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Rekindling of Nurse-Midwifery in Brazil: Public Policy and Childbirth Trends


  • Marylou Carr CNM, MSN,

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    • Marylou Carr, CNM, MSN, has lived and worked as a nurse, a nurse-midwife, and a health consultant in Brazil, the United States, and Mozambique. She is presently living in Rio de Janeiro, Brazil.

  • Maria Luiza Gonzalez Riesco PhD

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    • Maria Luiza Gonzalez Riesco, PhD, is a professor of nurse-midwifery at the University of São Paulo.

Address correspondence to Marylou Carr, CNM, MSN, Rua Candidô Gaffreé 126, Urca, Rio de Janeiro, RJ 22291-080 Brazil. E-mail:


In the last decade, nurse-midwifery in Brazil has experienced many changes both professionally and politically. In the 1990s, Brazil's Ministry of Health generated policies to improve childbirth services. Included in these policy initiatives was legislation for the reimbursement of nurse-midwifery services and a substantial increase in financing of nurse-midwifery schools throughout the country. It was during this period that the Brazilian National Nurse-Midwifery Organization was formed to provide professional leadership and an alternative model of childbirth care. The future is hopeful, but the nurse-midwifery profession will need collective determination to succeed in changing practices and improving services to women and families.