A arte de pintar o ventre materno: história oral de enfermeiras e obstetrizes / El arte de pintar el vientre materno: la historia oral de las enfermeras y parteras / The art of maternal womb painting: oral history of nurses and midwives

Resumo Objetivou-se, neste estudo, descrever quando, como e por que a enfermeira e a obstetriz aplicam a pintura no ventre de gestantes. Tratou-se de uma pesquisa exploratória, de abordagem qualitativa, na qual foi adotado o método da história oral temática. Participaram sete profissionais de saúde que aplicam a pintura no ventre e atendem gestantes no Brasil. A coleta ocorreu por meio de entrevistas, realizadas entre os meses de janeiro e maio de 2016. Os dados foram analisados com base na análise temática de conteúdo, de Laurence Bardin. A partir dos discursos, elaborou-se uma árvore histórica da pintura no ventre e emergiram três categorias que elucidam quando, como e por que a enfermeira e a obstetriz aplicam esta arte. Conclui-se que a pintura no ventre tem sido adotada no cuidado pré-natal e dentro da maternidade como estratégia de educação em saúde e na promoção do bem-estar materno e familiar.

Resumen El objetivo de este estudio fue describir cuándo, cómo y por qué la enfermera y la partera aplican la pintura en el vientre de mujeres embarazadas. Se trata de un estudio exploratorio cualitativo, donde se adoptó la metodología de la historia oral temática. Participaron siete profesionales de salud, los cuales aplican la pintura en vientre y atienden a mujeres embarazadas en Brasil. La recolección de datos ocurrió a través de entrevistas, realizadas entre Enero y Mayo de 2016. Los datos fueron analizados de conformidad con el análisis temático de contenido, de Laurence Bardin. A partir de los informes, ha sido elaborado un árbol histórico de la pintura en el vientre, junto a eso emergieron tres categorías las cuales aclaran cuándo, cómo y por qué la enfermera y partera aplican este arte. Se concluye que la pintura en el vientre ha sido adoptada en la atención prenatal y también dentro de la maternidad como estrategia de educación en salud, además de promover el bienestar materno y familiar.

Abstract The present study aimed to describe when, how and why the nurse and the midwife apply the painting on pregnant wombs. It was an exploratory research, qualitative approach, in which thematic oral history was adopted as method. Seven health professionals, who apply painting on the womb and attend pregnant women in Brazil, took part of it. The data provided through interviews conducted between January and May 2016. Data were examined based on the thematic analysis of content, of Laurence Bardin. From the interviews, historical tree of womb painting has been drawn up and three categories emerged, which clarify when, how and why the nurse and the midwife apply this art. The womb painting has been adopted in the prenatal care and in the maternity as a strategy for health education and the promotion of maternal and family well-being.

Historia de las enfermeras obstétricas: importancia de sus cuidados en la atención al parto / The History of Obstetric Nurses and Importance of their Care in Childbirth

RESUMEN Introducción: la mayoría de los informes antiguos señalan que casi todos los partos eran atendidos por mujeres y que este arte era enseñado de una mujer a otra. Su rol ha existido desde el inicio mismo de la civilización, basada en la relación de confianza y de complicidad que son capaces de establecer con la mujer y la familia durante los cuidados en el parto. Objetivo: distinguir la importancia del rol de la enfermera obstétrica para la prestación de cuidados durante el parto. Métodos: se realizó una revisión bibliográfica sistemática para desarrollar un análisis crítico reflexivo del contenido de documentos, se consideraron tesis de doctorado, maestría, artículos originales y de revisión publicados entre 2005 y 2015 en español e inglés. La búsqueda fue realizada en las bases de datos SciELO y Google académico de enero a marzo de 2016, las palabras clave utilizadas fueron: "historia", "comadronas", "enfermeras obstétricas" y "funciones". Tras la identificación de los estudios pre-seleccionados, se llevó a cabo la lectura de los títulos, resumen y palabras clave, comprobando la pertinencia con el estudio. Conclusión: el recorrido por la historia y evolución de la enfermería obstétrica permitió reconocer el valor de las comadronas en la prestación de cuidados así como su influencia en la evolución de esta especialidad con el surgimiento de la Enfermería(AU)

ABSTRACT Introduction: Reports from the past times mostly note that almost all deliveries were attended by women and that this art was taught from woman to woman. Their role has existed since the very beginning of civilization, based on the relationship of trust and complicity they are capable of establishing with the woman and the family during childbirth care. Objective: To distinguish the importance of the obstetric nurse role for the provision of childbirth care. Methods: A systematic bibliographic review was carried out to develop a reflexive-critical analysis of the content of documents. We considered doctoral dissertations and master's degree theses, as well as original and review articles published between 2005 and 2015 in both Spanish and English. The search was made in the databases SciELO and Academic Google, from January to March 2016. The key words used were: historia [history], comadronas [midwives], enfermera obstétrica [obstetric nurses], and funciones [functions]. After the identification of the pre-selected studies, the titles, summary and key words were read, verifying the pertinence with the study. Conclusion: The review throughout the history and evolution of obstetric nursing allowed recognizing the value of midwives in the provision of care as well as their influence on the evolution of this specialty with the appearance of nursing(AU)

Oral Histories of Nurse-Midwives in Georgia, 1970-1989: Blazing Trails, Building Fences, Raising Towers.

INTRODUCTION: This article provides an account of the establishment and development of the contemporary nurse-midwifery profession in Georgia, which was previously undocumented. Oral history interviews with nurse-midwives who were in clinical and educational practice in Georgia during the 1970s and 1980s were collected and analyzed to identify factors that affected the establishment of nurse-midwifery in this state. METHODS: This study relied on historical methodology. Oral history interviews provided primary sources for analysis. Secondary sources included archives belonging to the narrators' nurse-midwifery services as well as scholarly and professional publications from 1923 to the present. Data were analyzed using Miller-Rosser and colleagues' method. RESULTS: In-depth interviews were conducted with 14 nurse-midwives who worked in clinical practice or education in Georgia in the 1970s and 1980s. The narrators' testimonies revealed facilitators for the establishment of nurse-midwifery in Georgia, including increasing access to care, providing woman-centered care, interprofessional relationships, and the support of peers. Resistance from the medical profession, financial constraints, and public misconceptions were identified as barriers for the profession. DISCUSSION: Oral histories in this study provided insight into the experiences of nurse-midwives in Georgia as they practiced and taught in the 1970s and 1980s. Interprofessional connections and cooperation supported the nurse-midwifery profession, and relationships with peers anchored the nurse-midwives. Mentoring relationships and interprofessional collaboration supported the nurse-midwives as they adapted and evolved to meet the needs of women in Georgia.

Attrition from midwifery programmes at a midwifery school in the English midlands 1939-1973: A historical study.

OBJECTIVE: This paper explores the features of attrition from a Midwifery Training programme in mid-twentieth century England. DESIGN: The research uses an historical methodology to explore rates of attrition from a Midwifery Training School in the English Midlands between 1939 and 1973. It uses principally the record books of the Training School which gave details about pupils across the period. This evidence is contextualised through national written and oral archive material. SETTING: Mid-twentieth century England. The period was a time of significant change in the maternity services, at both a philosophical and organisational level with the creation of the National Health Service and a move towards institutional rather than community based maternity care. Midwifery pupils were regulated by the Central Midwives Board, the national body which governed midwifery, and sat national exams based on national syllabi. PARTICIPANTS: Pupil midwives based at the Midwifery Training School whose records are being explored. These included pupils who were had nursing qualifications and those who did not. FINDINGS: Numbers of pupils entering training varied across the period in relation to external workforce factors. The greatest proportions of those in training were pupils who already held a nursing qualification, although numbers of untrained pupils rose across the period. Rates of attrition were particularly high within this group, but across all groups rates rose across the period. CONCLUSIONS: The evidence suggests that despite the very different organisation of midwifery training and care across the period in comparison to contemporary practice, rates of attrition from training programmes appear remarkably consistent.

La socialización de los practicantes a través de los manuales del Dr. Felipe Sáenz de Cenzano 1907-1942 / Socialization of 'Practicantes' through the Manuals of the Dr. Felipe Sáenz de Cenzano 1907-1942

Desde la creación en España del título de practicante en 1857, su enseñanza fue regulada por varios planes de estudio hasta la unificación en 1953 de las tres titulaciones auxiliares de la medicina (practicante, matrona y enfermera), en la de Ayudante Técnico Sanitario (ATS). Este trabajo analiza la socialización de los practicantes a través de las distintas ediciones de El Manual del Practicante (1907, 1922, 1934 y 1942), elaborado por el médico encargado de su enseñanza oficial en Zaragoza, Felipe Sáenz de Cenzano. Tras el análisis de su estructura y su contenido, en especial los fundamentos de su saber y las competencias técnicas o de cuidados al enfermo, resaltamos las diferencias que se observan en los manuales y las legalmente establecidas, que fueron siempre más restrictivas. En conjunto se perfila la configuración de dos escenarios laborales distintos para el practicante, la ciudad y la zona rural, que proyectaron dos imágenes profesionales distintas

Since the creation of the qualification of Spanish practitioner 'practicante' in 1857 in Spain, its teaching was regulated by several curriculums until the unification in 1953 of the three auxiliary degrees in medicine ("practicante", midwife and nurse), in the technical health assistant (ATS). This paper analyzes the socialization of "practicantes" through the various editions of "El Manual del Practicante" (1907, 1922, 1934 and 1942), prepared by the physician in charge of their formal education in Zaragoza, Felipe Sáenz de Cenzano. After analyzing its structure and content, especially the basis of their knowledge and technical skills or nursing care, we highlight the differences observed in the manuals and the legally established, which were always more restrictive. In summary, it be outlined the configuration of two different work settings, the city and the rural area, that projected two different professional images

El informe de Pedro Varaez sobre el oficio de comadre y la réplica de Francisco Antonio Díez de Cabrera / O relatório de Pedro Varaez sobre a profissâo de parteira e o resposta de Francisco Antonio Díez de Cabrera / The report of Pedro Varaez about the profession of midwife and the answer of Francisco Antonio Díez de Cabrera

Objetivos: se ha partido del objetivo de aportar información sobre la visión del oficio de comadre en la España de los siglos XVI y XVII. Constatar las posturas diferentes que, con relación a la práctica de esta actividad, existía en dicho periodo histórico. Método: se ha realizado un análisis pormenorizado de la información que incluye sobre esta temática un manuscrito inédito conservado en la Real Biblioteca de Madrid. Un interesante manuscrito inédito conservado en la Real Biblioteca de Madrid proporciona información sobre la profesión de partera. Consta de dos partes diferenciadas. La primera, más extensa, incluye el informe que redactó el licenciado Pedro Varaez para demostrar que los hijos de madres que practicaban este oficio no perdían sus privilegios nobiliarios en caso de poseerlos por nacimiento. En su exposición, recoge citas de los Libros Sagrados, de las obras de autores clásicos y, sobre todo, de expertos canonistas medievales y diferentes juristas de los siglos XVI y XVII. La segunda, escrita por el también licenciado Francisco Antonio Díez de Cabrera, rebate todos los argumentos esgrimidos por Varaez, pero sin mencionar apenas más que unas cuantas referencias. El documento contiene asimismo interesantes noticias para la historia de la profesión de comadre y el reconocimiento que éstas gozaron en diferentes periodos, como personas que velaban por la salud de las parturientas, poniendo en juego toda su práctica, y cuya presencia era relevante a la hora de garantizar los derechos de los primogénitos, en caso de nacimientos múltiples (AU)

Objetive: To provide information on the vision of the office of midwife in the Spain of the sixteenth and seventeenth centuries. To describe the different positions in relation to the practice of this activity in this historical centuries. Method: Detailed analysis of the information on this subject that it’s included in an unpublished manuscript preserved in the Royal Library of Madrid. An interesting unpublished manuscript preserved in the Royal Library in Madrid provides information on the profession of midwife. It has two distinct parts. The first part includes the report that drafted the lawyer Pedro Varaez in order to show that children of mothers who practiced this profession didn’t lose their privileges in case of having by birth. In his presentation, collects quotes from the sacred books, the works of classical authors and, above all, expert medieval canonists and different jurists of the sixteenth and seventeenth centuries. The second, written by Antonio Diez also licensed Francisco Cabrera, rejected every argument put forward by Varaez, but without mentioning hardly more than a few references. The document also contains interesting information for the history of the profession of midwife and recognition they enjoyed in different periods, as people who ensured the health of women in labor, staking his entire practice, and whose presence was relevant when to guarantee the rights of the firstborn, in case of multiple birth (AU)

Objetivo: Fornecer informações sobre a visão do escritório de parteira na Espanha dos séculos XVI e XVII. Observe as diferentes posições em relação à prática desta atividade foi nesse período histórico.Método: Análise detalhada das informações sobre este assunto inclui um manuscrito inédito preservado na Biblioteca Real de Madrid. Um manuscrito inédito interessante preservado na Biblioteca Real de Madrid fornece informações sobre a profissão de parteira. É constituída de duas partes distintas. A primeira, maior, inclui o relatório que elaborou o advogado Pedro Varaez para mostrar que filhos de mães que praticaram este ofício não perder seus privilégios nobres devem possuir pelo nascimento. Em sua apresentação, recolhe citações dos livros sagrados, as obras de autores clássicos e, acima de tudo, canonistas medievais especialistas e diferentes juristas dos séculos XVI e XVII. O segundo, escrito por Antonio Diez também licenciado Francisco Cabrera, rejeitou todos os argumentos apresentados pela Varaez, mas sem mencionar pouco mais do que algumas referências. O documento também contém notícias interessantes para a história da profissão de parteira e reconhecimento que se em diferentes períodos, como pessoas que assegurada a saúde das mulheres em trabalho de parto, estacando toda a sua prática, e cuja presença era relevante quando para garantir os direitos do primogênito, em caso de nascimentos múltiplos (AU)

Frontier nurse-midwives and antepartum emergencies, 1925 to 1939.

This article examines how the Frontier Nursing Service (FNS) utilized nurse-midwives to respond to antepartum emergencies such as preterm birth, eclampsia, malpresentation, and hemorrhage in the women of Appalachia in the years 1925 to 1939. Particular attention is given to the preparation that nurse-midwives received during their midwifery education to prevent and respond to emergencies. Using traditional historical research methods and primary source material from the FNS papers in the Special Collections, University of Kentucky Libraries, Lexington, Kentucky, this article describes the nurse-midwives' experiences and how they implemented skills they had learned during their training in Great Britain. Working in the isolated mountainous area of Leslie County, Kentucky-for the most part without direct assistance from physicians-FNS nurse-midwives decreased maternal and neonatal mortality rates. During their first 2000 births, they had only 2 maternal deaths, whereas the national average maternal mortality rate was approximately 7 deaths per 1000 births. The nurse-midwives performed external cephalic versions on a routine basis. For pregnancy and birth emergencies, they administered sedation, gave general anesthesia, and performed invasive lifesaving techniques in order to protect the lives of the women in their care. During these 14 years, their cross-cultural engagement, assessment skills, clinical judgment, and timely interventions improved maternal and child health throughout the region.

El saber obstétrico y ginecológico de las mujeres curanderas y de las matronasen los siglos xv y xvi: investigación históricaa través de «La Celestina» / The obstetrical and gynecological knowledge of the women healers

OBJETIVO: Analizar la imagen social de la matrona española durante los siglos xv y XVI y su reflejo en la tragicomedia La Celestina. MATERIAL Y MÉTODOS: Estudio de investigación histórica y etnográfica. El método analítico empleado es el heurístico, mediante la revisión de fuentes escritas. RESULTADOS: El periodo comprendido entre los siglos xv y XVI se caracteriza por un fuerte rechazo general al género femenino y sus enfermedades, impulsado por la Iglesia. Unido a esto aparece una marcada inaccesibilidad de la mujer a la cultura. En medio de este clima destaca la presencia de una mujer sabia, curandera, partera, que ejerce un importante dominio en la práctica de la obstetricia y la ginecología y que cumple una función importante en la medicina doméstica. En la tragicomedia de Fernando de Rojas se muestra al personaje principal, Celestina, como una curandera ligada al mundo de la ginecología mediante su labor en la reconstrucción de virgos, y se expone la imagen social yel quehacer de esta mujer, íntimamente relacionada con la matrona. CONCLUSIONES: La matrona ha tenido un papel fundamental en el cuidado informal de la salud, motivado por una sociedad altamente supersticiosa que carecía de recursos sanitarios. Este carácter informal yel hecho de que las matronas fuesen a menudo mujeres de escasa formación propició que en ocasiones fuera una profesión poco respetada y objeto de persecución por parte de la Inquisición

AIM: To analyze the social image of Spanish midwives during fifteenth and sixteenth centuries and how is reflected in the tragicomedy La Celestina. MATERIAL AND METHODS: Study and research of ethnography and history. The analytic method used is the heuristic analysis which is made through the review of written sources. RESULTS: The period of time between fifteenth and sixteenth centuries is characterized by the strong rejection of feminine gender and everything related with women's diseases, which was prompted by the Church. In addition to that women were not allowed to access to education. In the midst of this situation there is the presence of a wisdom woman who is a healer, a midwife, and who performs her job with a significant mastery on gynecology and obstetrics. Furthermore the midwife had an important role in traditional medicine. In the tragicomedy of Fernando de Rojas is shown the main character, Celestina, as a healer linked to the gynecological assistance. She rebuilds hymens to preserve virginity and the way in which she works is related with midwifes. CONCLUSIONS: The midwife has had an important role in informal care. It was due to the lack of medical resources and the importance of superstition in that time. This informal care and the fact that some midwives were illiterate had made that many times midwives were not respected and prosecuted

"It's been a long road to acceptance": midwives in Rhode Island, 1970-2000.

A resurgence of midwifery came to Rhode Island in the 1970s. Midwives acted as modern health care professionals to conserve a traditional woman-centered birth, but the battle was long and arduous, from Dr. Ellen Stone attempting to eliminate midwives in the state in 1912 to doctors using the death of 2 home birth infants in the 1980s to undermine the growing presence of professional nurse-midwives in the state. Midwives prevailed when the state legislature passed measures in 1988 and 1990 increasing the power and authority of midwives, and when a federal grant in 1993 allowed the University of Rhode Island to open the first training program for nurse-midwives in the state.

Australian primary maternity units: past, present and future.

Primary maternity units are commonly those run by midwives who provide care to women with low-risk pregnancies with no obstetric, anaesthetic, laboratory or paediatric support available on-site. In some other countries, primary level maternity units play an important role in offering equitable and accessible maternity care to women with low-risk pregnancies, particularly in rural and remote areas. However there are very few primary maternity units in Australia, largely due to the fact that over the past 200 years, the concept of safety has become inherently linked with the immediate on-site availability of specialist medical support. The purpose if this paper is to explore the various drivers and barriers to the sustainability of primary maternity units in Australia. It firstly looks at the historical antecedents that shaped primary level maternity services in Australia, from the time of colonisation to now. During this period the space and management of childbirth moved from home and midwifery-led settings to obstetric-led hospitals. Following on from this an analysis of recent political events shows how Australian government policy both supports and undermines the potential of primary maternity units. It is important that researchers, clinicians and policy makers understand the past in order to manage the challenges facing the development and maintenance of midwifery-led maternity services, in particular primary maternity units, in Australia today.

Historical reflection on health promotion within midwifery care in the United States.

Heath promotion has become recognized as a vital component of health care delivery. It is well known that the traditional model of medical care delivery is limited by its focus on diagnosis of illness and treatment. The integration of public health concepts of prevention and health promotion offers depth and breadth of care that is associated with attaining optimal health status. This review offers a historical reflection on the early and continued integration of health promotion activities in midwifery care in the United States.

The campaigns for men to become midwives in the 1970s.

The oral testimony of forty men entering nursing (1950-2000) and twenty men entering midwifery (1970-2000) in Australia is littered with descriptions of gender discrimination. Men identify many of the barriers they encountered entering a female dominated profession. The Nurses' Registration Act in the States of Victoria (1958) and Tasmania (1952) explicitly stated no male could be registered as a midwife and this paper focuses on the personal accounts of three men (1974-1976) to change this legal impediment. In twenty-first century Australia the percentage of male midwives, like many countries around the world, remains very small, and depending on the state or territory of Australia is between 1 to 2.7 percent.

Chinese midwifery: the history and modernity.

AIM: to investigate how and why Chinese midwife numbers are dwindling, and to help understand the role of midwives in society in general. METHOD: to critically examine Chinese midwifery in three stages: (1) historical literature overview; (2) identification and reinterpretation of Chinese midwifery and its development; (3) placing issues that have arisen within a sociological context (i.e. the modernisation of obstetric technologies and the meaning of modernity). FINDINGS: no books on the history of Chinese midwifery were found. History was classified into three stages: (1) before 1929, a period of an indigenous model; (2) 1929-1996, the highs and lows of the bio-medical model; (3) after 1996, the demise of Chinese midwives. The issues identified were the legitimacy and professionalisation of Chinese midwives, the meaning of modernity and the reasons for the decline of Chinese midwifery. CONCLUSION: no sufficient evidence-based research was conducted to support the recent changes made to Chinese midwifery. The modernisation of maternity care in China took place amid dramatic social and cultural changes within society. As a consequence, midwifery as a profession in China has been marginalised. The modernisation of maternity care has failed to deliver on personal choice, quality of service and professional diversity. IMPLICATIONS FOR PRACTICE: evidence-based research and the state's responsibility are essential to ensure the quality of maternity care and to protect the interests of women. The state's responsibilities include legislation regarding the role of midwives, code of practice, professional standards, responsibility and accountability in order to make midwifery care a true choice for women.

A feminist history of Australian midwifery from colonisation until the 1980s.

This paper uses a feminist interpretation and secondary sources to describe the history of Australian midwifery from colonisation until the 1980s. There have been too few midwife scholars who have had access to or used primary data collections to describe the role and place of midwives in the colonising community. I draw on a range of biography, medical literature and work by sociologists and economic historians to produce a limited picture of the history of professional midwifery. This helps to explain the position of midwives today and the problematic relationship we often have with medicine.