A gestação de alto risco e o medo do colapso: o trabalho psíquico de gerar vida

Abstract

To gestate a baby is a job that involves biological and psychological aspects. In a high-risk pregnancy, the psyche is confronted with the fear of interruption of pregnancy, complications in the baby's development or the possibility of death for both. The aim of this dissertation is to articulate Winnicott's concept of fear of breakdown and the psychism in high-risk pregnant women. For this, fantasies and anxieties in pregnant women facing a highrisk pregnancy from hypertension were identified. Another point was to deepen Winnicott's theoretical concept of fear of breakdown, and associated themes. In addition, few possible interventions in cases of high-risk pregnancy were identified. The present work is a qualitative and exploratory research, conducted by a multiple cases study. Four high-risk pregnant women from the General Hospital of Caxias do Sul, a reference to the SUS, participated in the study. Those who were experiencing hypertension during the gestational period, living their first high-risk pregnancy, were included. A semi-structured interview was carried out and the Drawing-Story procedure with a theme was introduced, in order to deepen the understanding of the psychism aspects presented in this sensitive moment of maintenance of the pregnant woman's life and generation of a new being. The results were analyzed and discussed through content analysis, according to the mixed model, eight categories were proposed: life story elements; violence, abandonment and trauma; mourning; experiences and expectations of pregnancy; high-risk pregnancy; dreams; possible signs of fear of breakdown and, finally, expectations for the future. In the discussion, the concept of fear of breakdown and the experiences of pregnant women at high risk were articulated with relevant and current authors, highlighting Roussillon, integrating the original trauma and the return of the splitted with the understandings of Winnicott. The most primitive faults, from the mother environment, leave marks of something not lived. Pregnancy in the ambience of death threat implies the possibility of returning something that was not integrated. It arises a new possibility of experiencing the traumatic situation, a possible moment of re-signification, or maintaining the symptoms of what is still unnamable. In the end, the psychological work of pregnancy involves regressing, identifying with the baby and the baby she was. In an attempt to experience the unexperienced, they can understand themselves more and live the mourning of elements of their own history, when not lived in their fullness. [resumo fornecido pelo autor]