A trajetória da Casa do Parto Nove Luas, Lua Nova: concepções e práticas na atenção à gestação, parto e nascimento / The trajectory of Casa do Parto Nove Luas, Lua Nova: conceptions and practices in pregnancy, labor and birth care

Esta pesquisa teve como objetivo principal analisar em perspectiva histórica a trajetória da Casa do Parto Nove Luas, Lua Nova e trazer, à luz dessa experiência, elementos para a reflexão acerca dos modelos de atenção à gestação, ao parto e ao nascimento. A Casa do Parto Nove Luas, Lua Nova foi uma instituição da rede privada que funcionou entre 1993 e 1999, no município de Niterói, no Estado do Rio de Janeiro. Embora desde o início desse século o funcionamento das casas de parto esteja previsto e regulamentado por lei, questões relativas à organização espacial, às práticas e às categorias profissionais que as executam são, atualmente, foco de discussão e controvérsias. Buscou-se, nessa dissertação, trazer visibilidade à experiência da Casa do Parto Nove Luas no intuito de contribuir com novas perspectivas sobre o campo de disputas profissionais e ideológicas que se instauram no campo da humanização da assistência à gestação, parto e nascimento. Para tal, foi realizada uma pesquisa qualitativa, de caráter histórico, a partir de procedimentos descritivos e interpretativos de fontes documentais e entrevistas com os gestores da instituição. O olhar analítico percorreu tanto o processo de desenvolvimento da experiência da casa de parto (seu contexto, seus enredos, seus personagens, suas práticas, as interações internas e externas, os limites e as oportunidades que se apresentaram), como os conteúdos temáticos, dos quais se extraiam as visões de mundo, os sistemas de ideias e valores que a guiaram. As práticas assistenciais ali promovidas e seu legado, visíveis em diversos cenários ­ como na criação da REHUNA (Rede pela Humanização do Nascimento) e na implantação da Maternidade Leila Diniz e da Casa de Parto de Juiz de Fora ­ mostram o pioneirismo da instituição e a importância de seu resgate histórico para a melhor compreensão dos processos envolvidos na conformação do atual panorama de assistência ao parto e nascimento no Brasil.

This research had as main goal to analyze in a historical perspective the trajectory of Casa do Parto Nove Luas, Lua Nova and bring, enlightened by this experience, elements of reflexion about the types of attendance to gestation, labor and birth. The Casa do Parto Nove Luas, Lua Nova was a private institute that operated from 1993 to 1999, in the city of Niterói, Rio de Janeiro state. Although, since from the beginning of this century the functioning of birth centers with homelike settings is described and regulated by the Constitution, matters of spatial organization, practices and professional categories that execute the work are, currently, under the spotlight of debate and controversy. It was pursued, in this dissertation, bringing visibility to the experience of Casa do Parto Nove Luas, Lua Nova with the idea of adding to new perspectives about the professional and ideological dispute field that are established on matters of humanization of the assistance provided to gestation, labor and birth. Therefore, a qualitative investigation was executed, with historical character, based on descriptive and interpretative procedures of documental sources. The analytical view went through from development processes of the experience of this birth center (its context, scenarios, practices, interaction inside and outside, the limits and opportunities that emerged) to thematic contents, from which were extracted the world view, the system of ideas and values that guided them. Its promoted assistance practices and its legacy, visible in many circumstances ­ like the creation of REHUNA (Network of Birth Humanization) and implantation of Maternidade Leila Diniz and Casa de Parto de Juiz de Fora ­ show the pioneering of the institution and the importance of its historical account for better understanding the processes related to the composition of the current panorama of birth assistance in Brazil.

Profilaxia del abandono: cien años de protección de la infancia en Chile / Profylaxis of abandonment: one hundred years of children protecction in Chile

Introduction: During the 19th century and the beginning of the 20th century, infant mortality in Chile was one of the highest in the world. It was common that in poor spheres, children grew in orphan hood, abandonment, and vagrancy. Shelter and welfare institutions, which were supported by the religious and aristocratic philanthropy, had poor life expectancy indicators. Infancy rights were just appearing in the world. After the large epidemics at the end of 1900, the medical corps was sensitized and fomented promotion and primary prevention activities, which went beyond the pure biomedical scope, breaking the existent paradigms. From the second half of the century, life conditions, sanitation, and educational levels improved a lot. When the National Health Service was created, the medical care was organized and public policies with broad coverage were generated, which took us to health standards that were equivalent to those of developed countries. Aim: Travel through the history of infancy in our country and comment the effort of some infancy welfare works of large impact in mother and child health, such as Casa Nacional del Niño, Patronato Nacional de la Infancia, and Seguro Obrero Obligatorio. From here on, we consider the present and future challenges that are present in pediatrics. Conclusions: Chile has been through a fast epidemiologic and demographic transition, which has brought new challenges in the child health sphere, related with life styles, development and mental health. Accordingly, we, pediatricians, should broaden the welfare point of view, incorporating the development approach and the psychosocial and emotional dimensions in the children's care. Following our social pediatrics heritage, we should continue fighting for the equity of opportunities and for the actual fulfillment of the children's rights.

Introducción: Durante los Siglos XIX y principios del XX, la mortalidad infantil en Chile se encontraban entre las más elevadas del mundo y en los sectores populares era frecuente que los niños crecieran en medio de la orfandad, el abandono y la vagancia. Las instituciones de acogida y protección, que eran sustentadas por filantropía religiosa y aristocrática, tenían pobres indicadores de sobrevida; los derechos de la infancia recién emergían. Tras las grandes epidemias de fines del 1900 se sensibilizó el cuerpo médico, impulsando actividades de promoción y prevención primaria, que iban más allá del ámbito biomédico puro, lo que derribó los paradigmas existentes. En la segunda mitad del siglo se avanzó a pasos agigantados en las condiciones de vida, en el saneamiento ambiental y los niveles de educación. Con la creación del Servicio Nacional de Salud se organizó la atención médica y se generaron políticas públicas de amplia cobertura, las que nos llevaron a estándares comparables con países desarrollados. Objetivo: Recorrer la historia de la infancia en nuestro país y comentar la labor de algunas instituciones que tuvieron gran impacto en la salud materno infantil, como la Casa Nacional del Niño, el Patronato Nacional de la Infancia y el Seguro Obrero Obligatorio. A partir de ello, se reflexiona sobre los retos actuales y futuros de la pediatría. Conclusiones: Chile ha pasado por una rápida transición epidemiológica y demográfica que ha traído consigo nuevos desafíos en el ámbito de la salud infantil, relacionados fundamentalmente con los estilos de vida, desarrollo y salud mental. En consonancia, los pediatras deberíamos ampliar la mirada asistencialista incorporando el enfoque de desarrollo y las dimensiones psicosocial y emocional en el cuidado de los niños. Siguiendo nuestra herencia de pediatría social, deberíamos continuar abogando por la igualdad de oportunidades y por el efectivo cumplimiento de los derechos de la infancia.

The Life and Works of Han Shin Gwang: a Midwife and Nurse of Korean Modern Times / 의사학

Han Shin Gwang, born in an early Christian family in Korea in 1902, could get western education different from the ordinary Korean girls in that period. She participated in the 1919 Samil Independence Movement in her teens, and got nursing and midwifery education in a missionary hospital. She got a midwife license and worked as a member in an early mother-and-child health center. She organized 'Korean Nurses' Association' in 1924 and focused on public health movement as the chairwoman. She actively participated in women's movement organizations, and Gwangjoo Student's Movement. She was known to be a representative of leading working women, and wrote articles on woman's right, the needs and works of nurses and midwives. From late Japanese colonial period, she opened her own clinic and devoted herself to midwifery. After the Korean Liberation in 1945, she began political movement and went in for a senate election. During the Korean War, she founded a shelter for mothers and children in help. After the War, she reopened a midwifery clinic and devoted to the works of Korean Midwives' Association. Han Shin Gwang's life and works belong to the first generation of Korean working women in modern times. She actively participated in women's movement, nurses' and midwives professional movement, Korea liberation movement, and mother-and-child health movement for 60 years. Her life is truly exemplary as one of the first generation of working women in modern Korea, distinguished of devotion and calling.

Examen restrospectivo de los servicios medicos maternoinfantiles en el Hospital Albert Schweitzer, en el Haiti rural / A restrospective review of maternal and child health service at the Albert Schweitzer Hospital in rural Haiti

El Hospital Albert Schweitzer, en Deschapelles, Haiti, ha estado brindando durante los ultimos 25 aNos, una amplia variedad de servicios medicos maternoinfantiles a los habitantes de ese distrito rural. Se espera que el panorama general de esos servicios que se presenta en este articulo proporcione informacion util a los administradores de salud y a las instituciones que tratan de extender los servicios de atención de salud a las zonas rurales