"Parto ideal": medicalização e construção de uma roteirização da assistência ao parto hospitalar no Brasil em meados do século XX / "Ideal childbirth": medicalization and construction of a hospital delivery assistance script in Brazil in mid-20 th century

Resumo No Brasil, as práticas de parto e nascimento passaram por profundas transformações e intenso processo de medicalização, sobretudo em meados do século XX. Os partos, que ainda aconteciam em sua maioria nos domicílios com assistência de parteiras, passaram cada vez mais a ocorrer nos hospitais, assistidos por médicos obstetras, com intervenções, práticas e rotinas próprias. A partir da análise de 31 artigos publicados em periódicos científicos brasileiros da área da obstetrícia entre os anos de 1930 e 1970, procuramos compreender as ideias em torno do processo de construção de uma rotina "ideal" para o parto hospitalar e os argumentos que sustentavam a consolidação da figura do médico como profissional mais habilitado para a assistência ao parto. O debate de obstetras acerca de uma roteirização da assistência ao parto, incluindo intervenções e práticas obstétricas que deveriam ser realizadas como rotina, lançam luz sobre os primórdios do processo de medicalização do parto no Brasil. Com a justificativa de um dever médico de diminuir o tempo e as dores do parto, e não deixar a natureza "agir sozinha", as intervenções foram apresentadas como fruto de um novo conhecimento médico-científico que constituiria a obstetrícia moderna.

Abstract In Brazil, childbirth practices underwent deep changes and an intense medicalization process, especially in the mid-twentieth century. Childbirth, which by then still mostly took place at home with midwives' assistance, began to increasingly occur in hospitals, assisted by obstetricians with their own interventions, practices and routines. Based on the analysis of 31 articles published in Brazilian obstetrics scientific journals between the 1930s and 1970s, we sought to understand the ideas about the process of constructing an "ideal" routine for hospital delivery and the arguments that supported the consolidation of the physician's role as the most qualified professional for childbirth care. The obstetricians' discussion about a scripting of childbirth care, including interventions and obstetric practices that should be performed routinely, shed light on the early stages of the medicalization process of childbirth in Brazil. Justified by the medical duty of reducing time and pain of normal birth and to not let Nature "act alone", the interventions were presented as the result of a new medical-scientific knowledge that would constitute the modern obstetrics.

Changes of Maternal Age Distribution in Live Births and Incidence of Low Birth Weight Infants in Advanced Maternal Age Group in Korea / 대한주산의학회잡지

PURPOSE: The aim of our study is to identify the demographic changes of maternal age distribution in live births and incidence of low birth weight infants in advanced maternal age (> or =35 years of age) group at the time of birth in Korea. METHODS: Birth statistics in 1995, 2000, 2005, and 2008 were collected from Korean Statistical Information Service. Based on the data, total births in each group were 715,000, 634,000, 435,000, and 465,000, respectively. Maternal age distribution ranged from the age of 15 to 50, which were all fertile women. Infants were divided into groups according to birth weight. After maternal age distribution of each year and proportion of advanced maternal age group were examined, a retrospective analysis was conducted on incidence of low birth weight infant (LBWI) in advanced age pregnancy. RESULTS: Number of live births was constantly decreasing during the period of investigation. There was a shift in maternal age distribution; fertile women of the age of 25 to 29 accounted for 54.2% and 51.7% in 1995 and 2000 respectively, whereas those of the age 30 to 34 accounted for 40.8% and 42.7% in 2005 and 2008, respectively. Rate of delivery in elderly gravida were 4.8%, 6.9%, 10.8%, 14.5% in 1995, 2000, 2005 and 2008 respectively, showing a rapid increase. Of the live births, LBWI accounted for 3.0%, 3.8%, 4.3%, 4.9%, thus being increased by about 1.5 times. Overall, with rates of 7.8%, 10.3%, 15.2%, 19.0%, respectively, the proportion of advanced maternal age group with resultant LBWI was higher than that of elderly gravida alone. CONCLUSION: While there has been a constant decrease in number of live births in the last decade in Korea, proportion of advanced maternal age group is rapidly increasing and incidence of LBWI is also gradually increasing. Furthermore, considering that the incidence of LBWI among elderly gravida was increased by a higher degree than proportion of elderly gravida in maternal age distribution, maternal age can be one of the factors causing LBWI.

Diferenciais no comportamento reprodutivo das mulheres Brasileiras: uma análise a partir dos grupos ocupacionais / Differences in reproductive behavior among Brazilian women: an analysis based on occupational groups / Différences de comportement reproductif chez les femmes Brésiliennes: une analyse à partir des groupes professionnels

The aim of this study was to analyze reproductive behavior based on women's occupation in the work market. The hypothesis is that given occupations are associated with different strategies by women in relation to fertility, resulting in different reproductive histories. The study used the database from the Population Census for 2000 conducted by the Brazilian Institute of Geography and Statistics (IBGE). Women's birth histories were reconstructed, and demographic tools were used to perform a descriptive analysis of the relationship between women's reproductive behavior and their occupation. According to the findings, women in more highly qualified occupational groups tended to have fewer children and postpone motherhood longer.

Dans cette étude, on cherche à examiner le comportement reproductif à partir de la profession des femmes sur le marché du travail. On part de l'hypothèse que certaines professions sont associées aux différentes stratégies utilisées par les femmes quant à la fécondité, dont résultent des régimes reproductifs différents. On a utilisé les données du recensement brésilien de l'Institut Brésilien de Géographie et de Statistique (IBGE) en 2000. On a reconstitué l'histoire des naissances de ces femmes et, par le moyen d'instruments démographiques, on a effectué une analyse du rapport entre leur comportement reproductif et leurs emplois. On a vérifié que les groupes professionnels les plus qualifiés sont ceux où les femmes ont le moins d'enfants et retardent le plus la maternité.

STUDY OF THE CHILDBIRTH MARK OF FEMALE SYMPHYSIS OSSIUM PUBIS / 中国法医学杂志

Fifty pubis bone sample from female with childbirth history exihibited the childbirth marks at four sites: on the bony surface of the dorsal proximal margin of the symphyssis ossium pubis,surperior side and the crista ossis pubis,inferior crista,as well asuthe ventrol obligue face and the slope. In case of 48 outof 50 female with childbirth history,the childbirth marks were domenstrated on the bony surface of the dorsal proxiimal margin of the sympyhsois ossium pubis. Only in 3 out of 40 female without childbirth history,the childbirth marks were demonstrated on the bony surface of the dorsal proximal margin. No Mark was found at the rest sites. It was found that there is a positive relationship between times of childbirth and the childbirth mark appearing on the pubis symphysisossium. This method is useful for judging whethet the unknown female dead body has childbirth history or not