Made available in DSpace on 2016-04-28T20:39:48Z (GMT). No. of bitstreams: 1 Jorge Ramalho do Carmo.pdf: 927088 bytes, checksum: d999c9075d7132fc048ac22f635d5500 (MD5) Previous issue date: 2008-06-06 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / In the process of disenfranchised loss there is little or no opportunity for public expression to facilitate the mourning process, with few chances of sharing the grief of the loss openly. The fetal pathologies incompatible with life outside the womb are losses that happen during pregnancy or shortly after birth and it is not considered socially significant because it is as if the mother had no time to develop bond with the baby. This study aimed to examine and understand the process of grief through a case study related to the interruption of a anencephalic fetus pregnancy, identifying characteristics and peculiarities as the issue of religion and the family and social support at this kind of loss. It was conducted at Hospital Municipal de Sabóya Arthur Ribeiro, known as Jabaquara Hospital in Sao Paulo. The participant was a woman who had interrupted the pregnancy of a anencephalic fetus, and was submitted to an interview based on a semi-structured guide. Information was discussed through analysis of its content and the process of mourning was characterized from the peculiarity of the loss by lethal fetal abnormality and interruption of pregnancy. It was observed that the gestation s history characteristics influence the development of the process of mourning. The difficulties of healthcare professionals in dealing with patients in this situation were also observed. There is a gap of support between the diagnosis and the period of hospitalization that leaves the woman without guidance and emotional support in such difficult loss. The symptoms of unrecognized mourning are intensified depending of family s type of support that can be offered and also the religious support for these specific cases of pregnancy s interruption. Finishing this study is the possibility to understand the lacks of assistance to these women, concerning to the disenfranchised loss process. The determinant factors in Brazilian reality concerning to the mourning process include the religious support, the attitude of healthcare professionals from reference services, the family s support and personal structure. Reflect about these topics is an opportunity to think about the quality of care to these women and the continual support to the mourning process / No processo de luto não reconhecido existe pouca ou nenhuma oportunidade de expressão pública para facilitar o processo de luto, com poucas chances de se dividir abertamente o pesar da perda. As patologias fetais incompatíveis com a vida fora do útero são perdas que se concretizam durante a gestação ou logo após o parto, não sendo considerado socialmente significativo, pois é como se a mãe não tivesse tempo de vincular com o bebê. Esta pesquisa teve por objetivo analisar e compreender o processo de luto por meio de um estudo de caso relacionado à interrupção da gestação por feto anencéfalo, identificando características e particularidades como a questão da igreja e do apoio familiar e social neste tipo de perda. Foi realizado no Hospital Municipal Arthur Ribeiro de Sabóya, conhecido como Hospital Jabaquara em São Paulo. A participante foi uma mulher que interrompeu a gestação de feto anencéfalo, que se submeteu a uma entrevista partindo de um roteiro semi-estruturado. Por meio da análise de conteúdo as informações foram discutidas e o processo de luto caracterizado a partir da peculiaridade da perda por anomalia fetal letal e interrupção da gravidez. Observouse que as características da história da gestação influenciam no desenvolvimento do processo de luto. A dificuldade dos profissionais de saúde no manejo de pacientes nesta situação também foram observados. Desde o diagnóstico até o período de internação existe uma lacuna na assistência que acaba deixando a mulher sem orientação e suporte emocional frente a uma perda tão difícil de ser elaborada. O luto não reconhecido tem sua sintomatologia intensificada sofrendo influências do tipo de apoio que a família consegue oferecer e também de como se caracteriza o apoio religioso para estes casos de interrupção da gestação. Concluir este estudo é a possibilidade de perceber carências na assistência a essas mulheres, frente ao seu processo de luto não reconhecido. Fatores determinantes da realidade brasileira frente ao processo de luto incluem o apoio da igreja, a postura dos profissionais de saúde dos serviços de referência, o apoio familiar e a estrutura da pessoa. Refletir a respeito destes tópicos é uma possibilidade de se pensar na qualidade da assistência a estas mulheres e da continuidade do apoio frente ao processo de luto

The thesis deals with possible ways of coping with the consequences of miscarriage. The theoretical part first defines the topic of pregnancy from a medical and psychological point of view. It also includes the definition of miscarriage types. Furthermore, an overview of the experience of the child's loss in the early stages of pregnancy is elaborated, impacts on the psyche of the woman and manifestations in her behavior are considered. The process of grieving by individual authors is considered in the context of the early loss of the child. The issue of termination of pregnancy is also seen from the perspective of trauma theory. Possible protective and risk factors accompanying the loss-making process are discussed. Last but not least, the following professional psychological, medical and lay care for a woman after the loss of a child is mentioned. The empirical part of the thesis deals with the affection of the whole phenomenon of child loss during the early stages of pregnancy. Emphasis is placed on the mapping of protective and risk factors with which women had their own experience. The empirical part is based mainly on interviews with women with experience of loss of a child and with professionals who work in this field. Data evaluation was based on grounded theory principles. Keywords:...