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This essay addresses women and medicine in the Middle Ages, especially works concerning the female body and reproduction. Positive representations of the female body are found in the mystical writings of, for example, the thirteenth-century nuns of Helfta and Mechthild of Hackeborn, and, in contrast to later gynaecological works, which were often deeply misogynistic, Hildegard of Bingenߣs medical texts ascribe a redemptive quality to womenߣs reproductive processes. Most medical treatises, however, were not written for women, and even women involved in health care, including midwives, had little access to them. The Trotula, a compendium on womenߣs medicine taking its name from the twelfth-century woman physician Trota, was widely disseminated and translated as a whole and in parts, but although early Latin versions were addressed to women, later versions were owned largely by men. Nevertheless, there is some evidence of female readership and audiences, and the translation of medical treatises about women into the vernacular increased womenߣs access to this important form of textual knowledge.
This chapter studies medical midwifery in Japan, which developed in the 1860s–1890s in parallel with the management of vital statistics within the Meiji government. The chapter describes that the profile of midwives was significantly transformed in the Meiji period, from regionally diverse birth attendants, often implicated in abortion and infanticide, to medically informed and licensed healthcare practitioners, defined by their role in enhancing – yet simultaneously monitoring – people’s everyday reproductive experiences. At the same time, it also shows how this transformation of midwives was intimately tied to the public health officers’ desire to collect and manage more “accurate” data about infant births and deaths, which they judged would be essential to construct a genuinely “modern” public health system. In this context, the medical midwife was an invaluable local point from which statistical data on infant health entered into the state administrative system. By juxtaposing the history of the professionalization of midwives with that of the establishment of vital statistics in public health, this chapter shows how the burgeoning statistical rationale acted as a pivotal background for the making of medical midwifery in modern Japan.
Post-traumatic stress disorder frequently alters the quality of life.
Objectives
Assess the quality of life in midwives who have post-traumatic stress disorder.
Methods
We conducted a cross-sectional study among midwives in a single university hospital centre using a self-administered questionnaire. We screened post-traumatic stress disorder using the Impact of event scale and the quality of life using 5 items Likert scale.
Results
Our response rate was 82%. Out of 42 midwives who answered us, 18 had post-traumatic stress disorder symptoms (42.8%). They were all female. Their mean age was 45.6± 10.3 years. The traumatic event occurred mainly at work and was related to the death of a mother or a baby. Symptoms of post-traumatic stress disorder symptoms were severe in 5 midwives. The quality of life was altered in 38.8% of participants. Both post-traumatic stress disorder symptoms and alteration of the quality of life were more frequent in patients who don’t have leisure activities.
Conclusions
In conclusion, midwives are vulnerable to developing post-traumatic stress disorder. Encouraging sports and other leisure activities may protect them from having severe repercussions on their life.
Breastfeeding has numerous health benefits for the mother and child. For breastfeeding to be successful and continue for longer, women need adequate support. Fathers/partners play an important role in providing this support to women, but research suggests that fathers/partners often feel inadequately informed and supported by health professionals. Midwives and health visitors are in ideal positions to offer women and their partner’s timely and relevant breastfeeding information and support throughout the perinatal period. This article discusses the benefits of breastfeeding, presents research evidence of the crucial role fathers/partners play in promoting and supporting breastfeeding, and recommends ways in which health professionals can provide breastfeeding information and support to fathers/partners.
Inscriptions collected in this chapter demonstrate that women were employed in a wide range of occupations: not only were they engaged in gendered professions, as hairdressers, wet nurses and midwives, but they were also involved in more general vocations, for instance as physicians, albeit less frequently than men. Women were involved in trade and a limited number of crafts (primarily clothing and luxury production), and in education, entertainment and prostitution. Most working women we meet in inscriptions were freedwomen who had been trained as slaves. Their brief epitaphs advertise their professions as part of their social identity. Apart from funerary inscriptions, amphora stamps and painted messages on potsherds record the names of female ship owners and traders exporting wine and olive oil, brick stamps demonstrate their engagement as managers and owners of brick production and lead water pipes their management of lead workshops, graffiti advertise their services as prostitutes and wooden tablets their particpation in business transactions. Most testimonies are from Rome and the cities of Italy.
This chapter examines birth customs and bodily experiences and practices as an important but rarely considered dimension of private life under Nazism, setting them in the context of the complex racial and ethnic hierarchies created by Nazi occupation policy in Poland. It outlines the power relations and practices associated with women giving birth in the Nazi-annexed Polish territory of the ‘Reichsgau Wartheland’, and focuses in particular on the relationship between ethnic German (Volksdeutsche) women giving birth and the German and Polish midwives they sought out to assist them. Efforts by Reich German midwives to control events in the birth room sometimes faced fierce opposition on the part of the women giving birth, who asserted their right to privacy and to choose persons they trusted to be present at the birth. While the Nazi regime sought to exclude Polish midwives from attending German women giving birth, the supply of German midwives was inadequate. Polish midwives therefore continued to practise, though their precarious status made them vulnerable to harassment by the occupation authorities and accusations by Volksdeutsche of malpractice.
This chapter examines the home leave granted to soldiers during the Second World War as a fundamental dimension of private life for millions of Germans in wartime. It explores the topic from a number of different perspectives. It outlines the regime’s policies and propaganda regarding home leave as a privilege, focusing on the regime’s goals and its conflicting impulses both to control the time men spent away from their military duties and to allow some degree of undisturbed privacy. The chapter then examines personal letters between home and front in order to explore the expectations and experiences relating to home leave on the part of the men on leave and their wives or girlfriends and families. Finally, it uses cases from military and civil courts to show instances of marital conflict and domestic violence associated with home leave.
To appraise the awareness and knowledge levels of midwives and nurses concerning early screening for Zika virus (ZIKV) infection among pregnant women attending health care facilities in Bahrain.
Methods
This was a cross-sectional, purposely chosen study of Bahraini and expatriate midwives, nurses, and supervisors employed in gynecology/obstetrics and labor wards of Salmanya hospital, a maternity hospital, 4 private hospitals, and health centers in Bahrain. The chosen individuals were invited to participate in a survey on awareness and knowledge of early screening for ZIKV infection.
Results
Of 266 midwives and nurses employed in the study sites, 170 (64%) consented to participate in the study. Of those who agreed to participate, 76 were midwives and 94 were nurses. Admittedly, 39% of midwives and nurses were unaware of ZIKV infection. The grand mean knowledge score in the study was 39%. Expatriate midwives and nurses scored better than did Bahrainis (P<0.001). The grand mean knowledge scores of evening and night shift duty participants were significantly higher than those of the day duty participants.
Conclusions
The awareness and knowledge scores of midwives and nurses concerning ZIKV infection were inadequate, which supported our hypothesis. By harnessing modern technology and support systems, lifelong learning can be used as a means to enhance preparedness for public health crises such as ZIKV. (Disaster Med Public Health Preparedness. 2018;12:7–13)
The power of stories to persuade in infl uencing the process of change is the focus of this article. Attention is given to the importance of stories in making sense of past experience, of unifying groups, and in presenting options for future engagement and action. Unlike the narrative concern with sequencing, coherence and the need for a beginning, middle and end, it is argued that stories are often partial and ongoing, occur at multiple levels compete, complement and redefine positions. The plurality and political nature of stories are illustrated in an analysis of data drawn from a longitudinal study of six health care sites in remote and rural Scotland. The study concludes by arguing that stories are a powerful political vehicle in influencing sense-making and a critical component in maintaining choice and defl ecting the imposition of a single simple solution (hegemonic influence) over various interpretations of what are complex context-based issues.
After the passing of the 1902 Midwives Act, a growing proportion of women were delivered by trained and supervised midwives. Standards of midwifery should therefore have improved over the first three decades of the twentieth century, yet nationally this was not reflected in the main outcome measures (stillbirths, early neonatal mortality and maternal death). This paper shows that there was a difference in the risks associated with delivery by the different attendants, with qualified midwives having the best outcome, then bona-fide (untrained) midwives and lastly doctors, even when account is taken of the fact that doctors were called in cases of medical need and may have been booked where a problematic delivery was expected. The paper argues that the lack of improvement in outcome measures could be consistent with improving standards of care among both trained and bona-fide midwives, because increased attention to the rules stipulating when midwives called for medical help meant that a doctor was called into an increasing number of deliveries (including less complicated ones), raising the chance of unnecessary and dangerous interventions.
Women with pre-existing medical and obstetric problems are at increased risk of complications in pregnancy. Such high-risk pregnancies result in increased maternal, fetal and neonatal morbidity and mortality. In 2008, the National Institute for Health and Clinical Excellence (NICE) issued guidelines for routine antenatal care of healthy pregnant women. Common medical conditions that confer a higher risk to the pregnancy but are often unrecognised at referral are obesity and mental health disorders. Integrated care pathways can be used as tools to incorporate local and national guidelines into everyday practice, manage clinical risk and meet the requirements of clinical governance. Training programmes for midwives, obstetricians, GPs and psychiatrists should include perinatal psychiatric disorders. The needs of the local population must be taken into account when planning a service in terms of providing the correct care, particularly in areas where there are large numbers of women from migrant and ethnic minority populations.
Increasingly, attention is shifting away from a focus on postnatal depression to the recognition that depression may be a recurrent experience in many women’s lives with the perinatal period constituting a time of particular vulnerability. This article reports on a study undertaken in one primary care trust which explored mothers’ and practitioners’ experience and awareness of antenatal depression and considered the service response offered by midwives and health visitors. The mothers who participated in focus groups felt ill prepared for the possibility that depression could occur during pregnancy. They identified social and role expectations as well as professional attitudes and service delivery models as barriers to disclosing feelings of depression during this period. The midwives and community nurses surveyed placed rather less emphasis than mothers on the value of continuity of care in pregnancy in promoting disclosure of mental health problems. Community midwives appeared less confident than health visitors in detecting and responding to antenatal depression but both groups of professionals had little knowledge of relevant community services. Co-ordination between midwives and health visitors appeared limited and contact with mental health services was lower than might have been anticipated; the general practitioner (GP) was still seen as the key resource in cases of antenatal depression. However, many of the mothers participating in the study found GPs unresponsive to expressions of negative feelings in pregnancy. The article considers approaches for increasing awareness and detection of antenatal depression and improving co-ordination between services.
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