Associação das Parteiras Tradicionais do Maranhão: relato da assistência ao parto / Association of Traditional Midwives in Maranhão, Brazil: report on assistance during childbirth

Resumo Estudo etnográfico sobre o trabalho de assistência ao parto prestado pelas parteiras tradicionais do Maranhão, que atendem gestantes residentes no bairro do Anjo da Guarda, na região da área Itaqui-Bacanga, zona periférica de São Luís, MA. Investigou-se o processo de surgimento do trabalho das parteiras a partir dos relatos de 18 parteiras e sua relação com a Secretaria Municipal de Saúde, bem como suas ações. Evidencia também este estudo as atividades desenvolvidas por essas parteiras tradicionais com as gestantes e parturientes da área Itaqui-Bacanga, como complemento ao Serviço Público de Saúde do Hospital e Maternidade Nossa Senhora da Penha. Investigou-se, ainda, o ritual do parto realizado pelas parteiras, tendo como fundamento o saber adquirido empiricamente. O resultado da pesquisa apontou que o trabalho desenvolvido pelas parteiras tradicionais contribui com o processo de conscientização das gestantes para a realização do pré-natal, além de proporcionar conforto psicológico para as gestantes e parturientes, humanizando, assim, o atendimento prestado à mulher no período gravídico.

Abstract Ethnographical study about the work of childbirth assistance provided by traditional midwives, who attend pregnant women residing in Anjo da Guarda, in the region of Itaqui-Bacanga, the metropolitan area of São Luís, MA., The research focused on investigating how the association was created, in accordance with the account of 18 associated midwives, their relationship with the local health care municipal department and the actions derived from such relationship. This study also points out the activities developed by traditional midwives that give assistance to pregnant and parturient women in the Itaqui-Bacanga area, as a complement to the health services rendered by Public Health Care of Nossa Senhora da Penha Hospital-Maternity. The research also focused on childbirth ritual performed by local midwives, considering such ritual as a result of empirical knowledge. The research points out that the tasks carried out by traditional midwives help pregnant women become conscious that they require prenatal care, as well as provide psychological comfort to pregnant and parturient women, humanizing the attendance of such patients.

Intervenciones de capacitación en parteras tradicionales 2005-2011 / Training of traditional midwives in the 2005-2011 period

Introducción: la atención de los eventos de la salud sexual y reproductiva por parte de las parteras tradicionales en el mundo en desarrollo es una realidad y se relaciona con bajas coberturas por parte de los servicios de salud, problemas de acceso cultural y dificultades económicas generadas por conflictos armados internos, entre otras. Objetivo: establecer el estado del arte en relación a los resultados de las intervenciones de capacitación en parteras tradicionales a nivel mundial durante el período 2005-2011. Métodos: estudio documental de corte cualitativo. Las unidades de análisis fueron los artículos científicos de todas las nacionalidades en idioma español, inglés y portugués. Los datos se trataron mediante el análisis de contenido. Resultados: la búsqueda bibliográfica reportó 12 artículos que respondían al objetivo del estudio. De las regiones donde se realizaron las intervenciones, 11 se llevaron a cabo en África y Asia; en contextos rurales dominados por la pobreza, la morbilidad y mortalidad materna perinatal y alteraciones de la salud sexual. Ocho intervenciones se realizaron en el área de la salud materno perinatal y tres en el tema de salud sexual. Cinco implicaron la participación de otros agentes tradicionales y tres de ellas de profesionales de la salud y/o de actividades para potencializar las acciones de capacitación de las parteras. Conclusiones: nueve de los estudios presentan evaluaciones positivas que resaltaron lo conveniente de las intervenciones de capacitación de parteras tradicionales en pro de mitigar las problemáticas de la salud sexual y reproductiva en el mundo subdesarrollado(AU)

Introduction: The care delivery by traditional midwives of sexual and reproductive health events in the developing countries is a reality and is linked to low health service coverage indexes, cultural differences and economic restrictions generated by domestic war conflicts, among other reasons. Objective: To set the state of the art as to the results of training programs for traditional midwives worldwide in the period of 2005 through 2011. Methods: Qualitative documentary study. The analysis units were scientific articles in Spanish, English and Portuguese from a number of countries. Data were processed by the content analysis method. Results: The documentary search reported 12 articles that match with the objective of the study. Among the regions where these training programs were implemented, eleven were carried out in Africa and Asia in rural settings in which poverty, perinatal maternal morbidity and mortality and sexual health disorders prevailed. Eight trainings were performed in the field of perinatal maternal health and three in the sexual health area. Five involved other traditional agents and three included health professionals and/or activities to potentiate training actions aimed at the midwives. Conclusions: Nine studies showed positive assessment that highlighted the suitability of training traditional midwives in order to mitigate the sexual and reproductive problems in the underdeveloped world(AU)