Para além do parto: a manutenção-mudança das práticas obstétricas
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Data
2019-04-24
Autores
Andrade, Ana Carolina Julio da Silva
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Universidade Federal do Espírito Santo
Resumo
This PhD. dissertation aims to analyze how obstetrical practice organization motivates the practitioners (not) to opt for a “humanized” normal birth, contributing to the maintenance and/or the change of giving birth as a social practice. I used the practice ontoepistemology according to Schatzki and I conducted a Practice-Based Study in a Brazilian public maternity. Birth is revealed as the intersection of three practices: medical practices, maternal/paternal practices and healthcare management practices. In this overlapping of practices a social movement emerges in favor of changing practices and a more “humanized” maternity care. One of the goals of this movement is to reduce high cesarean rates. My argument is that maintenance and change constitute a single process of "maintaining-changing"; which emphasizes that these phenomena have a recursive relation. The first theoretical contribution of this dissertation is the explicit and direct analysis of obstetrical practices changing process. The second contribution is the analysis of "maintaining-changing" practices as a single, simultaneous and recursive process. The third contribution is to overcome the apparent dichotomy between "maintaining" and "changing" phenomena. In addition, this study reinforces the understanding of "changing" as not an uncommon episode, but as a constitutive element of organizational/social life. This dissertation also reaffirms that "micro" and "macro" phenomena are mutually constituted, once changing process results from a interdependent relationship between local practices and their broader contexts. Finally, in practical terms, this dissertation can contribute to public policies that understand obstetrical practices beyond medical techniques, taking into account its historical-social context. The second contribution is the analysis of a seemingly punctual health issue (giving birth) in a wider way. Thus, other health issues could be analyzed in the same way, since problems such as childhood obesity are also part of a practice nexus
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Práticas sociais , Mudança organizacional , Processos organizativos , Parto humanizado , Gestão hospitalar , Maternidade , Social practices , Organizational change , Organizing , Humanized birth , Hospital management , Maternity