1 process of creATINg THe BrAZILIAN AssocIATIoN of mIdwIves ANd oBsTeTrIc NUrses

objective: to describe the process of creating the Associação Brasileira de Obstetrizes e Enfermeiras Obstetras National by obstetricans nurses. method: this a qualitative study of social historical approach. The corpus of analysis of this study was to the primary sources that consisted of written documents and oral testimony got from interwiews. We used for the analysis triangulation of data, in the light of the theoretical framework of Pierre Bourdieu. results: The process of creating the Associação Brasileira de Obstetrizes e Enfermeiras Obstetras Nacional started with the approach of the Obstetric Nurse to the Associação Brasileira de Obstetrizes and the international recognition of the Obstetric Nurse by the the Midwives and the transformation of this association. conclusión: Associação Brasileira de Obstetrizes e Enfermeiras Obstetras was established in 1992, from a political alliance between the midwife/ midwife and obstetric nurse, as were recognized as subjects with legitimate practices. descrIpTors: Obstetric nursing. History of nursing. Women’s health. o processo de crIAção dA AssocIAção BrAsILeIrA de oBsTeTrIZes e eNfermeIros oBsTeTrAs


INTrodUcTIoN
The late 1970s and early 1980s was a period of intense political upheaval in the country, especially in the large urban centers, as demonstrations against the military dictatorship intensified with the participation of trade union and women's movements.In this context, specifically regarding the feminist movement, which advocated female protagonism, integral care that no longer focused only on pregnancy was proposed.] This program had a strong base in educational actions, as it was believed that educational groups could empower women towards the exercise of citizenship. 3In the implementation of the PAISM actions, nurses were allied, using their latest work instrument, approved by Law No. 7498/1986, the nursing consultation in prenatal care and gynecology.
In the 1980s, there were also many discussions focused on care during the delivery.International and national criticism revolved around the authoritarianism of physicians, including questioning the scientific nature of their technologies and interventions used in childbirth as routine.This led to the Pan American Health Organization (PAHO) and the regional offices in Europe and the Americas of the World Health Organization (WHO) conducting three consensus conferences, emphasizing the rights of the population in relation to prenatal care and information about the various technologies used in childbirth, describing the role of health institutions in relation to the birth and criticizing the biomedical model.][6] Issues relating to women's health were discussed amid the political movements in the field of health in Brazil and according to international directions.In this sense, in 1986, the VIII Health Conference took place, which, in its final report, proposed the establishment of the Brazilian National Health System (SUS). 7Two years later, in 1988, a new Constitution was promulgated in Brazil and placed health as a right of the citizens and duty of the state, following the recommendations of this Conference.
] In this context of democratization of the country and fight for the rights of citizenship, the obstetric nurses were organized politically and, in the city Rio de Janeiro, created the Brazilian Association of Midwives and Obstetric Nurses (Associação Brasileira de Obstetrizes e Enfermeiros Obstetras ABENFO-National), in 1992.This study aims to describe the process of creating the ABEN-FO-National by the obstetric nurses.

meTHod
This was a qualitative study that used a sociohistorical approach.The initial time delimitation was the year 1989, chosen due to this being the beginning of the transition period of the Brazilian Association of Midwives (Associação Brasileira de Obstetrizes -ABO) to the ABENFO-National.The year 1992 was the final time delimitation, marked by the first meeting for the creation of the ABENFO-National.
The primary sources consisted of written documents and oral statements.The written docu-ments were obtained from public and private collections, from official journals and the internet.The written documents were stored in folders.The only criteria established for this organization was the year of the documentary source.The reading of the documents played a major role in this phase of organization of the sources.For each document, a record was created to explain the type of document, from this action, a table was created with the synthesis and classification of the materials obtained.
Oral statements of six nurses who participated in the process of creating the ABENFO-National were obtained from interviews, however, for this article, the statements of only two obstetrical nurses were used: Marilanda Lopes de Lima -Founder and First President of the ABENFO-National (Interview 01) and Maria Luiza Gonzalez Riesco -First President of the São Paulo section of ABENFO (Interview 02).
For the collection of oral statements, semistructured interviews were used, following a script that focused on the following topics: description of their inclusion in nursing and in the obstetric nursing specialty and their roles in the ABENFO-National.The reports were obtained from March to June 2013.
With the construction of the data set, the following steps were used as a method of analysis: [10][11] for the ordering of the data, the interviews were transcribe in their entirety aiming to make the initial ideas operational and systematize them, which directed the development of the subsequent operations; the classification of the data, reading of the transcribed interviews and documentary analysis were performed, the relevant structures of the social actors and the central ideas transmitted by the subjects were identified and, from there, the data were organized into categories, with a subsequent triangulation of data; i.e., the findings in the interviews were articulated with the written documents, always taking into account the assumption and the objectives of the study, considering the theoretical framework of Pierre Bourdieu and the historical context of the time.
In this analysis process, three categories representing the phenomena that occurred in the creation of ABENFO-National were identified, which will be described below: the approach of the ABO; recognition of the Brazilian Obstetric Nurses by the Midwives of the Inter-American Federation of Midwives (IAFM); and the transformation of ABO into the ABENFO-National.
Considering Resolution No. 196/96 of the Ministry of Health, which deals with research involving human subjects, permission to conduct the study was requested from the board of the ABEN-FO-National.The Research Ethics Committee of the Universidade Estadual do Rio de Janeiro/SR2 approved the study, according to Declaration No. 05/2012.All interviewees authorized their participation in the study, as well as the disclosure of their names, by signing the consent form and disclosure of the names of the institutions mentioned was authorized by the President of the ABENFO-National.

resULTs ANd dIscUssIoN
The approach of the obstetric Nurse to the Brazilian Association of midwives It was in the 1970s, in the struggle for democratization of the country and the rights of workers and women, that Maria de Lourdes Garcia de Andrade, president of the Union of Midwives of Rio de Janeiro, met the professor of the Faculty of Nursing of Universidade Estadual do Rio de Janeiro (UERJ), Therezinha Nobrega da Silva, who, in turn, introduced this president to an obstetric nurse, also a professor of the Faculty of Nursing of UERJ, Marilanda Lopes de Lima.
From the meeting of these agents, in the 1980s, came the possibility of adding obstetric nurses to the Union of Midwives of Rio de Janeiro, which was in decline due to the termination of the training of these professionals in Brazil since the early 1970s.
Given this situation, the statement below shows that the intentions of the leadership of the Union of Midwives with the affiliation of obstetric nurses was that these specialists would become the heirs of the patrimony of this entity: you will have the union office, because this office belongs to us, and we have to pass this on, you need to inherit this property 4/8 from us, the telephone, an office in Rio de Janeiro city center [...] (Interview 01).
However, this entry of the obstetric nurses also moved the Union, with the promotion of events.Among them, we highlight the I Meeting/ State Seminar of Obstetric Nurses, held in 1988, which was supported by teachers and students of obstetric nursing of the Faculdade de Enfermagem, Universidade Estadual do Rio de Janeiro (ENF/UERJ).At this meeting, the participation of obstetric nurses in the labor market and the lack of autonomy of these professionals was discussed, which most bothered the organizers of the event we organized and held the 1 st Obstetric Nursing Seminar in Rio de Janeiro.Because

we wanted to know the situation of the nurses in the labor market, what was the level of satisfaction of these nurses, what was going on [...] I did my training in São Paulo, where the nurse had autonomy, the nurse would assist both institutional and home low risk deliveries [...] In Sao Paulo, many private hospitals allowed midwives and obstetric nurses on the shifts. They didn't even have doctors [obstetricians], they had a general surgeon, an anesthetist, a pediatrician within reach, but who was in charge of all the delivery and the shifts was the nurse/midwife. So I came from São Paulo with this reality and here in Rio de Janeiro [...] I couldn't do this and couldn't do that. It always bothered me a lot [...] (Interview 01).
It was in this field that Maria de Lourdes Garcia de Andrade presented the ABO, of which she was one of the founding members, to Marilanda Lopes de Lima.As with the Union of Midwives, the ABO, which was presided over by the Midwife Zilda Nogueira Rodrigues, was also in decline.

Maria de Lourdes [Garcia de Andrade] said to me, you need to know Zilda Nogueira [Rodrigues]. She is the president of the ABO. Because this Association of Midwives no longer exists, so this Association has to be taken over by the obstetric nurses [...] (Interview 01).
Several attempts to contact the president of ABO were made without success.However, the most concrete opportunity came about with the Third National Congress of Matrons/VIII Inter-American Congress of Midwives, organized by the (IAFM) and by the College of Matrons of Chile, which took place between 22-27 October 1989 in the city of Santiago.
The agents Marilanda Lopes de Lima and Maria de Lourdes Garcia de Andrade signed up for this event in order to find out whether the Inter-American Federation of Midwives (IAFM) could collaborate in the incorporation of the ABO by the obstetric nursing.However, to enroll in the Congress, it was necessary to be associated with the ABO.
Thus, before signing up at the event above and in order to join the ABO, once again, the agent Marilanda Lopes de Lima went to meet the agent Zilda Nogueira Rodrigues who kept all the documentation of the ABO at her residence, including the statute and the new member registration forms.
According to this Statute, published on August 22, 1967, certain items were important for the appointment of new members, such as: in Chapter I (of the Constitution), article 2 said that this institution is social, professional, recreational, cultural and charitable, consisting of an unlimited number of members aged over 18 who possessed the title of registered Midwife, or Obstetric Nurse trained in Medical Faculty courses, irrespective of nationality, race, color, political or religious beliefs; and in Chapter IV (of the Admission of Members), Article 11 said that the admission of members would be made upon the proposal being presented to the Board by a sitting member.Before being decided by the Board, the proposal should receive the opinion of an Union Committee convened by the President of the Association.Proposals should be accompanied by the membership fee, first monthly fee and two size 3x4 photographs.* In this sense, the agent Marilanda Lopes de Lima had some items to join the ABO, such as the proposal of a sitting member within the Association, which in this case was the agent Maria de Lourdes Garcia de Andrade, and the money to pay.However, the agent Zilda Nogueira Rodrigues rigorously demanded that Chapter I of the statute was fulfilled.Thus, Marilanda Lopes de Lima could not join because she was not a Midwife or Obstetric Nurse trained in a Medical School.
This difficulty for the obstetric nurse trained in a nursing school to be included in the ABO can be explained by the struggles that existed between midwives/obstetricians and nurses in the 1950s.These struggles were for occupation of the space in the obstetric field, which was reconfigured to the detriment of the process of medicalization and hospitalization of the delivery.
However, given the ABO conditions during the period studied, the agent Zilda Nogueira Rodrigues and the few members who were active We can explain that this acceptance of an obstetric nurse by the midwives happened due to an "respectful distance", which is a characteristic of those who do not have an advantage in the field, because when there is a visibly expressed distinction, as was the case, the acceptance comes from those agents that do not have provisions and conditions for apprehension of these cultural products. 12

The International recognition of the obstetric Nurse by midwives
Duly associated with the ABO, the agent Marilanda Lopes de Lima requested authorization to be a representative of the Association at the III National Congress of matrons/VIII Inter-American Congress of Midwives, which was agreed by the agent Zilda Nogueira Rodrigues, with the issuing a document: she [Zilda Nogueira Rodrigues] said: 'Well, then, considering this, we will have a meeting to approve your trip to Chile'.Then she gave me a document to authorize my inscription there, and I went to this event as the Brazilian representative [ABO] (Interview 01).
Thus, the agent Marilanda Lopes de Lima went to the congress in Chile in 1989, accompanied by the agent Maria de Lourdes Garcia de Andrade and by the president of the ABO.The theme of this Congress was "The Matron (Midwife) in Latin America -Evolution and Prospective Trends" and aimed to contribute to the professional exchange of matrons in Latin America for the benefit of the health of the woman and newborn; they also had several meetings and a meeting of the Board of the IAFM Directors as activities.
The president and the representative of the ABO in Congress attended the meeting of the Board of Directors of the IAFM, where the goals to be achieved by the Federation and disseminated to member countries were drawn up.At that meeting, the agent Marilanda Lopes de Lima, was internationally recognized by the midwives as the representative and reproducer of the goals of the Federation in Brazil.
When I introduced myself to the other people as an obstetric nurse, the president of the Federation [Sabina Pineda Rojas] said, an obstetric nurse?We do not have that category here.So I said to the president that in Brazil midwives have not been trained for a long time.It is the obstetric nurses who are assuming responsibility for mother and child care in Brazil and she then welcomed me at the meeting and said that, as the representative of Brazil, since there was no more midwives, it would be up to me to reproduce in Brazil the goals and proposals of the Inter-American Federation of Obstetrics (Interview 01).
Recognition of the obstetric nurse by an International Entity of Midwives helped the agent Marilanda Lopes de Lima become an authorized spokeswoman for the Brazilian obstetric nurses and midwives of the period, as it increased her symbolic power in the field.However, this agent should make visible and trustworthy the ideals of the IAFM in Brazil.
It is important to note that the symbolic power is the invisible power, always hidden, that constructs reality making the agents subordinate to it.It can only be exercised with the complicity of those who do not want to know that they are subjects of it or even that they the exercise it.This power can vary according to the position occupied in the field.It is a power not seen by the social agents, but exercised with the communion of these social agents (dominant) that exercise it, with those subjects who do not want to exercise it (dominated).] Therefore, from this recognition, there was the commitment of this agent to construct a group of Brazilian obstetric nurses, with the mission of contributing to obstetric nursing care, according to the government programs recommended by the Ministry of Health and PAHO, the main one being reducing maternal mortality.

The transformation of the ABo into the ABeNfo-National
The first collective meeting for the constitution of the group of Brazilian obstetric nurses, agreed upon with the midwives of the IAFM after the Congress in Chile, was only performed on June 19, 1992, in the Oswaldo Nazareth Maternity Hospital, also known as the Praça XV Maternity Hospital, in Rio de Janeiro.On that occasion, the slogan was introduced "It's Time to Combine the Parts", which was an allusion to the union of midwives and nurses for the creation of a new association of obstetric nurses.
After this meeting, in the same month of June 1992, in São Paulo, the I Meeting of Obstetric Nurses was organized by the ABEn/SP, together with the Nursing Department of the Paulista School of Medicine.In this event, the agent Marilanda Lopes de Lima used what was an important academic field of training of obstetric nurses to promote the creation of an association of obstetric nurses, from the ABO.
In 1992, we had here in São Paulo a Meeting of Obstetric Nurses, organized by the ABEn of São Paulo together with the Nursing Department of the Paulista School of Medicine.And in this national meeting, organized in 1992, we had Marilanda [Lopes de Lima], who came from Rio to participate and spread the news.She made a disclosure in this national meeting, also with the poster 'Let's Combine these Parts'.She announced that there was a meeting there in Rio trying to organize their own Association (Interview 02).
Thus, a new meeting was scheduled for August 6, 1992, again at the Praça XV Maternity Hospital/RJ, in order to discuss the creation of the new association.This second meeting was attended by two professors at the University of São Paulo (USP), Maria Luiza Gonzalez Riesco and Isabel Cristina Bonadio.
We went to this meeting, Isabel [Christina Bonadio] and I [Maria Luiza Gonzalez Riesco] because the proposal was to create, resume the ABO, which had practically not functioned for many years, and there was a president, Zilda [Nogueira Rodrigues] who had gone to the congress there in Chile, but did not get any more members, because midwives were not being trained in Brazil any more [...] I think the only ones that were not from Rio were Isabel [Christina Bonadio] and I [Maria Luiza Gonzalez Riesco].The president of the ABO [Zilda Nogueira Rodrigues] was not present at the meeting.But, it was important, I think that it incorporated the idea of that meeting that Marilanda [Lopes de Lima] had already called there in Rio in June, of not really letting it die, not let the ABO be extinguished, but transforming the ABO into an Association also of obstetric nurses.The former ABO [...] that I remember, only accepted midwives, but we had the intention [...] that the ABO would open to receive in its new framework the successor of the midwives, us obstetric nurses (Interview 02).
In this sense, the invitation to these professors can be interpreted as a strategy to construct alliances with the São Paulo obstetric nurses, who had a strong tradition in the training of these specialists and could help in the creation and consolidation of the new Association.

Both the USP School of Nursing and the Paulista School of Medicine had and have a tradition of always training obstetric nurses. For a long time, I think the Paulista School of Nursing, from its inception, trained obstetric nurses and still does. Here at the school [USP],
obstetric nurses were also being trained, mainly in the 1960s, and later when the Graduate Course in Obstetrics was incorporated, and the teachers came from this course.So we had a very strong tradition in the obstetric nursing area [...] (Interview 02).
It should be noted that this strategy was efficient, so that the first sector of the ABENFO-National was established in São Paulo, in the year 1993.Also the I Brazilian Congress of Obstetric and Neonatal Nursing (I COBEON) was held in São Paulo on 1994, evidencing the strong support of the nurses of São Paulo, at the expense of the nurses of Rio de Janeiro.
After the second meeting, it was agreed that an association of nurses would be created that also included midwives, who at the time did not have an academic background in Brazil any more, and were therefore dying out.
And in that meeting we came to the conclusion that the ideal was to have an association of obstetric nurses and not salvage the ABO.But the group thought at the time that we would lose a part of history, we could not let the ABO go.And to think about the possibility of salvaging the Inter-American Federation of Midwives whether it could be a gain or not, this matter was not even discussed anymore, it was contemplated but it wasn't discussed anymore by the group.Then the group came to the conclusion that the ideal was to open up a society of specialists in Obstetric Nursing, and we tried several options of names until we got the ABENFO name.And it was decided at that meeting that we were going to include the Midwives and they would not include us, we would include the history of the Midwives and would keep the name of the Midwives in the name of ABENFO.And so we created the Brazilian Association of Midwives and Obstetric Nurses (Interview 01).
This play of forces in the creation of the ABENFO-National was evident.On the one side there were the defenders of the inclusion of obstetric nurses into the ABO, i.e. of the revitalization of the existing association; and on the other, there were those that wanted the inclusion of midwives in a new association of Obstetric Nurses.
We understand that, to reconcile the divergent groups, there had to be a possible path between the two proposals.This path was to create an interim board for the ABO, chaired by an obstetric nurse, who would then transform the ABO into the ABENFO-National.At the same time, there would be no extinction of the ABO and there would be a new association, which would also include the midwives and would be called the ABENFO-National.
Thus, according to the book of the ABO minutes on September 1, 1992, the nurses recovered all the documents of the ABO that were in the house of the agent Zilda Nogueira Rodrigues, appointing a committee for this procedure.**After the contact of the Commission with president Zilda Nogueira Rodrigues, there was a publication in the "O Globo" newspaper, on October 5, 1992, with the call for the members to the general meeting in order to pass the objects of the ABO to the successor group of obstetric nurses, who registered this heritage in the notary's office.***However, this would be a symbolic ritual or rite of passage, which "is a set of formal, expressive acts, carrying a symbolic dimension". 15nly when the newspaper published the meeting as if it were a general assembly, to pass all the objects to us, to pass all of the ABO.Then, we were notarized and registered.What this is here, Registration (Civil) of Legal Entities [...] We were given all the furniture that existed within the ABO headquarters.We were given the photographs, a flag, a book of minutes [...] (Interview 01).
When registered in the notary's office, the institutional ritual became public, as the ritual could not be self-administered, it needed a higher authority entitled to transmit the cultural capital, like happens in magic, that officially and publicly named what was obtained.][18][19][20] The successor group, in legitimate possession of the assets of the ABO, but without any election called or held, on October 15, 1992 met for the allocation of positions on the new board for the triennium 1992/1995, which was composed of five nurses: President -Marilanda Lopes de Lima; Vice President -Lucimar Rodrigues Ferreira; First Secretary -Flávio de Almeida Cabral de Melo; Treasurer -Neide da Costa Reis; and Secretary of Legislation and Culture -Cassia Quelho Tavares.The new board used the Union of Midwives of Rio de Janeiro as the headquarters, as directed by the president of that union, Maria de Lourdes Garcia de Andrade.
Thus, on October 20, 1992, there was the first meeting of the new board of the ABO, in order to discuss and operationalize the reactivation of the organization, to create alternative ways of attracting members and to define the social and scientific technical activities.Discussions revolved around the statute change, which was only altered in 1994, with the advent of I COBEON.
However, the name of the association was immediately changed to the Brazilian Association of Midwives and Obstetric Nurses, creating the acronym ABENFO-National.The minutes stated that the name of Midwives has been retained in the new Association because of its historical and cultural value, even though the training of these professionals did not exist in Brazil at that time.From this moment, the agent Marilanda Lopes de Lima became the founding president of the ABENFO-National.

coNcLUsIoN
It was in a Brazilian scenario of major transformations in the political, health and women's health areas, that obstetric nurses organized themselves and created the ABENFO-National.In the process of creation, we highlight the participation of the Union of Midwives of Rio de Janeiro, under the leadership of Maria de Lourdes Andrade de Garcia and the Faculty of Nursing of UERJ, under the leadership of Professor Marilanda Lopes de Lima, the founding agents of the process.
The ABENFO-National was established in 1992, from a political alliance between midwifes and obstetric nurses, who were recognized as subjects with legitimate practices.This process of creation was first supported by the School of Nursing of USP, followed by the Anna Nery School of Nursing (EEAN) -Federal University of Rio de Janeiro.The first two sectors to be created were that of São Paulo in 1993, under the presidency of the obstetric nurse Maria Luiza Gonzalez Riesco (USP), and that of Rio de Janeiro in 1994, under the presidency of Maria Antonieta Rubio Tyrrell (EEAN-UFRJ).It should be highlighted that the São Paulo sector promoted the I COBEON in 1994, held at the School of Nursing of USP, and the Rio de Janeiro sector promoted II COBEON in 1999, held at UERJ.
Currently, the ABENFO-National has sectors in 26 Brazilian states and is actively participating with the federal agencies to strengthen the training and practice of obstetric nurses and midwifes, with the aim of transforming the medicalized model in the obstetrical field, which has been taking place since the beginning of the 1990s, according to the claims of the labor and birth humanization movement.Therefore, this Association strengthens this social movement nationwide.
Finally, and given the recent events in Japan, where the government has recommend that universities close their Human Science courses, aimed at an operational university with the sole purpose of turning the wheel of the production system, we urge against this process, so that nurses may increasingly preserve their memory, because without this there is no history.In this regard, it is suffice to say that the interpretations of the history of nursing, in addition to giving visibility to not being dominant in the health field, helps us to understand the present and thus guides us in decision making.
The written documents used in the study were: Folder of the Third National Congress of Matrons/ VIII Inter-American Congress of Midwives, 1989; Statute of the ABO -1967; Minutes No. 001 of the Board of Directors of ABENFO-1992; the document drawn up by the obstetric nurse Maria Luiza Gonzalez Riesco entitled ABENFO -Brazilian Association of Midwives and Obstetric Nurses; some fragments of history that were presented in the Nursing Problems discipline of the Inter-unit Doctoral Program of the University of São Paulo Nursing Schools (São Paulo, Brazil) of 1994.

*
* Brazilian Association of Midwives.Minutes No. 001 of the National Council Board on 20 October 1992.Text mimeographed 1992.Riesco ML.ABENFO -Brazilian Association of Midwives and Obstetric Nurses -some fragments of the history.1994.Paper presented to the of Nursing Problems discipline of the interunit doctoral program of nursing schools of USP, São Paulo, 1994.*** Brazilian Association of Midwives and Obstetric Nurses.Register of Transmission of Board Positions of the Brazilian of Midwives.Rio de Janeiro May 06, 1993.Text mimeographed, 1993.
Marilanda Lopes de Lima as a member by presenting her with the titles specialist in Obstetric Nursing and Social Obstetrics and Master's in Nursing issued by the Departamento de Enfermagem da Escola Paulista de Medicina.
* Brazilian Association of Midwives.Statute of the Brazilian Association of Midwives.Official Diary of the Union, Brasilia, DF, August.1967.Section I. Part I. p. 8760-2.accepted