Ejercicio tradicional de la partería frente a su profesionalización: estudio de caso en Jalisco, México

Resumen Objetivo: analizar el estado de la parteria en Jalisco, Mexico, frente al proceso de profesionalizacion. Metodologia: Estudio de caso, realizado desde junio de 2011 a julio de 2013 en tres momentos: I. Entrevistas a profundidad con 20 parteras, II. Cuatro asambleas regionales con 44 parteras, III. Una asamblea estatal con 136 parteras, personal de salud y otros actores sociales, retomando tecnicas educativas populares. Los datos cualitativos fueron analizados bajo el modelo actancial semiotico y los datos sociodemograficos de parteras en Epi Info 7, realizando una meta-inferencia con ambos hallazgos. Resultados: 180 parteras informantes, 89% de zona rural, media de edad 56 anos, 73% con estudios de secundaria o menos, 95% son parteras tradicionales, adoptando esta practica desde la adolescencia, capacitandose en instituciones de salud y entre las mismas parteras; 16,7% estudiaron enfermeria buscando posicionamiento institucional, sin dejar de ser parteras. Actualmente otorgan atencion materno-infantil y a nosologias tradicionales, aludiendo abandono institucional. Existen posturas de rechazo y aceptacion de su incorporacion al sector salud en medicos y enfermeras, mientras que otros actores sociales, piden su reconocimiento. Conclusiones: la parteria en Jalisco, Mexico, es una practica tradicional vital, con o sin reconocimiento institucional, transformandose en respuesta a necesidades de atencion, teniendo que considerar el perfil sociodemografico de las parteras, su papel actual, la perspectiva del personal de salud y otros actores sociales, junto con la estrecha relacion sociocultural y economica del pais, frente a su profesionalizacion. Abstract Objective: to analyze the status of midwifery in Jalisco, Mexico and its professionalization process. Methodology: a case study conducted from June 2011 to July 2013 in three stages: I. in-depth interviews with 20 midwives, II. four regional assemblies with 44 midwives, and III. a state assembly with 136 midwives, health care staff and other social actors. The three stages employed popular educational techniques. In addition, qualitative data were analyzed using the actantial semiotic model, and the midwives’ sociodemographic data were processed in Epi Info 7. Finally, a meta-inference was performed with the findings from both datasets. Results: a total of 180 midwives participated in the study, 89% of which operate in rural areas. The average age was 56, and 73% of the midwives had secondary education or less. Moreover, 95% of them were traditional midwives who adopted this practice since their adolescence and received training from health care providing institutions and from other midwives. In addition, 16.7% studied nursing in order to obtain positions in institutions while remaining midwives. They currently provide care for mothers and children as well as for patients with traditional nosologies. They also mention that they suffer institutional neglect. Among doctors and nurses, there are positions of rejection and acceptance regarding their inclusion in the health sector, while other social actors request their acknowledgement. Conclusions: midwifery in Jalisco, Mexico, is a traditional and vital practice with or without institutional recognition. It is an answer to the need for health care. Likewise, it is necessary to consider the sociodemographic profile of midwives, their current role, the views of the health care staff and other social actors and the close cultural and economic relationship of the Country regarding its professionalization.