Autora: Sónia Pintassilgo


Artigo| Pintassilgo, S.; Carvalho, H. (2017), Trends and consequences of the technocratic paradigm of childbirth in Portugal: a population-based analysis of birth conditions and social characteristics of parents, Sexual and Reproductive Healthcare, vol.13, 58-67


Resumo: Objective: The aim of this paper is to analyse the evolution of birth conditions in Portugal and to establish a correspondence between maternity care and the socio-economic characteristics of new mothers. Methods: A multivariate quantitative analysis (Multiple Correspondence Analysis and Cluster Analysis) was used, based on official quantitative data from different surveys. Results: There is a consistent trend to a technocratic model of birth in the Portuguese context, where socio-economic characteristics appear to influence fertility rates and birth conditions. The evolution of birth conditions in Portugal reveal the institutionalisation of birth, with a strong presence of doctors, a higher frequency of births on certain weekdays, an increase in the proportion of births in private hospitals and an increase in the frequency of caesarean sections. There is an association between higher social status and more medicalised forms of assistance in childbirth. Women with higher levels of education, aged between 30 and 39 years and who were married tended to be distinguished from the population of Portuguese women as a whole by three factors: birth in a hospital, the standardisation of pregnancy duration and the presence of a doctor at the birth. Women’s educational and professional status also appears to influence their adoption of alternative models of birth, however, such as home birth. Discussion: Limiting the study of childbirth to its medical aspects leaves important dimensions out of the analysis: women’s perception of birth-related risks associated with the medicalised offer of maternity care, and the implications of this childbirth paradigm for health outcomes and for future care.


Autora: Virgínia Batista


Artigo| Batista, Virgínia (2016), “Os partos e as maternidades em Portugal (1889-1943) os casos nas cidades de Lisboa, Porto e Coimbra”, Revista de História Regional, vol. 21, no 2, pp. 364-388


Resumo: O objetivo deste artigo é debater os partos, e seus contextos familiares e sociais, realizados por médicos, a nível regional, em três cidades de Portugal – Lisboa, Porto e Coimbra- entre 1899 e 1943. As datas referem-se aos anos em que começámos e finalizámos as pesquisas nos livros de inscrição das parturientes, em duas maternidades de Lisboa. Pretendemosresponder a três questões principais: − Qual a visão política e social da época sobre o trabalho das mulheres? Houve evolução nos cuidados de saúde das parturientes e dos recém-nascidos? Que sistemas de proteção social foram concedidos às mulheres quando chegavam às maternidades? Seguindo diferentes fontes, concluímos que só as mulheres trabalhadoras mais pobres obtinham assistência social para os partos nos hospitais enquanto só algumas mulheres acediam à previdência social pelo mutualismo ou pelos empregadores.


Consultar: http://revistas2.uepg.br/index.php/rhr/index

Autora: Susana Mourão


Artigo| Mourão, S.; Bernardes, S. F. (2019), What determines immigrant caregivers’ adherence to health recommendations from child primary care services? In Primary Health Care Research & Development


Resumo: Aim: To investigate the diversity and specificity of the determinants of immigrant caregivers’ adherence to child primary care (CPC) health recommendations. Background: Immigrant caregiver’s adherence to CPC health recommendations is of utmost importance to minimize their children’s health-related vulnerabilities. Some research has been conducted on the determinants of immigrants’ access to health services, but much less is known about the determinants of their adherence to health professionals’ recommendations once they get there, especially in a primary health care context. This study contributes to bridge these gaps. Methods: Interviews and focus groups were conducted, with immigrant and non-immigrant caregivers living in Portugal (n=35), from heterogeneous socioeconomic backgrounds. Focus group and individual interview scripts were developed to explore caregivers’ understanding and use of CPC services and, particularly, their adherence to CPC recommendations. A socio- demographic questionnaire was also administered. Qualitative data were analyzed using a grounded theory methodology. Findings: ‘Adherence to CPC health recommendations’ is a core and multidimensional concept. Several determinants were identified at individual, interpersonal, organizational and structural levels. Some determinants were highlighted both by immigrant and non-immigrant caregivers: Valuing children’s health, usefulness of recommendations, perceived health-care professionals’ competence, central role of vaccination in CPC and caregivers’ socio-economic conditions. Other determinants were specifically mentioned by immigrant caregivers: Expectations about traditional versus pharmacological treatments, cultural mismatches in children’s care practices, perceived quality of Portuguese CPC services versus CPC from countries of origin. These results provide innovative theoretical and empirical contributions to the field of primary health care and, particularly, to immigrant caregivers’ adherence behaviors. Implications for research on treatment adherence in primary care contexts, the development of interventions that promote caregivers’ adherence to CPC health recommendations and for child protection will be discussed.


Consultar: https://repositorio.iscte-iul.pt/handle/10071/17706

Autora: Susana Mourão


Artigo | Mourão, S.; Bernardes, S. F.; Carvalho, H. (2021), Assessing caregivers’ adherence to child primary care recommendations: development and validation of a scale In Child Care in Practice


Resumo: Introduction: Caregivers’ adherence to Child Primary Care (CPC) health recommendations is particularly relevant for the protection of children’s health and promotion of their optimal development. Nevertheless, there are currently no measures to assess it, as the majority of measures are focused on pharmacological treatment adherence instead of adherence to preventive health recommendations. Thus, this paper describes the development and validation of a new instrument to assess caregivers’ adherence to CPC health recommendations regarding children aged between 2 years and 6 years old, which would also be sensitive to the specificities of caregivers in more vulnerable conditions—the CPC-Adherence Scale. Methods: Six hundred sixty-two parents (93.4% women; 6.6% immigrant), living in Portugal and with children aged between 2 years and 6 years, participated in a cross-sectional study using a paper or electronic protocol. The protocol was composed by: (1) the CPC- Adherence Scale; (2) questions regarding experiences in CPC; (3) the European Task Force on Patient Evaluation of General Practice Care (EUROPEP); (4) socio-demographic information. Results: The exploratory and confirmatory factor analyses supported a 2-factor solution: (1) Adherence to a safe psychomotor development (n = 14 items; Cronbach’s Alpha = 0.894); (2) Adherence to nutritional counseling (n = 6 items; Cronbach’s Alpha = 0.608). The CPC-Adherence Scale showed good content and criterion-related validity. It discriminated levels of adherence of caregivers with different levels of knowledge about CPC recommendations, satisfaction with care and different socio-economic and immigrant t status. Discussion: The CPC-Adherence Scale is an innovative and promising measure that may play a relevant role on future research and intervention for the promotion of adherence behaviors in a primary prevention context.


Consultar: https://www.tandfonline.com/doi/abs/10.1080/13575279.2020.1776682

Autor: MárioJDS Santos


Artigo | Sadler, M.; Santos, M. J.; Ruiz-Berdún, D.; Rojas, G. L.; Skoko, E.; Gillen, P.; Clausen, J. A. (2016); Moving beyond disrespect and abuse: addressing the structural dimensions of obstetric violence, Reproductive Health Matters, Vol.24, Issue 47


Resumo: During recent decades, a growing and preoccupying excess of medical interventions during childbirth, even in physiological and uncomplicated births, together with a concerning spread of abusive and disrespectful practices towards women during childbirth across the world, have been reported. Despite research and policy-making to address these problems, changing childbirth practices has proved to be difficult. We argue that the excessive rates of medical interventions and disrespect towards women during childbirth should be analysed as a consequence of structural violence, and that the concept of obstetric violence, as it is being used in Latin American childbirth activism and legal documents, might prove to be a useful tool for addressing structural violence in maternity care such as high intervention rates, non-consented care, disrespect and other abusive practices.


Consultar: https://www.tandfonline.com/doi/full/10.1016/j.rhm.2016.04.002

Autor: MárioJDS Santos


Artigo| Santos, M., Augusto, A. (2016), ‘Se estava tudo bem, porque é que eu havia de ir a uma obstetra?’: identidade, risco e consumo de tecnologia médica no parto domiciliar em Portugal, Sociologia, Problemas e Práticas, 82.


Resumo: O parto domiciliar contemporâneo é um fenómeno raro, pouco visível e, enquanto terreno empírico, é pouco explorado. Partindo de entrevistas a mulheres e casais que experienciaram um parto em casa planeado, o artigo pretende fornecer um primeiro retrato sociológico do fenómeno em Portugal. Este surge não como um retorno ao tradicional ou uma procura de uma experiência mística, mas antes como um acontecimento físico concreto, grandemente enformado por conhecimento científico e médico, que se inscreve numa procura de coerência identitária. Emergiram diversas perceções de risco social e de risco médico, tornando-se visível um consumo reflexivo de tecnologias médicas modelado por essas mesmas perceções. Ainda que destitua algum do protagonismo da medicina na gravidez e no parto, de facto não pode dizer-se que se trate de um fenómeno de desmedicalização.


Autor: Mário JDS Santos


Capítulo de livro| Clausen, J., Santos, M. (2017), Capturing the complexity of practice as an insider: in-labour ethnography, in Church, Sarah et al. (eds.), New Thinking on Improving Maternity Care: International Perspectives, London: Pinter & Martin Ltd.


Autor: Mário JDS Santos


Artigo| Santos, M. (2017), Where the thread of home births never broke – an interview with Susanne Houd, Women and Birth, Vol.30, Issue 2


Resumo: Background The option of a planned home birth defies medical and social normativity across countries. In Denmark, despite the dramatic decline in the home birth rates between 1960 and 1980, the right to choose the place of birth was preserved. Little has been produced documenting this process. Aim To present and discuss Susanne Houd’s reflection on the history and social dynamics of home birth in Denmark, based in an in-depth interview. Methods This paper is part of wider Short Term Scientific Mission (STSM), in which this interview was framed as oral history. The whole interview transcript is presented, keeping the highest level of detail. Findings In Susanne Houd’s testimony, four factors were highlighted as contributing to the decline in the rate of home births from the 1960s to the 1970s: new maternity hospitals; the development of obstetrics as a research-based discipline; the compliance of midwives; and a shift in women’s preference, favouring hospital birth. The development of the Danish home birth models was described by Susanne Houd in regard to the processes associated with the medicalisation of childbirth, the role of consumers, and the changing professional dynamics of midwifery. Conclusion An untold history of home birth in Denmark was documented in this testimony. The Danish childbirth hospitalisation process was presented as the result of a complex interaction of factors. Susanne Houd’s reflections reveal how the concerted action of consumers and midwives, framed as a system-challenging praxis, was the cornerstone for the sustainability of home birth models in Denmark.


Consultar: https://www.sciencedirect.com/science/article/abs/pii/S1871519216301159

Autor: Mario JSD Santos


Artigo | Neves, D. M.; Santos, M. (2018), Babies born better: o uso do software MaxQDA na análise preliminar das respostas portuguesas à secção qualitativa do inquérito, Revista de Pesquisa Qualitativa, Vol.6, n.º10.


Resumo: A saúde materna envolve um vasto conjunto de conhecimentos e práticas que visam não só a promoção da saúde na gravidez e parto mas também uma experiência que seja entendida como positiva pelas mulheres. O inquérito Babies Born Better tem como objetivo informar o debate público sobre a qualidade dos cuidados de saúde, partindo do discurso das mulheres. Baseado na componente qualitativa do inquérito, este artigo consiste num ensaio de recurso ao MaxQDA para a análise das respostas portuguesas. A utilização deste software revelou ser útil à mediação entre os dados e a análise, facilitando a sistematização da informação. A análise veio salientar a importância da relação entre as mulheres e os profissionais de saúde, enquanto fator estruturante das experiências de parto.


Consultar: https://editora.sepq.org.br/index.php/rpq/article/view/210

Autor: Mario JDS Santos


Artigo| Santos, M. (2018), Can the unequal access to home birth be framed as a source of inequalities? A comparison between Portugal and Denmark, Portuguese Journal of Social Science


Resumo: Planned home births happen across Europe, but there are countries and formal limitations can be found by This article draws upon a short research project conducted in Denmark in March 2014, which aimed to explore the organization of home birth in Denmark and to compare it to the Portuguese case. Private home births, in Portugal, and publicly funded home births, in Denmark, show interesting similarities when looking at the individual experience of choosing and planning a birth at home. However, through this comparative analysis, I argue that the limitations imposed around the option of home birth in Portugal raise important inequalities between women and families planning to give birth at home and those planning a hospital birth. The success:fa models found in Denmark can potentially serve as grounds for a broader discussion and as a trigger for change in Portuguese policies, to promote ethical and evidence based practices among professionals, and the improvement in perinatal health outcomes for families who experience planned home births.


Consultar: https://www.ingentaconnect.com/content/intellect/pjss/2018/00000017/00000003/art00005