RESUMO
INTRODUCTION: Indigenous peoples in the state of Chihuahua, Mexico, are known to outsiders as the Tarahumaras. The Tarahumaras are one of the few cultural groups known to have no traditional birth attendants, and Tarahumara women often give birth alone and outdoors. Currently, little is known about this group, their health status or their culture. OBJECTIVE: The objective of this study was to assess the state of reproductive health outcomes, risks, protective factors, beliefs and behaviors in the Tarahumara population. DESIGN: This paper reports on the qualitative results of a mixed methods study, comprised of focus groups, interviews, participatory exploratory methods, ethnographic observation and household surveys investigating the reproductive health status of the Tarahumara peoples and contextual factors influencing it. Qualitative data is presented, supported by preliminary quantitative findings. RESULTS: This study supports speculation that the Tarahumara population is burdened by severe maternal health problems. The sample size was too small to definitively assess risk factors for the outcome of maternal mortality, but qualitative findings point to some important contextual issues that contribute to participants' perceptions of susceptibility to and severity of the problem, their reproductive health beliefs and behaviors, and barriers to behavior change. Major issues included disparities in biomedical knowledge, trust between non-indigenous providers and indigenous patients, and structural issues including access to medical facilities and infrastructure. CONCLUSION: Qualitative data is drawn upon to make recommendations and identify lessons applicable to similar situations where cultural minorities suffer serious health inequities. This study underscores the importance of needs and assets assessment, as it reveals unique contextual factors that must be taken into account in intervention design. Also, collaborative partnership with community members and leaders proved to be invaluable in the research, warranting further collaboration by both governmental and non-governmental groups attempting to improve the health of this population. This becomes especially important when making and enforcing health policy.
Assuntos
Atitude Frente a Saúde/etnologia , Características Culturais , Comportamentos Relacionados com a Saúde/etnologia , Indígenas Norte-Americanos , Bem-Estar Materno/etnologia , Tocologia , Saúde Reprodutiva/etnologia , Feminino , Grupos Focais , Disparidades nos Níveis de Saúde , Parto Domiciliar , Humanos , Lactente , Mortalidade Infantil/etnologia , Recém-Nascido , Entrevistas como Assunto , México/epidemiologia , Gravidez , Pesquisa QualitativaRESUMO
Las mujeres indígenas en toda América Latina, incluyendo Panamá, presentan condiciones de inequidad en lo que se refiere a la salud sexual y reproductiva. La fecundidad elevada, el alto índice de embarazo adolescente, y la falta de una adecuada atención y asistencia a la salud materna, son evidencia de esto. Las altas tasas de mortalidad materna están relacionadas con falta de cobertura de los servicios de salud sexual y reproductiva...
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Humanos , Bem-Estar Materno/etnologia , Desigualdades de Saúde , Mortalidade Materna/etnologiaRESUMO
OBJECTIVE: to explore the experiences and perceptions of parenthood and maternal health care among Latin American women living in Spain. DESIGN: an exploratory qualitative research using focus groups and thematic analysis of the discussion. SETTING AND PARTICIPANTS: three focus groups with 26 women from Bolivia and Ecuador and three focus groups with 24 midwives were performed in three towns in the Valencian Community receiving a large influx of immigrants. FINDINGS: the women interpreted motherhood as the role through which they achieve fulfilment and assumed that they were the ones who could best take care of their children. They perceived that men usually make decisions about sex and pregnancy and recognised a poor or inadequate use of contraceptive methods in planning their pregnancies. Women reported that it was not necessary to go as soon and as frequently for health examinations during pregnancy as the midwives suggested. The main barriers identified to health-care services were linked to insecure or illegal employment status, inflexible appointment timetables for prenatal checkups and sometimes to ignorance about how public services worked. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: empowering immigrant women is essential to having a long-term positive effect on their reproductive health. Antenatal care providers should be trained to build maternity care that is culturally sensitive and responds better to the health needs of different pregnant women and their newborns.
Assuntos
Serviços de Saúde Materna , Bem-Estar Materno , Tocologia , Poder Familiar , Adulto , Bolívia/etnologia , Competência Cultural , Equador/etnologia , Emigrantes e Imigrantes , Feminino , Grupos Focais , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Serviços de Saúde Materna/métodos , Serviços de Saúde Materna/normas , Bem-Estar Materno/etnologia , Bem-Estar Materno/psicologia , Bem-Estar Materno/estatística & dados numéricos , Tocologia/métodos , Tocologia/normas , Poder Familiar/etnologia , Poder Familiar/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Fatores Sexuais , Percepção Social , Fatores Socioeconômicos , Espanha/epidemiologiaRESUMO
This qualitative research project explores how poverty, the built environment, education, working conditions, health care access, food insecurity and perceived discrimination are experienced by Puerto Rican Latinas through the course of their lives. Five focus groups were conducted with the primary objective of documenting community experiences and perspectives regarding: 1) stress, including perceived discrimination based on race/ethnicity (racism); 2) the impact of stress on Puerto Rican women of reproductive age, their families, and/or their community; and 3) stressors that affect maternal health. Focus groups were conducted in English and Spanish in the two cities with the highest rates of premature birth and low infant birthweight in the state of Connecticut. Focus group findings indicate that participants perceived poverty, food insecurity, lack of access to quality education, and unsafe environments as significant life stressors affecting maternal and child health.
Assuntos
Hispânico ou Latino/psicologia , Bem-Estar Materno/etnologia , Bem-Estar Materno/psicologia , Estresse Psicológico/etnologia , Adolescente , Adulto , Pesquisa Participativa Baseada na Comunidade , Connecticut , Feminino , Grupos Focais , Abastecimento de Alimentos , Acessibilidade aos Serviços de Saúde , Humanos , Gravidez , Resultado da Gravidez/etnologia , Preconceito , Cuidado Pré-Natal/estatística & dados numéricos , Porto Rico/etnologia , Pesquisa Qualitativa , Fatores de Risco , Meio Social , Apoio Social , Fatores Socioeconômicos , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
A significant body of research on minority health shows that although Latino immigrants experience unexpectedly favorable outcomes in maternal and infant health, this advantage deteriorates with increased time of residence in the United States. This study evaluates the underlying assumptions of two competing hypotheses that explain this paradox. The first hypothesis attributes this deterioration to possible negative effects of acculturation and behavioral adjustments made by immigrants while living in the United States, and the second hypothesis attributes this deterioration to the mechanism of selective return migration. Hypothetical probabilistic models are simulated for assessing the relationship between duration and birth outcomes based on the assumptions of these two hypotheses. The results are compared with the empirical research on the maternal and infant health of first-generation, Mexican-origin immigrant women in the United States. The analysis provides evidence that a curvilinear pattern of duration and birth outcomes can be explained by the joint effects of both acculturation and selective return migration in which the former affects health status over the longer durations, and the latter affects health status at shorter durations.
Assuntos
Aculturação , Emigrantes e Imigrantes/estatística & dados numéricos , Bem-Estar do Lactente/etnologia , Bem-Estar Materno/etnologia , Americanos Mexicanos/estatística & dados numéricos , Resultado da Gravidez/etnologia , Simulação por Computador , Emigração e Imigração/estatística & dados numéricos , Feminino , Humanos , Lactente , Saúde das Minorias/etnologia , Saúde das Minorias/estatística & dados numéricos , Gravidez , Fatores de Tempo , Estados Unidos/epidemiologiaRESUMO
Introdução - A área de "saúde materna", tradicional na saúde pública, tem sido enriquecida e tornada mais complexa pelo surgimento dos conceitos de "saúde integral da mulher" e posteriormente, de saúde sexual e reprodutiva. Os três conceitos reconhecem as dimensões sócio-econômicas envolvidas na área, no entanto, enquanto os dois conceitos mais recentes enfatizam as dimensões sócio-culturais e de gênero, a saúde materna como campo de conhecimento é frequentemente associada a uma versão essencialista e conservadora da maternidade e das relações de gênero - o chamado materno-infantilismo. Objetivos - Descrever e analisar as transformações políticas e conceituais relacionadas ao campo/área de saúde materna, em sua interação com os seguintes conceitos: saúde sexual e reprodutiva, direitos sexuais e reprodutivos, violência de gênero, as noções de evidências em saúde materna, e vieses de gênero na saúde materna e perinatal; a criação e a utilização de indicadores gênero-sensíveis e de uma agenda de pesquisa em gênero e saúde materna no SUS. Método - Releitura e análise de uma seleção de textos sobre o tema, como autora única ou com colaboradores e alunos, de forma a refinar os conceitos que foram esboçados no decorrer da produção científica, e suas implicações para a criação de indicadores gênero-sensíveis em saúde materna. Resultados - Foram desenvolvidos ou refinados os seguintes conceitos relacionados ao gênero e aos direitos sexuais e reprodutivos na saúde materna: violência de gênero nas ações de saúde materna, integridade corporal materna, dano iatrogênico associado à assistência materna, dor iatrogênica associado à assistência materna, bem-estar materno, pessimização do perto, visibilidade de gênero dos desfechos, hierarquias sexuais-reprodutivas, práticas baseadas em direitos e evidências. Conclusão - Os vieses de gênero que modulam a saúde materna se expressam na superestimação dos benefícios da tecnologia, na subestimação ou na negação dos desconfortos e efeitos adversos das intervenções, e em modelos de assistência correcionais e discriminatórios. O reconhecimento e a transformação destes aspectos políticos e culturais das práticas são fundamentais para atingir uma atenção à saúde materna mais efetiva, segura, humana e baseada em direitos.
Assuntos
Humanos , Feminino , Bem-Estar Materno/etnologia , Relações Interpessoais , Direitos da Mulher , Brasil , Saúde Mental , Indicadores Sociais , Violência/etnologiaAssuntos
Comportamentos Relacionados com a Saúde/etnologia , Serviços de Saúde Materna/organização & administração , Tocologia/organização & administração , Mães/educação , Papel do Profissional de Enfermagem , Complicações na Gravidez/prevenção & controle , Adulto , Terremotos , Feminino , Haiti , Humanos , Bem-Estar Materno/etnologia , Relações Enfermeiro-Paciente , Gravidez , Complicações na Gravidez/etnologia , Saúde da Mulher/etnologiaRESUMO
BACKGROUND: A significant body of research on minority health shows that while Hispanic immigrants experience unexpectedly favorable outcomes in maternal and infant health, their advantage deteriorates with increased time of residence in the USA. This is referred to as the 'acculturation paradox.' OBJECTIVE: We assess the 'acculturation paradox' hypothesis that attributes this deterioration in birth and child health outcomes to negative effects of acculturation and behavioral adjustments made by immigrants while living in the USA, and investigate the potential for the existence of a selective return migration. DESIGN: We use a sample of Mexican immigrant women living in two Midwestern communities in the USA to analyze the effects of immigrant duration and acculturation on birth outcomes once controlling for social, behavioral, and environmental determinants of health status. These results are verified by conducting a similar analysis with a nationally representative sample of Mexican immigrants. RESULTS: We find duration of residence to have a significant and nonlinear relationship with birth outcomes and acculturation to not be statistically significant. The effect of mediators is minimal. CONCLUSION: The analyses of birth outcomes of Mexican immigrant women shows little evidence of an acculturation effect and indirectly suggest the existence of a selective return migration mechanism.
Assuntos
Aculturação , Emigrantes e Imigrantes , Emigração e Imigração , Bem-Estar do Lactente/etnologia , Bem-Estar Materno/etnologia , Chicago , Feminino , Inquéritos Epidemiológicos , Hispânico ou Latino , Humanos , Lactente , México/etnologia , WisconsinRESUMO
RATIONALE: Childhood asthma is a major public health problem, with mainland and island Puerto Rican children having the highest asthma rates of any ethnic group in the United States. OBJECTIVES: To examine the relationship between maternal mental health problems, prenatal smoking, and risk of asthma among children in Puerto Rico and the Bronx, New York. METHODS: A cross-sectional community-based study was conducted in the South Bronx in New York City and the San Juan Standard Metropolitan Area in Puerto Rico. Participants were Puerto Rican children 5 to 13 years of age and their adult caretakers with probability samples of children 5 to 13 years of age and their caregivers drawn at two sites: the South Bronx in New York City (n = 1,135) and San Juan and Caguas, Puerto Rico (n = 1,351). MEASUREMENTS: Self-reported maternal mental health, prenatal smoking, and rates of childhood asthma. Results. Maternal mental health problems were associated with significantly higher levels of prenatal smoking, compared with that among women without mental health problems (p < 0.0001). Both maternal mental health problems and prenatal smoking appear to make a contribution to increased odds of asthma among youth. After adjusting for prenatal smoking, the relationship between maternal mental health problems and childhood asthma was no longer statistically significant. CONCLUSIONS: Previous research suggests children of Puerto Rican descent are especially vulnerable to asthma. Our results suggest that maternal mental health problems and prenatal smoking are both associated with increased odds of asthma among Puerto Rican youth and that prenatal smoking may partly explain the observed relationship between maternal psychopathology and childhood asthma. Future longitudinal and geographically diverse epidemiological studies may help to identify the role of both maternal mental health problems and prenatal smoking in the health disparities in childhood asthma.
Assuntos
Asma/etiologia , Hispânico ou Latino/estatística & dados numéricos , Bem-Estar Materno/etnologia , Saúde Mental , Fumar/efeitos adversos , Fumar/psicologia , Adolescente , Adulto , Asma/epidemiologia , Asma/etnologia , Criança , Pré-Escolar , Feminino , Humanos , Entrevistas como Assunto , Masculino , Bem-Estar Materno/estatística & dados numéricos , Transtornos Mentais/complicações , Cidade de Nova Iorque/epidemiologia , Razão de Chances , Gravidez , Trimestres da Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Porto Rico/epidemiologia , Fumar/etnologiaRESUMO
OBJECTIVE: To describe on a national basis ethnic differences in severe maternal morbidity in the United Kingdom. DESIGN: National cohort study using the UK Obstetric Surveillance System (UKOSS). SETTING: All hospitals with consultant led maternity units in the UK. PARTICIPANTS: 686 women with severe maternal morbidity between February 2005 and February 2006. MAIN OUTCOME MEASURES: Rates, risk ratios, and odds ratios of severe maternal morbidity in different ethnic groups. RESULTS: 686 cases of severe maternal morbidity were reported in an estimated 775 186 maternities, representing an estimated incidence of 89 (95% confidence interval 82 to 95) cases per 100 000 maternities. 74% of women were white, and 26% were non-white. The estimated risk of severe maternal morbidity in white women was 80 cases per 100 000 maternities, and that in non-white women was 126 cases per 100,000 (risk difference 46 (27 to 66) cases per 100 000; risk ratio 1.58, 95% confidence interval 1.33 to 1.87). Black African women (risk difference 108 (18 to 197) cases per 100,000 maternities; risk ratio 2.35, 1.45 to 3.81) and black Caribbean women (risk difference 116 (59 to 172) cases per 100 000 maternities; risk ratio 2.45, 1.81 to 3.31) had the highest risk compared with white women. The risk in non-white women remained high after adjustment for differences in age, socioeconomic and smoking status, body mass index, and parity (odds ratio 1.50, 1.15 to 1.96). CONCLUSIONS: Severe maternal morbidity is significantly more common among non-white women than among white women in the UK, particularly in black African and Caribbean ethnic groups. This pattern is very similar to reported ethnic differences in maternal death rates. These differences may be due to the presence of pre-existing maternal medical factors or to factors related to care during pregnancy, labour, and birth; they are unlikely to be due to differences in age, socioeconomic or smoking status, body mass index, or parity. This highlights to clinicians and policy makers the importance of tailored maternity services and improved access to care for women from ethnic minorities. National information on the ethnicity of women giving birth in the UK is needed to enable ongoing accurate study of these inequalities.
Assuntos
Bem-Estar Materno/etnologia , Complicações na Gravidez/etnologia , Adolescente , Adulto , África/etnologia , Ásia/etnologia , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Reino Unido/epidemiologia , Índias Ocidentais/etnologia , Adulto JovemRESUMO
OBJECTIVE: to present information on traditional practices and medicinal uses of plants for treating health diseases related to the reproductive cycle of Criollo women living in the hills of the province of Córdoba; and to interpret these uses in the context of this population's folk medicine. DESIGN: data were collected during several field trips to the study area based on the guidelines of a research project that included ethnographic and ethnobotanical aspects of the study area. SETTING: a rural community of central Argentina. PARTICIPANTS: a total of 62 peasants were interviewed on the basis of a semi-structured system. Repeated open and extensive interviews were also undertaken with seven women who had previously worked as midwives in areas of difficult access. FINDINGS: this study found that 12 different female diseases and complaints are treated using a total of 48 plant species belonging to 27 botanical families, with 71 different medicinal uses. The traditional beliefs and practices associated with maternal-baby health care in rural areas highlights the existing combination of principles reformulated from humoral medicine, the use of analogical reasoning, and ontological and functional interpretations of morbid processes. The principle of Hypocratical opposition and hot-cold categorisation are significant criteria that rule over the practices of mother and child health care during birth and puerperium. IMPLICATIONS FOR PRACTICE: consequences of traditional knowledge on the health care of peasant women are discussed, based on the analysis of traditional practices from a peasant's point of view.
Assuntos
Atitude Frente a Saúde/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Bem-Estar Materno/etnologia , Medicina Tradicional , Extratos Vegetais/uso terapêutico , Adulto , Argentina , Comportamento Ritualístico , Características Culturais , Feminino , Humanos , Recém-Nascido , Plantas Medicinais , Gravidez , Cuidado Pré-Natal/métodos , Saúde da População RuralRESUMO
OBJECTIVES: We analyzed trends in mortality among infants born to White and to Black or mixed-race women in 3 population-based cohorts representing all births in 1982, 1993, and 2004 in Pelotas, southern Brazil. METHODS: Births were assessed during daily visits to all maternity hospitals. Maternal skin color was classified by the interviewers as White or Black or multi-racial. We used logistic regression to adjust for socioeconomic, demographic, and health services variables. RESULTS: The mortality rate among infants born to White mothers declined from 30.4 per 1000 live births in 1982 to 13.9 per 1000 in 2004, compared with 53.8 per 1000 to 30.4 per 1000 among those born to Black and mixed-race mothers. Differences for neonatal mortality were even more marked, with reductions of 47% and 11% for infants born to White and Black or mixed-race women, respectively. Adjusted analyses showed that ethnic group differences in neonatal and infant mortality were partly explained by differences in poverty and prenatal care. CONCLUSIONS: Over a 22-year period, improvements in health indicators were greater for infants born to White women than for other infants. The widening racial gap requires special attention from policymakers.
Assuntos
Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Disparidades nos Níveis de Saúde , Mortalidade Infantil/etnologia , Bem-Estar Materno , Adolescente , Adulto , Brasil/epidemiologia , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Entrevistas como Assunto , Masculino , Bem-Estar Materno/etnologia , Dinâmica Populacional , Estudos Prospectivos , Fatores de Risco , Fatores SocioeconômicosRESUMO
OBJECTIVES: We assessed the influence of maternal anthropometric and metabolic variables, including glucose tolerance, on infant birthweight. METHODS: In our prospective, population-based cohort study of 1041 Latino mother-infant pairs, we used standardized interviews, anthropometry, metabolic assays, and medical record reviews. We assessed relationships among maternal sociodemographic, prenatal care, anthropometric, and metabolic characteristics and birthweight with analysis of variance and bivariate and multivariate linear regression analyses. RESULTS: Forty-two percent of women in this study entered pregnancy overweight or obese; at least 36% exceeded weight-gain recommendations. Twenty-seven percent of the women had at least some degree of glucose abnormality, including 6.8% who had gestational diabetes. Maternal multiparity, height, weight, weight gain, and 1-hour screening glucose levels were significant independent predictors of infant birthweight after adjustment for gestational age. CONCLUSION: Studies of birthweight should account for maternal glucose level. Given the increased risk of adverse maternal and infant outcomes associated with excessive maternal weight, weight gain, and glucose intolerance, and the high prevalence of these conditions and type 2 diabetes among Latinas, public health professionals have unique opportunities for prevention through prenatal and postpartum interventions.
Assuntos
Peso ao Nascer/fisiologia , Diabetes Gestacional/etnologia , Intolerância à Glucose/etnologia , Bem-Estar Materno/etnologia , Americanos Mexicanos/estatística & dados numéricos , Obesidade/etnologia , Fenômenos Fisiológicos da Nutrição Pré-Natal/etnologia , Medição de Risco , Aumento de Peso/etnologia , Adulto , Antropometria , Diabetes Gestacional/metabolismo , Diabetes Gestacional/fisiopatologia , Feminino , Intolerância à Glucose/metabolismo , Intolerância à Glucose/fisiopatologia , Humanos , Recém-Nascido , Bem-Estar Materno/classificação , México/etnologia , Michigan/epidemiologia , Obesidade/metabolismo , Obesidade/fisiopatologia , Gravidez , Cuidado Pré-Natal , Prevalência , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos , Aumento de Peso/fisiologiaRESUMO
Various studies have observed that infants born to foreign-born women have better birth outcomes (lower rates of preterm, low birth weight, and infant mortality) than those delivered to US-born women. While much attention has been given to the "healthy migrant effect" as an explanation for these positive outcomes, this theory has not been examined in an internally migrant population. The purpose of this study is to examine the relationship between maternal mobility history and birth outcomes among infants born to US resident mothers of Mexican origin. The study used 1995-1999 National Center for Health Statistics (NCHS) live birth/infant death cohort files of singleton infants delivered in the US to white women of Mexican origin (n = 2,446,253). Maternal mobility history (MMH), which refers to the relationship between the maternal place of birth and the state of residence at delivery, was categorized into the four following groups: (a) foreign-born-place of birth outside the US and delivery in the US; (b) outside-region-place of birth in one US region and delivery in another US region; (c) within-region-place of birth in one US region and delivery in a different state in the same US region; and (d) within-state-place of birth and delivery in the same US state. Consistently, there is evidence to support the healthy migrant effect in an internally migrant population. Unique to this study are the findings that infants born to mothers with outside-region MMH had a lower risk of low birth weight (LBW) and small-for-gestational age (SGA) compared to those who did not move. Overall, this study provides evidence that the healthy migrant effect and its relationship to birth outcomes can be applied to an internally migrant population.
Assuntos
Emigração e Imigração/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Bem-Estar Materno/etnologia , Americanos Mexicanos/estatística & dados numéricos , Resultado da Gravidez/etnologia , Adulto , Estudos de Coortes , Modificador do Efeito Epidemiológico , Feminino , Humanos , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , México/etnologia , Gravidez , Medição de Risco , Estados Unidos/epidemiologiaRESUMO
El material presentado en este documento está organizado en distintos acápites: en la sección situación se intenta mostrar las distintas barreras culturales y de calidad que dificultan el acceso de las usuarias, particularmente indígenas, al establecimiento de salud; en la sección Algunas experiencias presenta trabajos de equipos de salud en proyetos que buscan soluciones a las problemáticas tratadas; en la sección recomendaciones se detallan una serie de sugerencias operativas que los equipos de salud pueden tomar como guía para la adecuación cultural de los servicios y de programas que responden a la realidad cultual y a las necesidades de la población
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Masculino , Feminino , Humanos , Bem-Estar Materno/etnologia , Prova de Trabalho de Parto , Parto , Parto Domiciliar , Apresentação no Trabalho de Parto , Cuidado Pré-Natal , Bolívia , GravidezRESUMO
Mães com bebês recém-nascidos internados em UTI Neonatal encontram-se em delicada espera aguardando a evolução da saúde dos filhos. Relatos obtidos em tal momento de fragilidade evidenciaram grande diversidade de situações, fugindo à expectativa de que o nascimento de um filho ocorra em condições de estabilidade e entendimento familiar/conjugal. Foram examinados 144 relatos de entrevistas de mães cujos bebês apresentavam bom prognóstico. Dados foram analisados a partir da confecção de um elenco de categorias de conteúdos sobre família, vida conjugal/amorosa, e maternidade, em procedimento de análise de conteúdo. Os resultados evidenciaram predominância de mães com até 20 anos, que não executam trabalho remunerado, com escolaridade concentrada no ensino fundamental, e que viviam uniões consensuais ou já estavam separadas quando da entrevista. A reação inicial da mãe e/ou pai do bebê à notícia da gravidez foi, predominantemente, de aceitação, apesar da interrupção da gestação ter sido cogitada como possibilidade. No caso das famílias de origem, a reação inicial foi, predominantemente, desfavorável. Constatou-se a importância de que a análise das temáticas abordadas no trabalho caminhe atrelada à análise do contexto social, econômico, cultural e familiar, implicando um repensar das práticas de análise e intervenção pertinentes.(AU)
Mothers with newborn babies submitted to intensive care at hospital units find themselves in a delicate situation while waiting for the evolution of their children's health. Reports obtained in such a fragile moment revealed a great diversity of situations, diverging from the expectation that a child's birth occurs under conditions of stability and familial/conjugal understanding. An amount of 144 reports from interviews of mothers whose babies presented a good prognosis were examined. Data were analyzed based on a set of content categories about family, conjugal/love life, and motherhood, in a content analysis procedure. The results show the predominance of mothers less than 20 years old, who do not perform paid work, with formal education concentrated in the elementary and junior high school levels, and who lived consensual relationships or were already separated when the interview took place. The mothers' and fathers' initial reaction to the pregnancy news was of acceptance, although the idea of interruption was considered. In the case of the origin families, the initial reaction was, predominantly, unfavorable. This study showed that it is important that the analysis of the theme studied in this work is linked to the analysis of the social, economic, cultural, and familial context, implying a rethinking of the pertinent analysis and intervention practices.(AU)
Assuntos
Comportamento Materno/psicologia , Bem-Estar Materno/etnologia , Unidades de Terapia Intensiva Neonatal , Relações FamiliaresRESUMO
Helicobacter pylori infection causes chronic digestive diseases that disproportionately affect Hispanics and other immigrant groups in the United States. Information on the epidemiology of H. pylori infection in pregnant women who reside along the U.S.-Mexico border is critical to understanding the dynamics of current H. pylori transmission patterns within families along the border. We describe the epidemiology of H. pylori infection in pregnant women recruited from Women, Infants, and Children (WIC) clinics in El Paso, Texas, and Mexican Social Security Institute maternal-child clinics in Ciudad Juarez, Mexico, from April 1998 to October 2000. We interviewed participants regarding environmental factors and tested their serum for IgG antibodies. We used logistic regression to estimate associations between environmental exposures and the odds of H. pylori prevalence. Definitive serological tests were available from 751 women. Seroprevalence was 74% in Juarez women and 56% in El Paso women. Prevalence increased with age, crowding, poor sanitation, and residence in Mexico, decreased with education, and was not associated with the woman's number of living children. In the U.S.-Mexico border region, women of reproductive age have a high prevalence of H. pylori infection, apparently related to poor socioeconomic conditions.
Assuntos
Infecções por Helicobacter/etnologia , Helicobacter pylori/isolamento & purificação , Bem-Estar Materno/etnologia , Americanos Mexicanos/estatística & dados numéricos , Complicações Infecciosas na Gravidez/etnologia , Adolescente , Adulto , Emigração e Imigração , Feminino , Pesquisa sobre Serviços de Saúde , Infecções por Helicobacter/microbiologia , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Estudos Soroepidemiológicos , Texas/epidemiologiaRESUMO
This paper explores the content, prevalence, and determinants of husbands' involvement in two aspects of their wives' maternal health: (1) providing advice and care during pregnancy and (2) attending birth. Using primarily women's reports of their spouses' involvement taken from qualitative and survey data from a sample of rural Guatemalan households, I find that husband participation is relatively high compared to some expectations and that the dynamics of male involvement differ between the two aspects. The analysis of receiving advice or care from husbands during pregnancy, an analysis done only among women who experienced a complication during pregnancy, suggests that the type of prenatal care sought and the quality of the familial and marital relationships are important factors. On the other hand, husbands' attendance at birth seems driven more by men's availability and access to birth. Together, the data show that "male involvement" is not a singular behavior and point to ways to conceptualize its complexity.
Assuntos
Relações Interpessoais , Casamento , Bem-Estar Materno/psicologia , Homens/psicologia , Apoio Social , Cônjuges/psicologia , Adolescente , Adulto , Aconselhamento , Escolaridade , Feminino , Guatemala , Humanos , Trabalho de Parto , Masculino , Bem-Estar Materno/etnologia , Gravidez , Complicações na Gravidez/psicologia , Cuidado Pré-Natal , População Rural , Cônjuges/etnologiaRESUMO
OBJECTIVE: To describe perceived well-being and functional status during uncomplicated late pregnancy among low-income minority women, and to examine the relationship of functional status to depression and social support. METHODS: Hispanic and black women with low-risk pregnancies completed an interview consisting of demographics, the Medical Outcomes Study Short Form 36 (SF-36), Beck Depression Inventory-II (BDI-II), and the Norbeck Social Support Questionnaire. RESULTS: Of the 155 women who were eligible and asked to participate, 41 refused for a participation rate of 74%. Results of the SF-36 showed lowest perceived well-being in the vitality and physical role dimensions. Depressive symptomatology was high, with a mean BDI score of 15 (standard deviation 8.6). Using a BDI score of 14 as the cutoff point, over half of the sample was categorized as having significant depressive symptoms. Significantly lower functional status was seen for depressed subjects in all subscales of the SF-36 compared with nondepressed subjects. Although functional status was negatively correlated with BDI score in all dimensions (r =.23-.69), correlation of SF-36 scores with social support was much weaker (r =.06-.24). CONCLUSION: Elevated levels of depressive symptomatology are strongly correlated with lowered health-related functioning and perceived well-being. Social support is not associated with increased physical or emotional well-being but is weakly associated with mental health as measured by the SF-36.
Assuntos
População Negra , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/etnologia , Bem-Estar Materno/etnologia , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/etnologia , Apoio Social , População Branca , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Análise de Variância , Atitude Frente a Saúde , República Dominicana/etnologia , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Hispânico ou Latino/estatística & dados numéricos , Humanos , Incidência , Jamaica/etnologia , México/etnologia , Cidade de Nova Iorque/epidemiologia , Gravidez , Terceiro Trimestre da Gravidez , Porto Rico/etnologia , Qualidade de Vida , Medição de Risco , Fatores Socioeconômicos , América do Sul/etnologiaRESUMO
OBJECTIVES: This study sought to determine the relationship between maternal nativity and the postneonatal mortality rate of urban Mexican-American infants. DESIGN: This is a population-based study. METHODS: Stratified and logistic regression analyses were performed on a data set of 1992-1995 computerized birth-death records of all Mexican-American infants born to Chicago residents with appended 1990 United States Census income and 1995 Chicago Department of Public Health data. RESULTS: In Chicago, Mexican-American infants (N = 10,599) of US-born mothers had a postneonatal mortality rate of 3.2/1,000 compared to 2.1/1,000 for infants (40,813) of Mexico-born mothers; relative risk (95% confidence interval) equaled 1.5 (1.0-2.3). The adjusted odds ratio of postneonatal mortality was 1.4 (1.1-1.9) for Mexican-American infants of US-born mothers. The mortality rate due to preventable causes (sudden infant death syndrome, homicides, non-intentional injuries, and infections) for Mexican-American infants of US-born mothers was twice that of infants of Mexico-born mothers; relative risk (95% confidence interval) equaled 2.2 (1.3-3.8); this nativity differential persisted in non-impoverished communities. CONCLUSION: The postneonatal mortality rate of urban Mexican-American infants with US-born mothers exceeds that of infants with Mexico-born mothers. This nativity disparity is attributable to preventable causes.