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From the traditional midwife to the female obstetrician. Birth and pinnacle of the profession of licensed midwifery in 19th century Peru
Abstract
In Peru and the rest of the Hispanic world, the 19th century was a time of profound change in the practice of medicine and especially in obstetrics. Among the leading agents in this development were the midwives, whose profession was born and established at that time. Previously, traditional midwives were responsible for accompanying women during labour in an almost entirely female universe. In the late 18th century, enlightened Peruvians became interested in child-birth and the perinatal period. They mainly criticized the practice of traditional mid-wives and presented to public opinion the need for theoretical training under the supervision of medical staff. After Independence, the Enlightenment discourse was resumed by the public authorities of the nascent state. This project became a reality thanks to the arrival in Peru of the French midwife, Benita Paulina Fessel, an enterprising woman who wished to establish the Parisian (Port-Royal) birth model. The confluence of these factors led to the birth in 1826 of the first Maternity Hospital in the Hispanic world with a specific function, which was associated with a Childbirth school led by Madame Fessel, who was herself an alumna of the Maternity Hospital in Paris. Lima Maternity Hospital trained several generations of midwives, who received an excellent theoretical and practical training and established themselves as competent professionals. During the second half of the 19th century, obstetricians, as they were named from that time in Peru, accompanied more and more women in the throes of childbirth and proved able to endure the pressure of doctors and take possession of this essential moment in the life of women.
... Study aims varied; two articles focused on identifying the experience of one partera tradicional via in-depth interviews describing practices and life experiences (Champion, 2013;Laza Vásquez, 2008). Another article analyzed the historical context of partería tradicional (Quiroz, 2012). Nine articles explored parteras tradicionales status within specific regions and relationships with pregnant women, environments, populations, formal health care providers, and governmental entities (Amanuel et al., 2019;Anderson et al., 2004;Davis-Floyd, 2001;El-Kotni & Ramírez-Pérez, 2017;Laureano-Eugenio et al., 2016;Laza Vásquez & Ruiz De Cardenas, 2010;Low et al., 2006;Rangel Florez et al., 2017;Romero Zepeda, 2012). ...
... During the 19th century, governments around the world promoted replacement of traditional practices by parteras tradicional with those extensively validated by modern medicine. However, partería tradicional preserves its culture today and strives to avoid incorporation of new elements into their practice (Quiroz, 2012). Rangel Florez et al. (2017) described such resistance as a response to misperceptions that formal health care systems have about partería tradicional. ...
Aim:
To identify practices, beliefs, and potential gaps in knowledge about partería tradicional in Latin America.
Background/introduction:
Partería tradicional (lay midwifery) refers to ancestral knowledge used by laypersons, mainly parteras tradicionales (lay midwives), to provide health care to women and children. This care, initiated prior to formalization of health care continues today. Descriptions of the intergenerational oral transmission of partería tradicional knowledge and practice in Latin America exist without related synthesis.
Methods:
Qualitative synthesis of the literature, including publications in Spanish, English, and Portuguese indexed in public databases over the previous 22 years concerning partería tradicional. Identification of categories, themes, and bias reporting via PRISMA processes, using the Thomas and Harden's approach and the Noblit and Hare's methodological recommendations.
Results:
Partería tradicional themes included "ancestral knowledge," "destiny and a spiritual calling," "woma's heritage," and "a means for providing health care."
Discussion:
Parteras tradicionales are key providers of health care for rural and urban marginalized communities. Limited knowledge and understanding of this practice impacts interactions between parteras tradicionales, midwives, and nurses. An interchange of knowledge is fundamental for care congruent with culture and the humanization of women's reproductive health.
Conclusions and policy implications:
Communities with unresolved health care needs benefit via collaboration between formal health practices and partería tradicional. A compelling need for inquiry to preserve the art of partería tradicional exists internationally. Parteras tradicionales must be considered when formulating health care policy, thereby enhancing their historic role among the most vulnerable populations in Latin America: protecting, caring, and addressing health care needs.
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