Métodos de preparação para o parto: um estudo sobre materiais impressos publicados no Brasil em meados do século XX / Methods of childbirth preparation: a study of printed matter published in Brazil in the mid-twentieth century

Resumo Discute-se a difusão das práticas de parto natural por meio da análise dos livros Parto natural: guia para os futuros pais, escrito pelo obstetra americano Frederick Goodrich Jr. em 1950 e publicado no Brasil a partir de 1955, e Parto natural sem dor, escrito pelo obstetra brasileiro George Beutner, em 1962. Ambos tiveram boa entrada na cultura brasileira e influenciaram a forma de pensar o parto e de parir, tanto no âmbito da obstetrícia brasileira como no que concerne às representações das mulheres. A partir das contribuições de Roger Chartier e das concepções sobre medicalização, concluímos que essas novas práticas de preparação do parto compartilhavam as visões médicas sobre o parto e o nascimento predominantes no período.

Abstract The article explores the dissemination of natural childbirth practices through an analysis of the books Parto natural: guia para os futuros pais, written by U.S. obstetrician Frederick Goodrich Jr. in 1950, under the title Natural Childbirth: a manual for expectant parents, and first published in Brazil in 1955, and of Parto natural sem dor, written by Brazilian obstetrician Beutner in 1962. Both books found a place in Brazilian culture and influenced thinking about childbirth and delivery in the field of Brazilian obstetrics and in representations of women. Based on Roger Chartier's contributions and on concepts of medicalization, we conclude that these new practices for childbirth preparation shared the period's prevalent medical views of childbirth and delivery.

William Hunter (1718-1783): su legado a trescientos años de su nacimiento / William Hunter (1718-1783): his legacy three hundred years from his birthday

The aim of this paper is to evaluate some aspects of the life of William Hunter (1718-1783), and to argue that he deserves a better place in history as he was one of the most outstanding figures in British medicine of the 18th century. A Scotsman, Presbyterian, from a family without means or connections, he underwent a classic education at the University of Glasgow, completed with apprenticeships with William Cullen and Alexander Monro first in Scotland, and then in London, with William Smellie, James Douglas and James Wilkie, in anatomy, obstetrics and surgery, respectively. Despite initial disadvantages, he was highly successful as an anatomist, educator, surgeon, man-midwife, artist, gentleman and collector. He moved and had influences in the highest medical, cultural and social circles of his time, was named Physician Extraordinary to Queen Charlotte, and was a member of many scientific, medical and cultural societies in Great Britain and in France, such as the Royal Society, the Royal College of Physicians and the Societé Royale de Médicine of Paris. His museum was notable in its magnitude and its diversity, including anatomical preparations, coins, shells, plants, birds, insects, fossils, and minerals. He donated his great museum to the University of Glasgow. His figure has been relegated mainly due to the absence of heirs, individuals or institutional, that could have cared for, maintained, and increased his legacy as happened with his brother John.

Ocitocina sintética e a aceleração do parto: reflexões sobre a síntese e o início do uso da ocitocina em obstetrícia no Brasil / Synthetic oxytocin and hastening labor: reflections on the synthesis and early use of oxytocin in Brazilian obstetrics

Resumo O artigo reflete sobre o processo de medicalização do parto, tendo como foco específico o desenvolvimento da ocitocina sintética em 1953. Investiga a vida social da ocitocina, isto é, sua sintetização, estabilização e uso em obstetrícia para acelerar o trabalho de parto. Por meio do levantamento em dois periódicos brasileiros de obstetrícia da época, é analisado o início do uso da ocitocina sintética no Brasil, a partir do final da década de 1950, e os argumentos dos obstetras acerca da recomendação ou não desse uso. É observada, nesse período, a centralidade cada vez maior do obstetra no parto, bem como a recomendação do uso encadeado de diferentes intervenções - com destaque para a ocitocina - visando menor tempo de trabalho de parto.

Abstract This article reflects on the medicalization of childbirth, focusing on the development of synthetic oxytocin in 1953. Specifically addressed is the social life of oxytocin; in other words, its synthesis, stabilization, and use in obstetrics to hasten labor. Two Brazilian obstetrics journals of this era were surveyed to analyze the early use of synthetic oxytocin in Brazil in the late 1950s, along with obstetric arguments for or against its use. Notable in this period is the increasingly central role of the obstetrician in childbirth, as well as the recommendation to use different interventions linked together (particularly oxytocin) to shorten labor.

Fontes para a história da ginecologia e obstetrícia no Brasil / Sources for the history of gynecology and obstetrics in Brazil

Resumo Este artigo se insere no debate sobre a medicalização do parto no Brasil, a partir do levantamento de fontes realizado em bases de dados de bibliotecas brasileiras, e apresenta como objetivo principal a disponibilização sistematizada dos títulos das publicações científicas especializadas existentes nas áreas de ginecologia e obstetrícia no século XX, especialmente na primeira metade desse século. Considerando a relevância da análise de periódicos na construção do conhecimento científico no Brasil, assim como a importância das revistas especializadas na constituição e no desenvolvimento de especialidades médicas, apresentou-se um detalhamento desses acervos, considerando localização, período de publicação e local de produção, apresentando mais detidamente o acervo situado na biblioteca da Maternidade-Escola da Universidade Federal do Rio de Janeiro.

Abstract This article contributes to the debate about the medicalization of childbirth in Brazil through a literature review of databases of Brazilian libraries. Its main goal is to enable the systematized availability of specialized scientific publications in gynecology and obstetrics in the twentieth century, especially 1900 to 1950. In view of the importance of the analysis of journals in the development of scientific knowledge in Brazil and the importance of specialized journals in constituting and developing medical specializations, details of these archives are presented, including their location, when they were published, and where they were produced, paying particular attention to the archive in the library of the Teaching Maternity Hospital (Maternidade-Escola) of the Universidade Federal do Rio de Janeiro.

A concorrência na arte de partejar na cidade do Rio de Janeiro entre 1835 e 1900 / Competition in the arts of midwifery in the city of Rio de Janeiro from 1835 to 1900

Resumo Este artigo discute a concorrência entre parteiras e médicos na oferta dos serviços de partos na cidade do Rio de Janeiro entre 1835 e 1900. Foram analisadas as atas da congregação, os livros do curso de partos e de termos de exames de verificação de médicos, cirurgiões, boticários e parteiras da Faculdade de Medicina do Rio de Janeiro, além de anúncios e propagandas de médicos e parteiras nas colunas "Anúncios" e "Indicações Úteis" do Jornal do Commercio . Observa-se como o aumento do número de médicos-parteiros e seus discursos científicos contribuíram para que as parteiras se vissem obrigadas a diversificar a clientela, instalando-se e atendendo em áreas populares e inóspitas.

Abstract The article discusses competition between midwives and doctors offering birth-related services in the city of Rio de Janeiro from 1835 to 1900. The research analyzed minutes from meetings, textbooks on births, and terms from qualification examinations for physicians, surgeons, apothecaries, and midwives at the Rio de Janeiro Medical School (Faculdade de Medicina do Rio de Janeiro), as well as announcements by and advertisements for doctors and midwives in columns featuring advertisements and useful recommendations in the Jornal do Commercio newspaper. An increase in the number of delivery physicians, and their scientific discourses led midwives to feel an obligation to diversify their clientele, consequently establishing themselves and working in lower-class and inhospitable areas.

A medicalização do parto no Brasil a partir do estudo de manuais de obstetrícia / The medicalization of childbirth in Brazil through the study of obstetrics handbooks

Resumo Nesta nota de pesquisa apresento um relato preliminar da pesquisa de doutorado em saúde da criança e da mulher que estou realizando no Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz. Elegi como objeto de estudo a difusão dos saberes e práticas relativas ao parto. Optei em realizá-lo por meio da análise dos manuais de obstetrícia. Analiso manuais publicados no Brasil, entre 1980 e 2011, e pretendo contribuir para a construção de uma assistência ao parto no qual a mulher e suas necessidades sejam o centro no processo de tomada de decisões sobre os cuidados, intervenções e procedimentos a serem dispensados no trabalho de parto e no parto.

Abstract In this research note, I present a preliminary account of doctoral research in women's and children's health at the Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira/Fiocruz. The aim is to study the spread of knowledge and practices relating to childbirth by analyzing obstetrics handbooks published in Brazil between 1980 and 2011, contributing to the development of childbirth care in which the woman and her needs are at the center of the decision-making process about which care, interventions, and procedures are to be dispensed during labor and childbirth.

Cesárea, aperfeiçoando a técnica e normatizando a prática: uma análise do livro Obstetrícia, de Jorge de Rezende / Cesarean sections, perfecting the technique and standardizing the practice: an analysis of the book Obstetrícia, by Jorge de Rezende

Resumo Discute a apropriação e o desenvolvimento das técnicas de cesariana pelos médicos no Brasil, no século XX, analisando o capítulo “Operação cesariana”, de três edições do livro-texto Obstetrícia, de Jorge de Rezende. O protagonismo desse autor na obstetrícia criou disposições para a normalização da prática da cesárea. As redes de significados praticadas nessa comunidade científica abarcam uma “disposição para um sentir e para um agir” (Fleck) que balizam a cesárea como um parto “normal”: manifesta normas que excluem imprevisibilidade, descontrole, caos, perigos associados à fisiologia do parto, atendendo à exigência de controle, disciplinamento e segurança, atributos associados às práticas técnicas e tecnológicas da biomedicina.

Abstract This article discusses the development of techniques for cesarean sections by doctors in Brazil, during the 20th century, by analyzing the title “Operação Cesárea” (Cesarean Section), of three editions of the textbookObstetrícia, by Jorge de Rezende. His prominence as an author in obstetrics and his particular style of working, created the groundwork for the normalization of the practice of cesarean sections. The networks of meaning practiced within this scientific community included a “provision for feeling and for action” (Fleck) which established the C-section as a “normal” delivery: showing standards that exclude unpredictability, chaos, and dangers associated with the physiology of childbirth, meeting the demand for control, discipline and safety, qualities associated with practices, techniques and technologies of biomedicine.

Surgimiento de la Escuela de Obstetricia en el mapa social de Costa Rica: finales del siglo XIX y principios del XX / Emergence of the School of Obstetrics at the social map of Costa Rica: end of 19th century and beginning of the 2001

ResumenIntroducción.El presente artículo muestra los resultados preliminares que forman parte de la investigación "Funciones sociales de la Enfermería en los diversos procesos históricos desde la construcción de la Salud Pública en la Costa Rica contemporánea", cuyo propósito es analizar los hechos sociales e históricos que favorecieron la profesionalización de la Enfermería, en un primer momento, con la fundación de la Escuela de Obstetricia en 1897.Materiales y método:Este artículo responde a una investigación histórica basada en tres pasos: la revisión de fuentes primarias como la Gaceta Médica y los informes de la Junta de Caridad, y fuentes secundarias; la evaluación crítica de los datos; y la interpretación y conclusiones de los hechos.Resultados:Los hechos que favorecieron la fundación de la Escuela de Obstetricia se relacionaron con la creciente tasa de mortalidad infantil, la necesidad de institucionalizar las prácticas sanitarias e higienizar a la población para construir un Estado fuerte que promoviera el desarrollo económico, así como con la lucha que emprendió la institución médica contra las prácticas populares de atención de salud.Conclusión.Se concluye que la represión de la curandería y la partería estuvo relacionada con el poder patriarcal. Además, la fundación de la Escuela de Obstetricia se relacionó a las condiciones sociales, políticas y económicas de la época basadas en la línea de desarrollo que estaba teniendo el país.

AbstractIntroduction:This article shows the preliminary results which are part of research "Social functions of nursing in different historical processes since the construction of the public health in the contemporary Costa Rica", whose purpose is to analyze the social and historical facts that favored the professionalization of nursing, initially, with the Foundation of the school of obstetrics in 1897.Method:This article responds to a historical research based on three steps: the revisión of primary sources such as the medical Gazette and the reports of the Board of charity, and secondary sources; the critical evaluation of data; and interpretation and conclusions from the facts.Results:The facts that favored the Foundation of the school of obstetrics was linked with the rising rate of infant mortality, the need to institutionalize health practices and sanitize the population to build a strong State for promoting economic development, as well as the struggle undertaken by the medical institution against popular health care practices.Conclusión:It is concluded that the repression of the quackery and midwifery was related to patriarchal power. In addition, the Foundation of the school of obstetrics was related to social, political and economic conditions of the time based on the line of development which was taking the country.

The Lives and Diseases of Females during the Latter Half of the Joseon Dynasty as Reconstructed with Cases in Yeoksi Manpil (Stray Notes with Experienced Tests) / 의사학

Through the cases of approximately 80 females in the case records of traditional physician Yi Sugwi (1664-1740?), the present study divided and reclassified the lives and diseases of females during the latter half of the Joseon Dynasty into childhood, obstetrics- and gynecology-related problems in adulthood, other diseases in adulthood, and old age and analyzed them. According to the results, female children were treated less preciously than were male children so that treatments by traditional physicians were sought out less when they were ill than in the case of male children, and acute infectious diseases were the most serious health problems. In the process of receiving treatment from traditional physicians as adults, females came in contact with traditional physicians, who were male, when necessary including face-to-face sessions and the reception of pulse examination but the yangban (literati-official) class practiced sex segregation as much as possible while the lower classes were considerably free from such restrictions. For female adults, the most serious health issues were pregnancy and childbirth so that they received help from traditional physicians and midwives when there were problems. Traditional physicians determined females' pregnancy and the health of fetuses and pregnant women through pulse examinations and medication and actively responded to diverse problems that surfaced in the process with medication and other treatments. Acute infectious diseases, too, were serious diseases suffered by females, and problems involving cold damage and the digestive system were among diseases frequently suffered by females in adulthood and old age. In old age, females often became ill in the arduous process of dealing with the deaths of adult descendants, siblings, and spouses, and tumors were among the major causes of their deaths. The deaths of those aged 70 or above were accepted as quite natural. Aged females endeavored to maintain their health and played the role of elders giving care to their descendants.

Homenaje al Dr. Richard V. Lee (1937-2013) / A tribute to Richard V. Lee, M.D.

Richard V Lee, MD, MACP, FRGS, Professor of Medicine and Pediatrics and Obstetrics, Adjunct Professor of Anthropology and Social and Preventive Medicine. Director, Division of Maternal & Adolescent Medicine, and Director, Division of Geographic Medicine, Department of Medicine, State University of New York at Buffalo, USA, passed away on May 7,2013. His academic degrees and university positions are a vivid testimony of his wide professional interests and capabilities. As a humanist and ecologist, he became involved in a broad range of medical and research activities in the Brazilian Amazon, the Chilean Southern Andes, the African deserts and highlands, India, the Himalayas, and China. His extensive bibliography on ecology, the health status of geographically isolated populations and the role of physicians on cultural and macro environmental factors, has been summarized in his posthumous book "Out of Bounds. Medicine and The Hundred Acre Wood", recently published by the Royal Society of Medicine, London. The Sociedad Médica de Santiago-Chilean Society of Internal Medicine and its journal Revista Médica de Chile are indebted to his enthusiastic contributions and advice.

A dinamica hospitalar da Maternidade Dr. Joao Moreira, em Fortaleza, nas primeiras decadas do seculo XX / The hospital dynamics at Maternidade Dr. Joao Moreira, Fortaleza, in the early decades of the twentieth century

A Maternidade Dr. João Moreira, primeiro hospital dedicado a mulheres em Fortaleza, foi criada em março de 1915. Seus objetivos eram diminuir os índices de mortalidade durante o parto e inserir o corpo feminino como objeto da prática médica em Fortaleza. Para isso, disponibilizava suas enfermarias tanto para o atendimento das mulheres da cidade quanto para a realização de curso de formação de parteiras. Neste trabalho, analisamos dinâmicas internas dessa instituição: sua organização espacial, seus regimes de cura e disciplina, sua relação com as pacientes, sua equipe hospitalar etc. A consulta de registros estatísticos e de casos clínicos produzidos por médicos auxiliou o estudo desse que foi um dos principais marcos do desenvolvimento da obstetrícia no Ceará.

Maternidade Dr. João Moreira, the first women's hospital in the Brazilian city of Fortaleza, was founded in March 1915. It was created with the goal of reducing infant mortality during childbirth and made the female body an object of medical practice in the city. Its wards were used not just by the city's womenfolk, but also for midwife training courses. In this study, we analyze the dynamics inside the institution: its spatial organization, its healing and disciplinary methods, its relationship with its patients, its medical staff, etc. Statistical records and clinical case studies produced by doctors were important sources of research in this, one of the first initiatives in the development of obstetrics in the state of Ceará.

A higienização das parteiras curiosas: o Serviço Especial de Saúde Pública e a assistência materno-infantil (1940-1960) / The health education of folk midwives: the Serviço Especial de Saúde Pública and mother-child assistance (1940-1960)

Discute as ações de treinamento e controle das parteiras curiosas promovidas pelo Serviço Especial de Saúde Pública, confiadas aos programas de higiene pré-natal e da criança, implantados entre as décadas de 1940 e 1960. Para os sanitaristas, o treinamento e controle das parteiras curiosas atuantes nas comunidades rurais brasileiras eram importantes para o sucesso do projeto de implantação de serviços sanitários locais de assistência materno-infantil. Ao atuar diretamente junto às parteiras curiosas, pretendia-se não somente lhes impor rigorosos padrões higiênicos na realização de partos e nos cuidados com os recém-nascidos, mas, sobretudo, recorrer a sua influência e seu prestígio naquelas comunidades para popularizar ações de saneamento.

The article addresses an endeavor by Serviço Especial de Saúde Pública (Sesp) to train folk midwives who worked in rural communities and to exercise control over these women's activities. The task was entrusted to the agency's prenatal and child hygiene programs, established between the 1940s and 1960s. The agency believed this training and control initiative would be of major importance in helping ensure the success of its project to establish local sanitary services offering mother-child assistance. The goal of working directly with the folk midwives was not only to force them to employ strict hygiene standards when delivering and caring for newborns but especially to use their influence and prestige within these communities to convince the general population to adopt good health practices.

La Ginecobstetricia se reúne en el Balcón del Oriente cubano / Gynecology and Obstetrics to meet in the Cuban East Balcony

El día 7 de abril de 2011, Las Tunas, Ciudad de puertas abiertas acogió una representación de ginecobstetras de todo el país para celebrar, en las hermosas y cuidadas instalaciones de su Facultad de Ciencias Médicas, dos días de fructíferos intercambios en muchos temas de la especialidad.A pesar de las dificultades que enfrenta nuestro país, el ingente esfuerzo de los directivos de la filial Las Tunas de nuestra Sociedad Cubana de Obstetricia y Ginecología liderada por el Dr. Julio Pérez Pantoja junto a un grupo de entusiastas colegas en la comisión organizadora local y los ginecobstetras de la provincia, se vio coronado con el éxito.En este empeño, resultó indispensable y meritorio, el apoyo del Partido y gobierno provinciales, de la Dirección Provincial de Salud, del Rector y Ejecutivo de la Facultad de Ciencias Médicas tunera, del PAMI provincial, de los trabajadores de la gastronomía y los servicios de Tunazúcar y del Club Familiar, que apoyaron con los aseguramientos necesarios, pero sobre todo, proporcionaron una gran dosis de hospitalidad, aquilatando la importancia que tienen estos encuentros científicos para mejorar cada día más nuestro trabajo en pro de la salud de la mujer cubana. ..