[Ableist obstetric violence against women with disabilities: An integrative literature review]. / Violencia obstétrica capacitista hacia mujeres con discapacidad: Una revisión integradora de la literatura.

Women with disabilities face increased precarity throughout their lives, with one of the most affected areas being their sexual and reproductive health. The aim of this study was to identify and analyze the scientific literature on obstetric violence against women with disabilities. The search was conducted from August to October 2022 in five databases: PubMed, Web of Science, Dialnet, SciELO, and Scopus. A total of 194 articles were retrieved, and after applying selection criteria, ten articles were analyzed. Through thematic analysis, the dimension "ableist obstetric violence towards women with disabilities" emerged. Findings suggest that women with disabilities are marginalized during obstetric care, resulting in untimely attention and cascading interventions. At present, there is scarce literature addressing this phenomenon from a rights-based perspective. Urgent measures are needed to train healthcare teams on the provision of care to people with disabilities. Additionally, it is crucial to critically examine the relationship between healthcare personnel and institutions to women with disabilities within the framework of their sexual and reproductive rights.

Las mujeres con discapacidad se ven enfrentadas a una mayor precariedad a lo largo de sus vidas. Una de las áreas más afectadas es su salud sexual y reproductiva. El objetivo de este estudio fue identificar y analizar la literatura sobre violencia obstétrica en mujeres con discapacidad. La búsqueda se realizó durante los meses de agosto a octubre de 2022 en cinco bases de datos: PubMed; Web of Science; Dialnet; SciELO y Scopus. Se recuperaron 194 artículos y luego de aplicar los criterios de selección se analizaron diez artículos. Del análisis temático, emergió la dimensión: "violencia obstétrica capacitista hacia mujeres con discapacidad". Los hallazgos sugieren que las mujeres con discapacidad son invisibilizadas durante la atención obstétrica, lo que genera un cuidado inoportuno e intervenciones en cascada. Existe escasa literatura que aborde el fenómeno desde una perspectiva de derechos. Es urgente contar con equipos de salud aptos para atender a personas con discapacidad, así como también, problematizar el vínculo entre el personal e instituciones de salud y las mujeres con discapacidad en el marco de sus derechos sexuales y reproductivos.

Politico-Epistemic Tensions Regarding Personal Assistance and Care for People with Disabilities: An Integrative Literature Review.

BACKGROUND: Since the 1960s, the Independent Life Movement has demanded personal assistance as a right for people with disabilities to access autonomy. In turn, feminist movements have shown a special concern for the care and profile of the providers. Both postures have created tensions around the provision of personal assistance and care for people with disabilities. AIM: To know and analyze the scientific evidence regarding approaches to personal assistance and care for people with disabilities. METHODS: An Integrative Literature Review using five databases: Dialnet, Scielo, PubMed, Scopus, and Web of Science. The Boolean combinations were: "Personal assistance AND disability"; "Personal assistance AND care AND disability"; "Care AND disability" in English, and "Asistencia personal AND discapacidad"; "Asistencia personal AND cuidados AND discapacidad"; "Cuidados AND discapacidad" in Spanish. A total of 31 scientific articles were obtained. A content analysis was then, with five analysis dimensions emerging. RESULTS: The articles approached the positive aspects of personal assistance. Others established the need for more resources in order to not be an exclusive reality for developed countries. Profiles were made of racialized, young, migrant women as the identity behind (informal) care. From the perspective of a feminist disability care ethic, new forms of providing care are proposed, by changing the focus from individual and family responsibility, towards a social and collective focus. CONCLUSION: The evidence analyzed considers various dimensions of the epistemo-political tension between personal assistance and care. The meeting point between both perspectives is interdependence and autonomy; on the one side, for people with disabilities, and on the other, for the women profiled as the main caregivers.

Bienestar mental perinatal: el miedo como emoción movilizadora de técnicas de resiliencia / Perinatal mental wellbeing: fear as a mobilizing emotion for resilience techniques

Objetivo: Analizar las experiencias en torno a los sentimientos y emociones de las gestantes como eje movilizador, y las estrategias resilientes desarrolladas durante el periodo de pandemia y pospandemia de COVID-19 en España. Personas/Material y método: Diseño cualitativo, fenomenológico. Se realizaron entrevistas semiestructuradas a mujeres que dieron a luz en pandemia y pospandemia en España. Resultados: El miedo estaba presente en todas las narrativas, ocasionando un cambio en las expectativas. Asímismo, destaca el carácter multifactorial que llevó a las gestantes a tomar decisiones y acciones que nunca se habían planteado. El miedo a la falta de seguridad física, a la aceptación social o a la violencia obstétrica obstaculizaron la experiencia positiva del nacimiento. A pesar de la situación de vulnerabilidad a la que se enfrentaron, como respuesta adoptaron técnicas de resiliencia. Conclusiones: El miedo es una emoción frecuente en la gestación y parto –acentuada en pandemia–; sin embargo, puede transformarse en la medida en que existen ciertas características de las mujeres y del entorno. Las diversas técnicas resilientes permiten resignificar positivamente emociones no gratas. El buen trato, la empatía y la información son aspectos que propician experiencias positivas. (AU)

Objective: To analyze the experiences around the feelings and emotions of pregnant women as a mobilizing axis and the resilience strategies developed during the pandemic and post-pandemic period by COVID-19 in Spain. Persons/Materials and method: Qualitative, phenomenological design. Semi-structured interviews were conducted with women who gave birth during pandemic and post-pandemic periods in Spain. Results: Fear was present in all narratives, which caused a change in expectations. Likewise, the multifactorial nature that led them to make decisions and take actions they had never considered before stands out. Fear of lack of physical security, social acceptance or obstetric violence hindered the positive birth experience. Despite the vulnerable situation they faced, in their response they adopted resilience techniques. Conclusions: Fear is a frequent emotion in gestation and childbirth - accentuated in pandemic - however it can be transformed to the extent that certain characteristics of the women and the environment exist. The different resilience techniques allow us to positively re-signify unpleasant emotions. Good treatment, empathy and information are aspects that promote positive experiences. (AU)

Entrega de malas noticias: emociones experimentadas por internos de obstetricia en un escenario clínico simulado / Breaking bad news: emotions experienced by midwifery students in a simulated clinical scenario

Objetivo: Identificar y analizar la respuesta emocional de un grupo de internos de Obstetricia durante el desarrollo de un escenario clínico simulado de entrega de malas noticias en salud. Métodos: Estudio cualitativo con enfoque fenomenológico en el que participaron 21 estudiantes de último año de la carrera de Obstetricia de la Universidad Mayor de Santiago de Chile durante el año 2019. Posteriormente a la simulación clínica con paciente estandarizado se realizaron cuestionarios y entrevistas semiestructuradas, que fueron analizados mediante Análisis Temático Cualitativo. Resultados: Emergieron una categoría central (Emociones experimentadas durante el proceso) y cuatro subcategorías (Autopercepción de emociones en el ejercicio simulado; Emociones y malestar ante la entrega de malas noticias en salud; Sentimientos encontrados y su afección en el desempeño de la actividad; y Gestión y estrategias para la entrega de malas noticias en salud). El miedo y la ansiedad fueron las emociones más referidas, vinculadas principalmente al desconocimiento sobre la posible respuesta del paciente. La tristeza y la empatía se relacionaron con experiencias propias. Las manifestaciones físicas de la emoción pueden tornarse intensas, pudiendo desorganizar y/o bloquear el desempeño. Por último, la principal estrategia de respuesta utilizada por los estudiantes fue la represión de sus propias emociones. Conclusiones: La simulación clínica de alta fidelidad con paciente estandarizado es una herramienta muy útil para el desarrollo de competencias de entrega de malas noticias en salud. Abogamos por incorporar la educación emocional en la formación de matronas y matrones. (AU)

Objective: To identify and analyze the emotional response of a group of Obstetrics interns during the development of a simulated clinical scenario of delivering bad health news. Methods: Qualitative study with a phenomenological approach in which 21 senior students of the Obstetrics career of the Universidad Mayor de Santiago de Chile participated during the year 2019. Questionnaires and semi-structured interviews were carried out after the clinical simulation with a standardized patient, the that were analyzed through Qualitative Thematic Analysis. Results: A central category emerged (Emotions experienced during the process) and four subcategories (Self-perception of emotions in the simulated exercise; Emotions and discomfort when delivering bad health news; Mixed feelings and their effect on the performance of the activity; and Management and strategies for the delivery of bad health news). Fear and anxiety were the most frequently reported emotions, mainly linked to ignorance about the patient's possible response. Sadness and empathy were related to their own experiences. Physical manifestations of emotion can become intense, disorganizing and/or blocking performance. Finally, the main response strategy used by the students was the repression of their own emotions. Conclusions: High-fidelity clinical simulation with a standardized patient is a very useful tool for developing skills in delivering bad news in health. We advocate incorporating emotional education in the training of midwives and midwives. (AU)

Violencia obstétrica capacitista hacia mujeres con discapacidad: Una revisión integradora de la literatura / Ableist obstetric violence against women with disabilities: An integrative literature review

RESUMEN Las mujeres con discapacidad se ven enfrentadas a una mayor precariedad a lo largo de sus vidas. Una de las áreas más afectadas es su salud sexual y reproductiva. El objetivo de este estudio fue identificar y analizar la literatura sobre violencia obstétrica en mujeres con discapacidad. La búsqueda se realizó durante los meses de agosto a octubre de 2022 en cinco bases de datos: PubMed; Web of Science; Dialnet; SciELO y Scopus. Se recuperaron 194 artículos y luego de aplicar los criterios de selección se analizaron diez artículos. Del análisis temático, emergió la dimensión: "violencia obstétrica capacitista hacia mujeres con discapacidad". Los hallazgos sugieren que las mujeres con discapacidad son invisibilizadas durante la atención obstétrica, lo que genera un cuidado inoportuno e intervenciones en cascada. Existe escasa literatura que aborde el fenómeno desde una perspectiva de derechos. Es urgente contar con equipos de salud aptos para atender a personas con discapacidad, así como también, problematizar el vínculo entre el personal e instituciones de salud y las mujeres con discapacidad en el marco de sus derechos sexuales y reproductivosa.

ABSTRACT Women with disabilities face increased precarity throughout their lives, with one of the most affected areas being their sexual and reproductive health. The aim of this study was to identify and analyze the scientific literature on obstetric violence against women with disabilities. The search was conducted from August to October 2022 in five databases: PubMed, Web of Science, Dialnet, SciELO, and Scopus. A total of 194 articles were retrieved, and after applying selection criteria, ten articles were analyzed. Through thematic analysis, the dimension "ableist obstetric violence towards women with disabilities" emerged. Findings suggest that women with disabilities are marginalized during obstetric care, resulting in untimely attention and cascading interventions. At present, there is scarce literature addressing this phenomenon from a rights-based perspective. Urgent measures are needed to train healthcare teams on the provision of care to people with disabilities. Additionally, it is crucial to critically examine the relationship between healthcare personnel and institutions to women with disabilities within the framework of their sexual and reproductive rights.

Reivindicative occupational practices of activist with disabilities / Práticas ocupacionais reivindicativas de ativistas com deficiência

Abstract Introduction The occupational praxis of activists with disabilities in the Latin America has presented actions of revindication from historically marginalised territories. Objective To explore and describe strategies used by Chilean activist with disabilities. Method Qualitative design via three research techniques: a) 11 in-depth interviews; b) six group chat sessions; c) content analysis of eight social networks belonging to collectives of activists with disabilities in Chile. Results Activists indicate various occupations for revindication as subjects with rights. These trajectories are exemplified with the following dimensions: 1) Interpellate full social participation: demanding justice and citizenship; 2) Showing defective bodies: public mobilisations; 3) Occupying institutional space by placing: bodies in the system. Conclusion Dissident occupational practices intervene and transform the limited comprehension about what human vulnerability and fragility is capable of. This situation is mainly appreciated in the Global South.

Resumo Introdução A práxis ocupacional de ativistas com deficiência na América Latina tem apresentado ações de reivindicação de territórios historicamente marginalizados. Objetivo Explorar e descrever as estratégias utilizadas por ativistas chilenos com deficiência. Método Desenho qualitativo por meio de três técnicas de pesquisa: a) 11 entrevistas em profundidade; b) seis sessões de chat em grupo; c) análise de conteúdo de oito redes sociais pertencentes a coletivos de ativistas com deficiência no Chile. Resultados Os ativistas indicam diversas ocupações para reivindicação como sujeitos de direitos. Essas trajetórias são exemplificadas com as seguintes dimensões: 1) Interpelar a participação social plena: reivindicar justiça e cidadania; 2) Mostrar corpos defeituosos: mobilizações públicas; 3) Ocupar o espaço institucional colocando: os corpos no sistema. Conclusão Práticas ocupacionais dissidentes intervêm e transformam a compreensão limitada sobre do que é capaz a vulnerabilidade e fragilidade humana. Esta situação é apreciada principalmente no Sul Global.

Salvajes, indígenas, cojas, inválidas: Epistemologías anticapacitistas del Sur / Selvagem, indígena, coxo, inválido: epistemologias anticapacitistas do Sul / Wild, Indigenous, Lame, Invalid: Anti-Ableist Epistemologies of the South

Resumen El objetivo del manuscrito es presentar una primera aproximación a una propuesta epistemológica que reflexione y se ocupe de la construcción y legitimación de conocimientos generados desde corporeidades abyectas, anormales o tullidas geopolíticamente ubicadas al Sur. Pone especial atención al sistema sexo-género-capacidad en la organización social y epistemológica del saber. En ese devenir, identificamos una posicionalidad y riqueza desperdiciada para el análisis y transformación social regional como resultado de un ordenamiento moderno colonial. De ahí que esta propuesta se inscriba dentro del pensamiento crítico latinoamericano para reflexionar sobre esos lugares otros de enunciación abyecta.

Resumo O objetivo deste artigo é apresentar uma abordagem inicial de uma proposta epistemológica que reflita e lide com a construção e a legitimação do conhecimento gerado a partir de corporeidades abjetas, anormais ou inválidas, geopoliticamente localizadas no Sul. Dá atenção especial ao sistema de sexo-gênero-capacidade na organização social e epistemológica do saber. No processo, identificamos uma posição e uma riqueza desperdiçadas para a análise e transformação social regional como resultado de uma ordem colonial moderna. Por isso, esta proposta se inscreve no pensamento crítico latino-americano para refletir sobre esses outros lugares de enunciação abjeta.

Abstract The aim of the article was to present a first approach to an epistemological proposal that reflects on and deals with the construction and legitimation of knowledge generated from abject, abnormal, or crippled corporeities geopolitically located in the South. It pays special attention to the sex-gender-ability system in the social and epistemological organization of knowledge. In this development, we identify a positionality and wasted wealth for regional social analysis and transformation as a result of a modern colonial order. Hence, this proposal is inscribed within the Latin American critical thinking to reflect on those other places of abject enunciation.

Geografías para un buen nacer: una aproximación geo(corpo)gráfica del parto en domicilio en Chile / Geographies for a good birth: a geo(corpo)graphic approach to home birth in Chile

RESUMEN El parto en domicilio ha complejizado la epistemología del nacimiento cuestionando la institucionalidad. Así surge el interés por conocer las narrativas que las mujeres chilenas le otorgan al escenario del parto en domicilio. Entre octubre de 2018 y enero de 2019, se entrevistó a 30 mujeres utilizando elementos de los mapeos corporales. Mediante el análisis temático emergió la categoría central geo(corpo)grafías del parto en domicilio, que implica un despliegue del cuerpo material/simbólico que permite que el nacimiento suceda; y tres subcategorías: crear el escenario ideal para el parto, que responde a imaginar y concretar el espacio ideal del nacimiento; el mejor lugar para parir dejando fluir los instintos, que se construye a partir de sentir y escuchar el cuerpo; y resignificar el escenario ideal, que implica otorgar un nuevo significado al domicilio para dar a luz. Las narrativas geo(corpo)gráficas del parto en domicilio reconocen la corporalidad y la disposición de este en el espacio, y permiten socializar el nacimiento y difuminar la barrera entre lo público y lo privado.

ABSTRACT Home birth has added a layer of complexity to the epistemology of birth, raising questions about its institutional aspects. From this standpoint, this article stems from an interest in the narratives that Chilean women ascribe to the scenario of home birth. Thirty women were interviewed between October 2018 and January 2019 using elements of body mapping. A central category emerged in thematic analysis: geo(corpo)graphies of home birth, which involves the deployment of the material/symbolic body in a manner that allows birth to occur. Three subcategories also emerged: creating the ideal setting for childbirth, which has to do with imagining and defining the ideal space for childbirth; the best place to give birth letting instincts flow, which is constructed by feeling and listening to the body; and resignifying the ideal scenario, which implies attributing a new meaning to the home in order to give birth. These geo(corpo)graphic narratives of home birth recognize corporality and its disposition in space, allowing birth to be collectively socialized, blurring the boundaries between the public and the private.

Construcción del género y sexualidad en la primera infancia: rol de la matrona en Chile / Construction of gender and sexuality in early childhood: role of the midwife in Chile

Objetivo: Identificar los elementos asociados a la construcción del género en la primera infancia y determinar las intervenciones educativas en salud sexual de la matrona en Chile.Método: Revisión bibliográfica en diferentes bases de datos académicas (CINAHL, PubMed, Web of Science, LILACS, Dialnet y Scielo), complementada con sitios web institucionales de Chile.Resultados: Emergieron cuatro categorías centrales: 1) contexto familiar; 2) contexto escolar; 3) contexto social, y 4) rol del profesional matrón/matrona en las intervenciones educativas en salud sexual.Las autoras no presentan conflicto de intereses en este artículo.Conclusión: La construcción del género en la primera infancia se produce en contextos familiares a través de los cuidadores principales: en contextos educativos mediante la función docente, y en contextos sociales a través de los medios de comunicación y actividades lúdicas. Sin embargo, los contextos familiares y educativos refieren no estar suficientemente preparados para abordar la sexualidad en esta etapa. Aunque el profesional matrón/matrona no ha podido involucrarse aún en la primera infancia, a pesar de lo señalado por las entidades nacionales, su rol puede ser fundamental, tanto por su preparación académica como por su experiencia técnica. (AU)

Objective: To identify the elements associated with the construction of gender in early childhood and determine the educational interventions in sexual health of the midwife in Chile.Method: Bibliographic review in academic databases (CINAHL, PubMed, Web of Science, LILACS, Dialnet and Scielo), complemented with institutional websites of Chile.Results: Four central categories emerged: 1) family context; 2) school context; 3) social context, and 4) role of the professional midwife in educational interventions in sexual health.Conclusion: The construction of gender in early childhood occurs in family contexts, through the main caregivers; in educational contexts, through the teaching function; and in social contexts, through the media and recreational activities. However, family and educational contexts refer to not being sufficiently prepared to deal with sexuality at this stage. Although the professional midwife has not yet been able to become involved in early childhood, despite what has been pointed out by national entities, his role can be fundamental, both for his academic preparation and technical experience. (AU)

The COVID-19 Pandemic in Spain: Experiences of Midwives on the Healthcare Frontline.

BACKGROUND: Midwives look after women during pregnancy, childbirth and puerperium. In Spain, the first wave of COVID was particularly virulent. There are few studies about the experiences of midwives providing care during the COVID pandemic and very few have been undertaken in the countries of southern Europe such as Spain. This article sets out to take a more in-depth look at the experiences of midwives who were on the frontline of care during the early months of the COVID-19 pandemic as well as to identify new needs and resilience strategies that can help midwives. METHODS: A qualitative methodology of phenomenological tradition was used, interviewing 10 midwives from primary care, hospital and independent care. RESULTS: After content analysis, three central categories emerged: (a) cascade of emotions; (b) professional occupation and concern for the women; (c) resisting the day-to-day; resilience and resistance strategies. CONCLUSIONS: Despite the difficulties, midwives are concerned about the loss of rights and autonomy and about the increased vulnerability of women. Midwives have become aware of the power they have in their actions both in health management and administration, as well as in the care of women, creating strategies to provide dignified care to their users.

Birth cultures: A qualitative approach to home birthing in Chile.

BACKGROUND: Birth cultures have been transforming in recent years mainly affecting birth care and its socio-political contexts. This situation has affected the feeling of well-being in women at the time of giving birth. AIM: For this reason, our objective was to analyse the social meaning that women ascribe to home births in the Chilean context. METHOD: We conducted thirty semi-structured interviews with women living in diverse regions ranging from northern to southern Chile, which we carried out from a theoretical-methodological perspective of phenomenology and situated knowledge. Qualitative thematic analysis was used to analyse the information collected in the field work. FINDINGS: A qualitative thematic analysis produced the following main theme: 1) Home birth journeys. Two sub-categories: 1.1) Making the decision to give birth at home, 1.2) Giving birth: (re)birth. And four sub-categories also emerged: 1.1.1) Why do I need to give birth at home? 1.1.2) The people around me don't support me; 1.2.1) Shifting emotions during home birth, 1.2.2) I (don't) want to be alone. CONCLUSION: We concluded that home births involve an intense and diverse range of satisfactions and tensions, the latter basically owing to the sociocultural resistance surrounding women. For this reason, they experienced home birth as an act of protest and highly valued the presence of midwives and their partners.

Perspectivas feministas sobre (in)justicias ocupacionales de maternidades adolescentes / Perspectivas feministas sobre (in) justiças ocupacionais de maternidades para adolescentes / Feminist perspectives on occupational (in)justices of adolescent motherhood

Resumen Introducción La maternidad supone un importante desafío ocupacional para las mujeres, situación que se complejiza cuando son adolescentes. Objetivo Analizar las trayectorias de mujeres madres adolescentes desde la perspectiva de la Terapia Ocupacional Feminista. Método Estudio cualitativo que, a través de entrevistas en profundidad y un análisis temático, analizó seis experiencias de maternidades adolescentes en España. Resultados Emergieron tres categorías centrales de análisis que explican parte de las trayectorias ocupacionales. Destacamos dentro de éstas: la "Precarización ocupacional: una vulnerabilidad sexo-genérica", la cual da cuenta de las condicionantes previas que posibilitan la gestación adolescente; "Una ocupación familiar: maternidad (inter)dependiente", refleja la organización familiar de los cuidados y la crianza dando cuenta de la relevancia de las figuras femeninas que sostienen esta experiencia; y, finalmente, la categoría "El giro ocupacional: sus repercusiones psicosociales", que considera el impacto de la maternidad en las proyecciones, tanto a nivel educativo como en su inserción laboral. Conclusión Las trayectorias de las mujeres madres adolescentes reflejan un vaivén de emociones y complejidades en sus maternidades asociadas al periodo de vida en el cual la llevan a cabo. Por ello, la emergencia de una Terapia Ocupacional Feminista consciente de las inequidades de género permite interpelar la injusticia ocupacional que enfrentan las mujeres madres adolescentes por una vida más justa y digna.

Resumo Introdução: A maternidade é um importante desafio ocupacional para as mulheres, situação que se torna mais complexa na adolescência. Objetivo: Analisar as trajetórias de mães adolescentes na perspectiva da terapia ocupacional feminista. Método: Estudo qualitativo que, por meio de entrevistas em profundidade e análise temática, analisou seis experiências de maternidades para adolescentes na Espanha. Resultados: emergiram três categorias centrais de análise que explicam parte das trajetórias ocupacionais. Dentre elas, destacamos a "Precariedade ocupacional: uma vulnerabilidade gênero-sexo", que dá conta das condições anteriores que possibilitam a gravidez na adolescência. A categoria "Uma ocupação familiar: maternidade (inter) dependente" reflete a organização familiar do cuidado e da educação, dando conta da relevância das figuras femininas que sustentam essa experiência. Por fim, a categoria "O turno ocupacional: suas repercussões psicossociais", considera o impacto da maternidade nas projeções, tanto no nível educacional como na sua inserção laboral. Conclusão: As trajetórias de mães adolescentes refletem uma flutuação de emoções e complexidades em suas maternidades associadas ao período da vida em que a realizam. Por isso, o surgimento de uma terapia ocupacional feminista atenta às desigualdades de gênero nos permite desafiar as injustiças ocupacionais enfrentadas pelas mães adolescentes na luta por uma vida mais justa e digna.

Abstract Introduction Motherhood is an important occupational challenge for women, a situation that becomes more complex when they are adolescents. Objective To analyze the trajectories of adolescent mothers from the perspective of Feminist Occupational Therapy. Method Qualitative study that, through in-depth interviews and thematic analysis, analyzed six adolescent maternal experiences in Spain. Results Three central categories of analysis emerged that explain part of the occupational trajectories. We highlight within them, the "Occupational precariousness: a gender-sex vulnerability", which accounts for the previous conditions that make adolescent pregnancy possible. The category "A family occupation: (inter) dependent motherhood" reflects the family organization of care and upbringing, giving an account of the relevance of the female figures who support this experience. Finally, the category "The occupational shift: its psychosocial repercussions", considers the impact of motherhood in the projections, both at the educational level and in its labor insertion. Conclusion The trajectories of adolescent mothers reflect a fluctuation of emotions and complexities in their maternity wards associated with the period of life in which they carry it out. Therefore, the emergence of a Feminist Occupational Therapy aware of gender inequalities allows us to challenge the occupational injustice faced by adolescent mothers for a more just and dignified life.

Subvertir la vulneración médica: itinerarios corporales disidentes de la discapacidad en Chile / Subverting medical vulneration: Dissident bodily itineraries of disability in Chile

RESUMEN El reconocimiento de los cuerpos disidentes de la discapacidad ofrece una situación de continua resistencia, por lo que nuestro objetivo fue analizar la vulnerabilidad y vulneración corporal de las personas activistas de la discapacidad en Chile. Para eso, entre septiembre de 2017 y febrero de 2018, se realizaron once entrevistas en profundidad utilizando la técnica de los itinerarios corporales y seis conversatorios. A través del análisis temático cualitativo, surgió la categoría central "el cambio o diferencia corporal: experien- cias de fragilidad medicalizada", y tres subcategorías: "diagnóstico corporal: la gestión institucional de las diferencias"; "tratamiento médico: corregir la anormalidad corporal y social"; y "rehabilitación: volver a funcionar como un cuerpo normativo". Los itinerarios de las personas activistas develan la coaptación y vulneración corporal a la que son some- tidas al ingresar a los dispositivos biomédicos que niegan sistemáticamente sus derechos humanos. Sin embargo, a pesar de intentar disciplinar y controlar sus cuerpos, crean estra- tegias para subvertir y validar sus subjetividades.

ABSTRACT Acknowledging dissident bodies of persons with disabilities is an act of continuous resistance, and as such our objective in this article is to analyze the vulnerability and bodily violation of disability activists in Chile. In order to do so, between September 2018 and February 2019 we conducted 11 in-depth interviews using the technique of bodily itineraries, as well as 6 discussion groups. Through qualitative thematic analysis, several categories emerged: the central category of "Bodily change or difference: experiences of medicalized fragility;" and three subcategories, "Bodily diagnosis: the institutional management of differences;" "Medical treatment: correcting bodily and social abnormality;" and "Rehabilitation: to function once again as a normative body." Activists' itineraries reveal the coaptation and bodily violation that they are subjected to by the biomedical apparatus, where they are systematically denied their human rights; however, despite attempts to discipline and control them, they create subversive strategies to validate their corporealities.

Exploring social and health care representations about home birth: An Integrative Literature Review.

AIMS: Exploring social and health care representations of home birth by conducting an integrative review of the literature. DESIGN: Integrative Literature Review. DATA SOURCES: The search was based on the following keywords: "birth, home," "home birth," "childbirth, home." And the terms: "planned home birth," and "empowerment women homebirth" (in English). "partos en casa," and "partos domiciliarios" (in Spanish) in the following databases: Biomedical Central, Cochrane Library, Dialnet, DOAJ, Lilacs, PubMed, Scopus, Scielo, and Web of Science. REVIEW METHODS: A total of 156 publications dated between 2004 and 2017 were initially obtained and a total of 41 articles were finally selected according to the criteria of inclusion, methodological rigor, and researchers' triangulation. RESULTS: Four dimensions of the issue emerged out of the 41 articles analyzed: (a) the Dimension of "Empowerment in Childbirth;" (b) the Dimension of "Comparative Socio-Medical Childbirth Studies;" (c) the "Institutional Dimension of Childbirth;" (d) the "Cultural Dimension of Childbirth." CONCLUSION: From the health management perspective, home birth is not widely accepted today as a valid and safe alternative. However, women's social representations indicate an interest in returning to birth at home as a response to the excessive medicalization and institutionalization of childbirth, and value highly its autonomy and comfort.

Lactancia materna exclusiva y participación en la vida diaria: una perspectiva ocupacional de la maternidad / Amamentação exclusiva e participação na vida cotidiana: uma perspectiva ocupacional da maternidade / Exclusive breastfeeding and participation in daily life: an occupational perspective of motherhood

Resumen Introducción La lactancia materna exclusiva está inmersa en un intenso debate. Por un lado, se considera que este fenómeno gira en torno a discursos vinculados a modelos biomédicos, sociales y patriarcales impactando en el rol de la mujer y, por otro lado, existe un movimiento social que aboga por este mandado de la maternidad. Si bien la literatura indica que el hecho de amamantar influye en la participación ocupacional- tanto en la diversidad como en la significación de las actividades cotidianas- no existe suficiente evidencia al respecto. Objetivo Comprender el impacto de la lactancia materna exclusiva en la participación ocupacional de un grupo de mujeres chilenas. Método Estudio exploratorio de carácter cualitativo realizado mediante un muestreo intencional con diez mujeres madres chilenas. Se utilizó la entrevista semiestructurada para la recogida de información. Los datos fueron analizados a través del proceso de codificación del contenido. Resultados Las narrativas de las mujeres madres en torno al impacto de la lactancia materna exclusiva en la implicación ocupacional, aluden al amamantamiento como: ocupación significativa y/o impositiva generando alteraciones en la transición ocupacional de la maternidad y la elección de nuevas ocupaciones. La influencia del contexto sociosanitario que explica y consolida este fenómeno. Finalmente, los roles de mujer madre o madre mujer que invitan a re-construir y re-pensar las nuevas identidades ocupacionales y roles de género asociados al amamantamiento. Conclusión Se puede establecer una relación directa entre la lactancia materna exclusiva y la participación ocupacional de las mujeres, por ello es fundamental comprender la construcción cultural de este fenómeno y sus implicaciones personales, ocupacionales y contextuales.

Resumo Introdução O aleitamento materno exclusivo está imerso em um amplo debate. Por um lado, este fenômeno é considerado a partir de discursos relacionados aos modelos biomédicos, sociais e patriarcais impactando os papéis ocupacionais das mulheres; por outro lado, existe um movimento social que o defende como um mandato de gênero da maternidade. Já a literatura indica que a amamentação de fato influencia a participação ocupacional - tanto na diversidade quanto na importância das atividades cotidianas, demonstrando provas suficientes a este respeito. Objetivo Compreender o impacto do aleitamento materno exclusivo na participação ocupacional de um grupo de mulheres chilenas. Método Trata-se de um estudo exploratório de natureza qualitativa, com amostragem intencional de dez mães chilenas. Utilizou-se entrevista semiestruturada para a coleta de informações. Os dados foram analisados através do processo de codificação. Resultados As narrativas das mulheres mães, em torno do impacto do aleitamento materno exclusivo na implicação ocupacional referem à amamentação como: ocupação significativa e/ou impositiva, gerando alterações na transição ocupacional da maternidade e da escolha de novas ocupações. A influência do contexto sócio sanitário que explica e estabelece esse fenômeno. Finalmente, os papéis como mulher mãe ou mãe mulher nos convidam a reconstruir e repensar novas identidades ocupacionais e os papéis de gênero associados com a amamentação. Conclusão Foi possível estabelecer uma relação direta entre o aleitamento materno exclusivo e a participação ocupacional das mulheres, por isso é fundamental compreender a construção cultural deste fenômeno e suas implicações pessoais, ocupacionais e contextuais.

Abstract Introduction Exclusive breastfeeding is immersed in a debate. On the one hand, is considered that this phenomenon revolves around speeches related to models biomedical, social and patriarchal impacting on the role of women and on the other hand, there is a social movement which advocates this errand of motherhood. While the literature indicates that the fact breastfeeding influences the occupational participation-both in the diversity and in the significance of daily activities- there is enough evidence in this respect. Objective To understand the impact of exclusive breastfeeding in a group of Chilean women occupational participation. Method exploratory study of qualitative nature carried out by intentional sampling with ten Chilean mothers. The semi-structured information collection interview was used. Data were analysed through the encoding process. Results The narratives of the mothers around the impact of exclusive breastfeeding in occupational engagement, refer to as breastfeeding: occupation imposition or significant generating changes in the occupational transition of the maternity and the choice of new occupations. The influence of the context public health that explains and consolidates this phenomenon. Finally, roles as mother women or women mother inviting you to rebuild and re - think new occupational identities and gender roles associated with breastfeeding. Conclusion To establish a direct relationship between exclusive breastfeeding and the occupational participation of women, therefore it is essential to understand the cultural construction of this phenomenon and its implications, occupational, personal and contextual.