O processo de gestar e parir entre os Guajajara da área de abrangência do polo base de Arame, no Estado do Maranhão

Abstract

This is a qualitative research with an ethnographic approach that aims to study childbearing and giving birth among the Guajajaras in the Arame complex area, in Maranhão State. For this purpose, this study sought to describe the main sociocultural practices and the traditional indigenous care patterns, as well as the therapeutic itinerary of the indigenous pregnant, reports the influence of western medical practices in the universe of Guajajaras women, and identifies the problem-situations of these women in relation to the theme studied. The results show that the process of childbearing and giving birth among the Guajajaras involves sociocultural practices and unique traditional care, with the menarche and the “moqueado feast” as the beginning of this process. The pregnancy is a period of no rituals or specific care. Child birth that in less than three decades ago, in its great majority, was performed in the village, in squatting position, surrounded by people who the pregnant trusted, nowadays is performed mainly in hospitals with the pregnant alone or just with restricted company, in a lithotomy position, and having medical or surgical interventions. In the post-natal period special care is experienced and a series of food and physical restriction happens in 30 to 40 days immediately after the postpartum. The therapeutic itinerary of these women is complex and influenced by many factors like: age, prior personal and/or family experience, difficulties in transportation and communication, precarity in health assistance t o the villages, as well as the incentive to the hospital birth given by the professionals. Among the factors that appear to influence most in the changing occurred in the process of childbearing and giving birth Guajajara over time are: the lengthy time of coexistence with the “non-indigenous” population, the evangelization of the population, the ethnocentric practices of the healthy system, and the apparently fragility of FUNAI’s performance. Even with the use of biomedicine knowledge at some time during the pregnant and puerperal cycle, the majority of the Guajajaras is able to articulate their traditional knowledge with the biomedical technicians. It was concluded that, in one hand the inclusion of new therapeutic resources in this process brought possib le benefits, as the capacity of resolution, and the search for minimization of health risks; on the other hand, it has created risks and damage like the childbearing medicalization. This research reveals an urgent necessity to revise the assistance given to this population in order to provide a secure service, of quality, and that not only consider the sociocultural aspects and the parties involved, but also that the two knowledges can be used harmonically so that the provision of health services can be offered in a decent way.