Planificação do acompanhamento das puérperas na atenção primaria à saúde com ênfase na saúde mental

Abstract

The postpartum period is characterized by intense biological, psychological, and social changes, involving specific demands that require comprehensive, continuous, and humanized healthcare follow-up. Primary Health Care (PHC) plays a strategic role in coordinating care for postpartum women, particularly regarding mental health promotion and the early identification of vulnerabilities. This dissertation aimed to plan postpartum follow-up in PHC, with an emphasis on mental health, through the development, implementation, and evaluation of a postpartum care protocol. This intervention study adopted a mixed-methods approach with a predominance of qualitative analysis and was conducted in a Primary Health Care Unit in the municipality of Brejo Santo, Ceará, Brazil. The participants were 12 postpartum women who were longitudinally followed throughout the postpartum period. Data were collected between November 2025 and January 2026 through the application of a clinical follow-up protocol consisting of three postpartum consultations, the use of the Edinburgh Postnatal Depression Scale (EPDS), and semi-structured interviews. Data were analyzed using thematic analysis and organized into three scientific manuscripts addressing the applicability of the clinical protocol, the emotional experiences of postpartum women, and the relevance of welcoming practices and qualified listening for the promotion of maternal mental health. The findings demonstrated that the use of a standardized protocol improved the organization and quality of care by enhancing the identification of physical, emotional, and social needs that are often underestimated in healthcare practice. Participants reported ambivalent feelings, including joy, fear, insecurity, and overload, as well as vulnerabilities related to social support networks. They highlighted welcoming practices, qualified listening, bonding with the healthcare team, and longitudinal follow-up as essential elements for promoting security, trust, and emotional well-being. As a Technical-Technological Product, a Postpartum Follow-up Protocol for Primary Health Care was developed to support professional practice and strengthen maternal mental health surveillance and promotion actions. It is concluded that the planning of postpartum follow-up, combined with the use of standardized instruments and humanized care practices, contributes to improving the quality of care, strengthening continuity of care, and promoting the mental health of postpartum women within PHC.