Saúde mental na gestação e puerpério: proposta pedagógica de intervenção em uma unidade básica de saúde do Distrito Federal

Abstract

Introduction: Scientific studies have shown a significant increase in the incidence and prevalence rates of psychological suffering / psychiatric disorders in pregnant and postpartum women in Brazil. However, it can be seen that the work processes developed for gestational and puerperal care in the Primary Health of the Federal District are still focused on physical / clinical signs and symptoms, privileging the biomedical model in prejudice of the biopsychosocial. Objectives: The present research aims to understand the perceptions of health professionals, pregnant and postpartum women of the Basic Health Unit of Vicente Pires about mental health in the pregnancy-puerperal cycle, in order to implement an interventional proposal for the qualification of mental health care during the prenatal and postpartum follow-up care offered at this health unit. Methods: It is based on the methodological design of Action-Research, of an applied nature and descriptive-explanatory objectives, using, as collection procedures, semi-structured interviews and participant observation. Sixteen health professionals and 18 women participated in the study, distributed among 14 pregnant and 4 puerperal women. For the analysis and interpretation of the data, the Content Analysis was used. Results and Discussion: The results pointed to stigmatized representations on mental health; focus of prenatal and postpartum actions in the clinical/physical/biological dimension; approaches to psychological suffering and/or psychosocial vulnerability that are inadequate from the theoretical-technical point of view in health studies; shortage of mental health care spaces in the pregnancy-puerperal cycle, despite the demand of the pregnant and puerperal women; excessive referrals to specialized services; inherent challenges in the work processes of the health unit, and barriers to access prenatal and postpartum quality care in Brazilian public health system. Based on the results and the diagnosis made at the unit, a pedagogical intervention proposal was implemented – a sensitization and instrumentation workshop – as a powerful strategy to trigger reflections and transformations on prenatal and postpartum care practices in the public health system of Federal District. Final Considerations: New studies in the area, greater investment in training and permanent education, and improvement of mental health care flows for pregnant and puerperal women in Primary Health Care are suggested.