O processo de desenvolvimento de um programa de visitação domiciliar para adolescentes gestantes e mães

Abstract

Este trabalho tem como objetivo relatar o processo de desenvolvimento de um programa de visita domiciliar para adolescentes gestantes e mães, implementado pelo Núcleo de Estudos da Violência da Universidade de São Paulo (NEV/USP). O local inusitado em que este programa tem origem um núcleo de pesquisas que tem como seu principal eixo de trabalho a relação entre democracia e direitos humanos, possibilitou que alguns conceitos, muitas vezes implícitos nas práticas de intervenção, fossem questionados e revistos a partir de questões relacionadas à cidadania, direitos e a democracia. Neste sentido, buscou-se, a partir de uma leitura de Michel Foucault sobre as práticas govenamentalizadas de poder, discutir questões que, tomadas como verdades, passam a acionar práticas prescritivas, normatizas e regularizadoras. Práticas que ativam e reativam relações de poder, muitas vezes de forma arbitrária e autoritária, principalmente quando tem alvo de suas intervenções o pobre e/ou a população empobrecida. Tendo como foco os saberes e, consequentemente, a produção discursiva que se forma em torno da adolescência e, posteriormente da gravidez na adolescência, buscou-se compreender em que contexto esta última se transforma não só em problema como também, a partir de sua associação com as idéias de risco e vulnerabilidade, passa a justificar práticas interventivas focadas, sobretudo, no indivíduo e/ou população. Por fim, busca-se descrever como estas questões conceituais foram constantemente tensionando os saberes e as práticas tanto da equipe envolvida na criação e implementação de um programa como também, posteriormente, das próprias participantes.Palavras Chave: Biopolítica, Adolescência, Gravidez na Adolescência, Risco, Vulnerabilidade, Programa de Visita Domiciliar The objective of this work is to report the process of development of a program of home visitation for adolescent pregnant women and adolescent mothers carried out by the Center for the Study of Violence of the University of São Paulo (NEV/USP). The unexpected institution where this program was born -a research center that has as its main axe of work the relationship between democracy and human rights -, made it possible that some of the concepts, frequently implicit on intervention practices, be questioned and revised from the point of view of matters of citizenship, rights and democracy. Departing from a reading of Michel Foucault about the governmentalized practices of power relations, this work sought to discuss matters that, taken as truths, trigger prescriptive, normative and regulating practices. Practices that activate and reactivate power relations, very often on arbitrary and authoritarian way, especially when the focuses of interventions are poor individuals or poor communities. Having as its focus the knowledge and, therefore, the discursive production that takes form surrounding adolescence and, latter, surrounding pregnancy during adolescence, the thesis sought to understand in which context this last one transforms itself into problems, as well as, f...

Public Policies for Promotion of Maternal-Infant Health in Brazil: Some Experiences with Adolescent Mothers in São Paulo

“…Therefore, upon reaching the UBS to confirm that they are pregnant, many adolescents say that they suffer negative or prejudiced comments. This reaction by health professionals runs counter to the stance proposed by humanized services, in that they do not welcome reproductive demands or recognize the adolescent as a holder of rights capable of making autonomous decisions [15].…”

“…Therefore, we can conclude that the notion of adolescent pregnancy being a problem reflects more the social, cultural, economic, and demographic issues of a community than biomedical risks. And as such, we cannot homogenize or generalize about the conceptions of what leads an adolescent woman to become pregnant [15][16][17][18].…”

“…This is not to say that the phenomenon should be treated as something normal, because it is not-but neither is it something abnormal. The proposition here is that we should discuss this matter outside of the scope of a universalizing and naturalizing view of normal/abnormal in order to seek out a new way of thinking that will allow for more humanized practices [15].…”

“…Furthermore, even in those cases where the family expressed dismay with the news of the pregnancy, primarily because they knew the difficulties that would be faced-lack of economic resources, dropping out of school and the subsequent problems in entering the labor market, and the adolescent's lack of maturity to care for a baby, among others-soon there was acceptance and increasing family support. It is also worth noting that in many cases, the adolescent had already left her parents' home and lived with her partner and the child's father, such was the couple's desire to have children [15,24].…”

“…Among pregnant women older than 20, 84.1% began prenatal care during the first 3 months: 30.3% starting in the first month, 36.8% during the second month, and 17% during the third month. Among pregnant women aged [15][16][17][18][19]73.6% began prenatal care during the first 3 months: 17.8% during the first month of pregnancy, 34.2% during the second month, and 21.6% during the third month [22].…”