Os primeiros casos de Aids surgiram no início da década de 1980 provocando reações de medo, preconceito e impotência na população e também na comunidade científica. Estudos epidemiológicos indicaram, naquela época, maior incidência de casos entre indivíduos homossexuais estabelecendo, inicialmente, uma relação entre os casos de adoecimento e a conduta de integrantes de grupos historicamente marginalizados. Paralelamente, investigações clínicas demonstraram fragilidade imunológica entre os indivíduos acometidos e conduziram as pesquisas à descoberta de um agente infeccioso, o HIV (Human Immunodeficiency Virus). As mudanças na forma de compreender e descrever a epidemia de HIV/Aids acompanharam estes processos e passaram, por fim, a considerar condições materiais e subjetivas de vida como elementos estruturantes da vulnerabilidade à contaminação. Neste contexto, as relações de gênero e a submissão do feminino são elementos importantes para a discussão da vulnerabilidade entre mulheres e seus efeitos para as práticas de prevenção. Este estudo buscou identificar, no relato de gestantes soropositivas ao HIV, sentidos acerca de suas vivências na(s) relações conjugais, relações familiares e sociais, convivência com a soropositividade, saúde reprodutiva e a experiência da maternidade, analisando-os sob a perspectiva das relações de gênero e da vulnerabilidade feminina. Foram realizadas entrevistas individuais com dez gestantes soropositivas ao HIV em atendimento pré-natal junto ao Ambulatório de Moléstias Infecciosas em Ginecologia e Obstetrícia (AMIGO) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto USP (HCFMRP-USP), serviço público de saúde e referência para a região. Os resultados apontam que dificuldades para distribuição do poder nas relações de gênero e a precarização das condições de vida são elementos estruturantes do processo de vulnerabilização ao contágio por HIV; há ainda rompimento de relações sociais e descontinuidade das perspectivas de vida em decorrência do medo do preconceito e da morte provocados pelo diagnóstico de soropositividade e um esforço para o redimensionamento do cuidado com os filhos, além de estratégias para reorganização da vida que vão se configuram ao longo do processo de enfrentamento ao contágio. Na maioria dos casos analisados, as mulheres reconhecem a si como vítimas da ação de seus parceiros, culpando-os pelo contágio. Aponta-se a necessidade de reestruturação das práticas de saúde no atendimento a mulheres soropositivas ao HIV, considerando a necessidade de fortalecimento de seus recursos cognitivos e afetivos para o enfrentamento das vicissitudes do contágio e consequente ruptura com a naturalização como vítimas. Dentre as estratégias para o fortalecimento destas mulheres, a discussão de sua apropriação do processo do contágio e a problematização do aceite tácito da pretensa superioridade masculina e das exigências do parceiro ou da família, são propostas para que se reconheça a passividade feminina como elemento que vulnerabiliza as mulheres, além de fragilizar práticas preventivas (CAPES). / The first AIDS cases appeared at the begining of 1980s provoking fear reactions, prejudice and impotence on the population and also on the scientific community. Epidemical studies indicated, in that time, a larger number of cases incidence among homosexual individuals demonstrating, at the beginning, a relationship between the illness cases and the group integrals marginal behaviour historically. Parallel, clinical investigations demonstrated immunology weakness among the onset individuals and conducted the researches to find out an infectious agent, HIV (Human Immunodeficiency Virus). Changes on the form of understanding and describing the HIV/AIDS epidemic followed these processes and at the end turned into considering material and subjective conditions of life as structural elements of the vulnerability among women and its effects for the prevention practices. This study searched to identify, concerning to HIV-positive pregnant women, considering their married, family and social relationship life history, familiarity with positive serum, reproductive health and maternity experience, analysing them under a perspective of female gender vulnerability relations. Individual interviews with ten HIV-positive pregnant women, who were pre-natal assisted in a gynaecology and obstetrics infectious deseases ambulatory (AMIGO) in Hospital das Clinicas da Faculadae de Medicina de Ribeirão Preto USP (HCFMRP-USP), a public health service as well as a reference for the region, were carried out. The results show that difficulties to the power distribution on gender relations and precariousness conditions of life are structural elements of HIV vulnerabity; yet there is a break of social relations and life perspectivity discontinuity due to prejudice and fear of death coming from the positivity serum and also an effort to redeem their childrens care, besides strategies to reorganize their lives occurences that will appear together with facing the contagion process. In the majority of the analysed cases, these women recognize themselves as being her partners actions, victims, blaming them for the contagion. Practice structures needs, in health attendance to these women, are pointed out, considering the necessity to reenforce their cognitive and affective resources, in order to face contagion vicissitudes and consequently rapture with the naturalization as victims. Among the strategies to the reenforcement of these women, the discussion of their appropriation contagion process as well as the assumed male superiority tacit acceptance problematic and families and husbands demandings are proposals to female passiviness as an element of women vulnerability, besides weakening preventive practices (CAPES).

Thesis. 1979. M.Arch.--Massachusetts Institute of Technology. Dept. of Architecture. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCH. / Bibliography: leaves 89-92. / M.Arch.

New Jersey is one of only three states in the United States offering a paid maternity leave benefit beyond temporary disability insurance at the present time. Understanding the impact of state maternity leave policies on low-income mothers is of particular urgency, since previous research suggests this group is less likely to utilize paid leave than wealthier women. In addition, existing literature also suggests that in a poverty environment, with its already existing vulnerability to social, emotional, cognitive, and health impairments, rapid return to work postpartum may be particularly damaging to the physical and emotional health of both mothers and their babies. This study examines the effectiveness of the New Jersey law mandating payments to postpartum mothers who were employed before giving birth. Using a mixed methods approach, outcomes from high- and low-income mothers were compared regarding the usage and impact of Family Leave Insurance (FLI), New Jersey’s paid family leave policy. For the quantitative study, data from 497 postpartum mothers from the Center for Disease Control’s 2012 Pregnancy Risk Assessment Monitoring System (PRAMS) data set were analyzed. For the qualitative study, three high- and three low-income mothers from the same New Jersey county were interviewed in depth, and six narrative profiles were constructed. Data from the qualitative and quantitative analyses were combined. Consistent with existing literature, quantitative results suggested poor FLI utilization. However, there was no significant association (p > .05) between low-income status (household income under $22,000) and FLI usage. A statistically significant (p < .05) association between FLI usage and postpartum depression in low-income mothers was noted. Qualitative findings supplemented and explained the quantitative results. The qualitative data suggested policy underutilization stemmed from poor public awareness due to inadequate publicity, lack of community education, and poor advisement on the part of human resource personnel and New Jersey Department of Labor of Workforce Development call-in center advisors. Results also suggest that if parameters of FLI and the awareness of the policy remain the same, the benefits existing research associates with paid maternity leave will not be fully reaped by New Jersey families.

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Orientador: Maria de Fátima Araújo / Banca: Hélio Rebello Cardoso Júnior / Banca: Maria Lúcia Boarini / Resumo: Este trabalho problematiza as práticas discursivas e não discursivas referentes ao papel materno que circulam no âmbito da saúde pública e no contexto da família. Para isso utilizamos um programa de saúde materno-infantil - o Programa Canguru, contextualizando historicamente os elementos envolvidos tanto em sua concepção quanto em sua efetivação: o conceito de maternidade, as práticas de maternagem e as políticas de humanização ao atendimento desenvolvido nas instituições hospitalares. Nosso objetivo foi analisar como estes elementos se articulam na construção de novos sentidos para o papel materno. Para isso entrevistamos dez mulheres usuárias do Programa Canguru num hospital da rede pública e também as observamos durante esta prática. Na análise dos dados utilizamos como método a análise do discurso. A partir de núcleos de sentidos apreendidos nos discursos das entrevistadas, definimos quatro dimensões de análise: família e religião; o impacto do nascimento prematuro; desconfiança e resistência nas relações com instituições e profissionais de saúde; e a experiência com o Programa Canguru. No trabalho analítico buscamos apreender o processo de singularização e as estratégias utilizadas pelas entrevistadas na produção de sentidos sobre a maternidade e as práticas de maternagem. A família, estruturada de forma hierárquica e com rígida divisão de papéis segundo o sexo, aparece como o principal organizador das experiências das entrevistadas e dos sentidos atribuídos à maternidade. O exercício da maternidade é descrito como essencial para a constituição do papel feminino. A religião surge... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This paper question the speech practices and non speech referring at the maternal function that are around the ambit of the public health and in the family context. For that was used a health program of maternal-childish - The Kangaroo Care, putting on the historical context the elements that are involved as much the conception as the effectuation: the concept of maternity, the practices of maternal care and the policy of humanization of the service developed at the hospital institutions. Our goal was analyze how these elements are articulate at the construction of new feelings to maternal play. So we interviewed ten women that was usurers of the Kangaroo Care in a public hospital and we observed them during the practice too. At the analyze of the dates it was used as a method the analyze of the speech. From the nucleus of the senses took at the speech of the subject, were define four dimensions to analyze: family and religion; the impact of the premature birth; suspicion and resistance in relations with institutions and health workers; and the experience with the Kangaroo Care. At the analytic work we tried to took the process of the signalize and the strategies used by the subjects at the production of the feelings about the maternity and the practices of maternal care. The family that has a hierarchy structure and rigid division of places according to the sex, appears as a mainly organizer of the experiences of the subjects and of the feelings attributed to maternity. The exercise of the maternity is descript as essential to the constitution of the feminine place. Religion shows up as an important element to guarantee the emotional support to the family in situation of crises, such as a premature birth of a child... (Complete abstract, click electronic access below) / Mestre

This thesis is a hermeneutic phenomenological study of the concept of disclosure in maternity care contexts using the example of sexual orientation. There is a significant body of literature within psychology and sociology relating to the health and social purposes and consequences of disclosure. There is a further body of outcomes-focused evidence relating to disclosure of sexual orientation in health care. There is, however, little research undertaken into the disclosure of sexual orientation in pregnancy as an action with motive and purpose. This study aimed to address this issue. The study employed unstructured interviews with eight lesbian mothers, seven of whom were birth mothers and one was a social mother. The hermeneutic method used an iterative process of analysis integrating researcher pre-understandings, thematic analysis of individual interview transcripts and broader analysis of the individual interview data within the total interview data, exploring the parts within the whole. The aim was to identify the shared meaning of disclosure for the participants Data analysis resulted in five main themes: being invisible/visible; being upfront; being me; being entitled; being safe. An additional finding was the process of managing negativity through strategies such as rationalisation. Three encompassing concepts were identified: protection; power; and identity. Two motivations for disclosure were also identified: pro-action and altruism The thesis concludes that disclosure is a motivated and purposeful act which has real meaning and consequences. It makes extensive recommendations for midwifery practice including acknowledging the disclosure, understanding the legal complexity, and recognising the lesbian family. Recommendations for policy suggest having explicit and detailed policies that include information about how to be inclusive rather than only abstract concepts of inclusion. Recommendations for research include qualitative and quantitative research with midwives about attitudes and knowledge as well as research exploring the role of the social mother in promoting family health outcomes.

The use of mainstream maternity services by urban Aboriginal women is an important issue for health professionals. Aboriginal mothers are much more likely to die in childbirth than are non-Aboriginal mothers and their excessive risk does not appear to have changed over the last two decades. The infant mortality rate is three times higher than for non-Aboriginal infants. Therefore, this project aimed to discover the cultural needs of urban Aboriginal women who use mainstream maternity services. Six Aboriginal women who were attending the ante-natal clinic at Daruk Aboriginal Medical Service were interviewed. The thesis included the following recommendations and strategies for their implementation: 1/. Establishment of a discrete Aboriginal women's health unit in Western Sydney. 2/. Provision of culturally acceptable education about pregnancy and childbirth. 3/. Promotion of breastfeeding. 4/. Education and encouragement for non- Aboriginal health professionals. / Master of Nursing (Hons)

In this study, the childbearing women's perception of the role of a midwife in Australia was explored using a descriptive study. Data was gathered using a semi structured questionnaire.The findings revealed that childbearing women in Australia overwhelmingly believed a midwife is specifically trained and qualified to deliver babies normally and to care for a woman in labour.In addition, the belief was that a midwife is trained to provide a comprehensive range of maternity related tasks.The overriding themes which emerged identified the midwife as a source of advice, information, support, education, guidance, specific midwifery knowledge and being a liason person between the doctor and the pregnant woman.Limitation of the role of a midwife was believed to be due to the nursing based training of a midwife.The findings from this study revealed that childbearing women in Australia, United Kingdom and Singapore have similar perceptions of a midwife's role.Recommendations were made for further studies to investigate the reasons for a persistent lack of information regarding the role of a midwife and the type of information required by pregnant women. / Master of Nursing (Hons.)

Masters Research - Master of Philosopy (MPhil) / For almost 20 years it has been known that the most common cause of preventable adverse events in hospital is communication problems between clinicians (1, 2). Within maternity services, ineffective communication has a strong relationship with adverse events for women and babies (3). Despite this knowledge, the ‘turf wars’ between some midwives and some doctors are a continuing concern. Although the link between poor communications and adverse events has been well known for a long time, no real change in how professions relate to each other has occurred. This dissertation describes a project that was designed to answer the research question: What factors affect interprofessional interaction in birthing units and how do these interactions impact on birthing outcomes? Midwives and doctors from 10 geographically diverse maternity units contributed to this qualitative research project. In-depth interviews were conducted. Analysis and theorizing was guided by feminist Interpretive Interactionism. New findings, about how health services can strengthen interprofessional collaboration in maternity services, are presented and explained. I argue that organisational factors are more important than the personalities of the individuals involved in the interactions because organisational factors frame, direct and limit what discourses and therefore behaviours, are possible. The dissertation ends with some procedural guidelines that show how administrators and clinical leaders can create and maintain collaborative work settings for public sector midwives and doctors.

Thesis (M. Nurs.)--University of Hong Kong, 2006.