamento materno. O segundo estudo tem como objetivo conhecer como ocorreu o processo de tornarse avó no contexto da gravidez adolescente. Participaram da pesquisa 12 mulheres na faixa etária dos 29 a 55 anos. As informações foram coletadas em Unidades Básicas de um município do Interior do Rio Grande do Sul por meio de entrevistas semiestruturadas e do jogo de sentenças incompletas. As análises das informações basearam-se no modelo teórico da Teoria Fundamentada nos Dados (TFD). Constatou-se que o momento de tornar-se avó caracteriza-se por sentimentos negativos: medo, raiva, tristeza e, positivo: felicidade. As participantes descrevem que não imaginavam tornar-se avó neste momento de suas vidas. Algumas avós consideram que ser avó é ser a segunda mãe da criança. Destaca-se a necessidade de elaboração de políticas públicas que contemplem esse público, além da inclusão de sua participação nas ações de saúde.

Indiana University-Purdue University Indianapolis (IUPUI) / Birth mothers of open adoption are not well studied. This inquiry explored birth mothers’ experiences surrounding unintended pregnancy and infant open adoption placement. The focused objective was to describe adolescent birth mothers’ lives following pregnancy and adoption placement. This qualitative study used naturalistic inquiry, with participants giving 1 to 2 hour tape recorded telephone interviews. Verbatim transcripts were de-identified and systematically analyzed. Birth mother samples were at either 1 to 5 years or 5 to 15 years after infant open adoption placement. Overall both samples chronicled stories from preconception through current life. Birth mothers of both samples were unanimous in their support of open adoption. The sample of 10 birth mothers who were interviewed 1 to 5 years postplacement shared life descriptions from prepregnancy; pregnancy with the decision for open adoption placement and choice of adoptive family; birth in context with the adoptive parents and birth child; postpartum and discharge. Postplacing birth mother findings were presented using the acronym AFRESH: A–adoption accomplishments; F–fresh start; R–relationships; E–emotions; S–support; H–healing. Personal, social, and relational benefits of open adoption far outweighed pregnancy, birth, and emotional challenges. Even though the process and outcome were “hard,” and included personal obstacles, the open adoption placement was “best.” Birth children were viewed as thriving, blossoming, and having a wonderful life. Adoptive families were cherished like those of extended family. Birth mothers thought health care providers should share the option, and then provide adoption friendly care. They also would advise pregnant teens to choose open adoption. Results from the 5 to 15 years postplacement sample of 5 birth mothers yielded themes of (1) satisfaction about decision for open adoption, choice of adoptive couple, and seeing a thriving birth child; (2) personal milestone accomplishments in education, finances, work, life, and relationships; (3) a sustaining sense of being a better person with an improved life; and (4) the essential need for support during and after the process.