Life Lived: Experiences of Extreme Maternal Morbidity. Stories of Women Survivors and Caregivers. Subregion of Urabá, Antioquia, 2016
DOI:
https://doi.org/10.17533/udea.rfnsp.v36n3a12Keywords:
maternal health, pregnancy complications, human capacities, autobiography, qualitative research, quality of health care, caregiversAbstract
Objective: To interpret the experience of women survivors and caregivers with regards to facing an event of extreme maternal morbidity in the subregion of Urabá, Antioquia 2016. Methodology: Autobiographical narrative research, which seeks to reconstruct the experience through a reflective process. A selection process was carried out for women survivors of extreme maternal morbidity and their caregivers, and in-depth conversational interviews were conducted for the construction of the narratives. The stories were transcribed textually and an interpretative process was made using an instrument that takes into account three mimetic moments based on Paul Ricoeur’s theory of the hermeneutic arc. Furthermore, ethical considerations relevant to this type of research were taken into account. Results: The story of surviving extreme maternal morbidity in Urabá gives meaning to the resignification of human care and the recognition of human capabilities. Conclusions: With the emergence of feelings of practical rationality, affiliation and emotions in the stories of survivors and caregivers, the experience of extreme maternal morbidity, understood as a narrative event, is shown in a richer and more humane way. The capabilities approach proposed by Nussbaum makes it possible to assess the quality of life, identify limitations of the social environment in order to unfold them, and reveal the absence of capabilities, inequality and ignorance of rights. This opens an area of study regarding life stories of extreme maternal morbidity from an ethical and political perspective of social justice in health.
Downloads
References
(1). Lotufo F, Parpinelli M, Haddad S, Surita F, Cecatti J. Applying the new concept of maternal near-miss in an intensive care unit. Clinics [internet]. 2012 [citado 2014 oct. 24]; 67(3):225-30. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3297030/. doi: 10.6061/clinics/2012(03)04.
(2). Lori JR, Starke AE. A critical analysis of maternal morbidity and mortality in Liberia, West Africa. Midwifery [internet]. 2012 [citado 2014 sep. 28]; 28(1):67-72. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21232836. doi: 10.1016/j.midw.2010.12.001.
(3). Haddad SM, Cecatti JG, Souza JP, Sousa MH, Parpinelli MA, Costa ML, et al. Applying the maternal near miss approach for the evaluation of quality of obstetric care: A worked example from a Multicenter Surveillance Study. BioMed Res Int [internet]. 2014 [citado 2014 oct. 15]; 1-10. Disponible en: https://www.hindawi.com/journals/bmri/2014/989815/. doi: http://dx.doi.org/10.1155/2014/989815.
(4). World Health Organization. Regional Office for Europe. (2004). Making pregnancy safer: First regional workshop on “Beyond the Numbers”: reviewing maternal and perinatal deaths and complications, Issyk Kul, Kyrgyzstan 30 May-2 June 2004. Copenhagen: WHO Regional Office for Europe [internet]. 2004 [citado 2014 oct. 20]; 1-21. Disponible en: http://apps.who.int/iris/handle/10665/107602
(5). Say L, Souza JP, Pattinson RC. Maternal near miss--towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol [internet]. 2009 [citado 2014 oct. 17]; 23(3):287-96. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/19303368. doi: 10.1016/j.bpobgyn.2009.01.007.
(6). Mbalinda SN, Nakimuli A, Nakubulwa S, Kakaire O, Osinde MO, Kakande N, et al. Male partners’ perceptions of maternal near miss obstetric morbidity experienced by their spouses. Reprod Heal [internet]. 2015 [citado 2016 mar. 30]; 12(1):23. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4384277/pdf/12978_2015_Article_11.pdf. doi: 10.1186/s12978-015-0011-1.
(7). Luna F. Vulnerabilidad: la metafora de las capas. Jurisprud Argentina [internet]. 2005 [citado 2016 ago. 24]; 4(3):60-7. Disponible en: http://www.saludcapital.gov.co/Capacitaciones Comit de tica para la Investigacin/6 Sesión 16 julio 2014/Luna_F[1]._Vulnerabilidad_la_metafora_de_las_capas.pdf
(8). Zuleta Tobón JJ. Editorial. La morbilidad materna extrema: una oportunidad para aprender de experiencias exitosas en el manejo de la complicación obstétrica. Fed Colomb Obstet y Ginecol [internet]. s. a. [citado 2014 ago. 15]; 180-1. Disponible en: http://www.scielo.org.co/pdf/rcog/v58n3/v58n3a01.pdf
(9). Pacagnella RC, Cecatti JG, Parpinelli M A, Sousa MH, Haddad SM, Costa ML, et al. Delays in receiving obstetric care and poor maternal outcomes: Results from a national multicentre cross-sectional study. bmc Pregnancy Childbirth [internet]. 2014 [citado 2014 oct. 24]; 14:159. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4016777&tool=pmcentrez&rendertype=abstract. doi: 10.1186/1471-2393-14-159.
(10). Pacheco AJC, Katz L, Souza ASR, de Amorim MMR. Factors associated with severe maternal morbidity and near miss in the São Francisco Valley, Brazil: A retrospective, cohort study. bmc Pregnancy Childbirth [internet]. 2014 [citado 2014 oct. 17]; 14:91. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3943583/. doi: 10.1186/1471-2393-14-91.
(11). Kaye DK, Kakaire O, Nakimuli A, Mbalinda SN, Osinde MO, Kakande N. Survivors’ understanding of vulnerability and resilience to maternal near-miss obstetric events in Uganda. Int J Gynaecol Obs [internet]. 2014 [citado 2016 jun 20]; 127(3):265-8. Disponible en: https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1016/j.ijgo.2014.05.019. doi: https://doi.org/10.1016/j.ijgo.2014.05.019.
(12). Påfs J, Musafili A, Binder-finnema P, Klingberg-allvin M, Rulisa S, Essén B. Beyond the numbers of maternal near-miss in Rwanda - a qualitative study on women’ s perspectives on access and experiences of care in early and late stage of pregnancy. bmc Pregnancy Childbirth [internet]. 2016; [citado 2014 oct. 20]; 16(257):1-11. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27590589. doi: https://doi.org/10.1186/s12884-016-1051-4.
(13). Tunçalp O, Hindin MJ, Adu-Bonsaffoh K, Adanu R. Listening to women’s voices: The quality of care of women experiencing severe maternal morbidity, in Accra, Ghana. PLos one [internet]. 2012 [citado 2014 sep. 26]; 7(8):1-8. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3432129&tool=pmcentrez&rendertype=abstract. doi: 10.1371/journal.pone.0044536.
(14). Moucheraud C, Worku A, Molla M, Finlay JE, Leaning J, Yamin A. Consequences of maternal mortality on infant and child survival: A 25-year longitudinal analysis in Butajira Ethiopia (1987-2011). Reprod Health [internet]. 2015 [citado 2015 sep. 26]; 12(Suppl 1):S4. Disponible en: http://www.reproductive-health-journal.com/content/12/S1/S4. doi: https://doi.org/10.1186/1742-4755-12-S1-S4.
(15). Nussbaum M. Creating capabilities. The Human Development Approach. Barcelona: Libros E; 2011.
(16). Gaviria MB. Hilos y tejido. Palabras y narración en salud. Rev Fac Nac Salud Pública [internet]. 2015 [citado 2015 oct. 15]; 33(Supl. 1):S64-S71. Disponible en: https://aprendeenlinea.udea.edu.co/revistas/index.php/fnsp/article/view/24537/20061. doi: 10.17533/udea.rfnsp.v33s1a11.
(17). Bolívar A, Domingo J. La investigación biográfica y narrativa en Iberoamérica: Campos de desarrollo y estado actual. Forum Qual Soc Res [internet]. 2006 [citado 2015 may. 9]; 7(4):Art. 12 Disponible en: http://www.qualitative-research.net/index.php/fqs/article/view/161/357.
(18). Vanegas B. La investigación cualitativa: un importante abordaje del conocimiento para enfermería. Rev Colomb Enfermería. 2010;6(6):128-42.
(19). Secretaria Seccional de Salud y Protección Social de Antioquia. Diagnóstico de situación de salud del Departamento de Antioquia 2010-2014: contexto territorial y demográfico [Internet]. Medellín; 2014 [citado 2015 ene. 28]. Disponible en: http://diagnosticosalud.dssa.gov.co/1-contexto-territorial-y-demografico/pagina-4-1-contexto-territorial-y-demografico/
(20). Cornejo M, Faúndez X, Besoain C. El análisis de datos en enfoques biográficos narrativos: desde los métodos hacia una intencionalidad analítica. Forum Qual Sozialforsch / Forum Qual Soc Res [internet]. 2017;18(1):Art. 16. Disponible en: http://nbn-resolving.de/urn:nbn:de:0114-fqs1701160. doi: http://dx.doi.org/10.17169/fqs-18.1.2491.
(21). Gaviria-Londoño MB, Luna-Carmona MT. Pluralidad humana en el destierro. Rev. latinoam. Cienc. Soc. niñez juv. [internet]. 2013 [citado 2015 dec. 12]; 11(2):475-91. Disponible en: http://revistaumanizales.cinde.org.co/index.php/Revista-Latinoamericana/article/view/930. doi: 10.11600/1692715x.1122141112.
(22). Ricoeur P. La vida: un relato en busca de narrador. 2006 [citado 2016 Apr 3]; 25:9-22. Disponible en: http://perio.unlp.edu.ar/catedras/system/files/ricoeur-la-vida-un-relato-en-busca-de-narrador.pdf
(23). Ricoeur P. Tiempo y narración i. Configuración del tiempo en el relato histórico [internet]. 2006 [citado 2016 may 04]; 9-22. Disponible en: https://textosontologia.files.wordpress.com/2012/11/tiempo-y-narracic3b3n-i.pdf
(24). Hinton L, Locock L, Knight M. Maternal critical care: What can we learn from patient experience? A qualitative study. bmj Open [internet]. 2015 [citado 2016 ago. 16]; 5(4):1-10. Disponible en: http://bmjopen.bmj.com/cgi/doi/10.1136/bmjopen-2014-006676. doi: 10.1136/bmjopen-2014-006676.
(25). Iván C, Sánchez P, Rodríguez MA. Condiciones e imaginarios sociales y culturales que motivan o definen las demoras i y ii asociadas con la mortalidad materna en diferentes contextos de población en Colombia. [internet]. 2015 [citado 2016 feb. 15]. Disponible en: http://sociologia-alas.org/acta/2015/GT-18/Condiciones%20e%20imaginarios%20sociales%20y%20culturales%20que%20motivan%20o%20definen%20las%20demoras%20i%20y%20ii%20asociadas%20con%20la%20mortalidad%20materna%20en%20diferentes%20contextos%20de%20poblaci%C3%B3n%20en%20colombia.docx
Downloads
Published
How to Cite
Issue
Section
License
The contents of the articles are the responsibility of the authors
The editorial committee has editorial independence from the National School of Public Health "Héctor Abad Gómez" of the University of Antioquia.
The editorial committee is not responsible for aspects related to copying, plagiarism or fraud that may appear in the articles published in it.
When you are going to reproduce and disclose photographs or personal data in printed or digital format, informed consent is required. Therefore, this requirement is required of the author at the time of receipt of the manuscript.
Authors are responsible for obtaining the necessary permissions to reproduce any material protected by reproduction rights.
The authors preserve the moral rights and assign the economic rights that will correspond to the University of Antioquia, to publish it, distribute electronic copies, include them in indexing services, directories or national and international databases in Open Access, under the Creative Commons Attribution license -Not Commercial-Share Equal 4.0 International Commercial (CC BY-NC-SA) which allows others to distribute, remix, retouch, and create from the work in a non-commercial way, as long as the respective credit and license are granted. new creations under the same conditions.
The authors will sign the declaration of transfer of economic rights to the University of Antioquia, after the acceptance of the manuscript.
The editorial committee reserves the right to reject the articles whose authors do not offer satisfactory explanations about the contribution of each author, to meet the criteria of authorship in the submission letter. All authors must meet the four criteria of authorship according to ICMJE: "a) .- That there is a substantial contribution to the conception or design of the article or to the acquisition, analysis or interpretation of the data. b) That they have participated in the design of the research work or in the critical review of its intellectual content. c) .- That has been intervened in the approval of the final version that will be published.d). That they have the capacity to respond to all aspects of the article in order to ensure that issues related to the accuracy or integrity of any part of the work are adequately investigated and resolved. "
-- 
--
