Maternal Welfare Research Articles

Health visitors' perceptions on their role to assess and manage postpartum depression cases in the community.

The present study gives an insight into the health visitors' perceptions on their role in assessing, managing, and supporting mothers with postpartum depression (PPD). The study took place in Cyprus among health visitors of a community Maternity and Child Welfare Clinic using qualitative approach. Data were collected through individual semistructured interviews. The findings showed that although health visitors are able to identify PPD cases, they stress the importance of protocols and evidence-based care as well as preventive interventions, and they also point out the importance of home visits. Finally, they support the need for education. It is concluded that health visitors can play an important role in women's health and their intervention on the prevention of PPD in the community especially through home visits is very important.

Problematisation and regulation: Bodies, risk, and recovery within the context of Neonatal Abstinence Syndrome

BackgroundNeonatal Abstinence Syndrome (NAS) is an anticipated effect of maternal drug use during pregnancy. Yet it remains a contested area of policy and practice. In this paper, we contribute to ongoing debates about the way NAS is understood and responded to, through different treatment regimes, or logics of care. Our analysis examines the role of risk and recovery discourses, and the way in which the bodies of women and babies are conceptualised within these. MethodsQualitative interviews with 16 parents (9 mothers, 7 fathers) and four focus groups with 27 health and social care professionals based in Scotland. All the mothers were prescribed opioid replacement therapy and parents were interviewed after their baby was born. Data collection explored understandings about the causes and consequences of NAS and experiences of preparing for, and caring for, a baby with NAS. Data were analysed using a narrative and discursive approach. ResultsParent and professional accounts simultaneously upheld and subverted logics of care which govern maternal drug use and the assessment and care of mother and baby. Despite acknowledging the unpredictability of NAS symptoms and the inability of the women who are opioid-dependent to prevent NAS, logics of care centred on ‘proving’ risk and recovery. Strategies appealed to the need for caution, intervening and control, and obscured alternative logics of care that focus on improving support for mother-infant dyads and the family as a whole. ConclusionDiffering notions of risk and recovery that govern maternal drug use, child welfare and family life both compel and trouble all logics of care. The contentious nature of NAS reflects wider socio-political and moral agendas that ultimately have little to do with meeting the needs of mothers and babies. Fundamental changes in the principles, quality and delivery of care could improve outcomes for families affected by NAS.

Specific features of self-perception and anxiety of a woman with pathology of pregnancy

Objective:The purpose of the article is to describe the empirical research of self-perception and emotional state of a woman with a pathology of pregnancy. At present, reproductive problems, both in women and men, are quite widespread in the world. According to the WHO data there are about 80 million couples in the world who have some difficulties in conception, carrying and giving birth to children. The reproductive health impairment is becoming one of the main problems of modern society, and consequently, the number of psychological problems also increases, because the inability to conceive or carry a baby safely, provided that there is a conscious desire to have children, is one of the most difficult life situations.Method:The leading method to investigate this problem is diagnostic and static methods that allow us to identify the presence of specific features in self-perception and emotional state of a woman during her pregnancy, focusing specifically on the psychological characteristics of women with pregnancy pathologies.Results:Based on the results of the empirical research, the hypothesis put forward about the presence of the specific features in self-perception and anxiety levels of pregnant women without pathologies and women with pathology of pregnancy was confirmed. Women with pregnancy pathology are less likely to feel self-confidence, they have lowered self-acceptance, but compared to women without pathology of pregnancy, the subjects often blame themselves for the situation that happened, they start to be responsive to their health and react to any bodily changes.Conclusion:Psychological support and guidance of pregnant women at maternity welfare centers (level I) should focus on the formation of personal and social perception of the concepts “I am pregnant” and “My child”; at antenatal clinics of maternity hospitals (II level) - to focus on the formation of rational ideas about the emerged pathology of pregnancy.

'The mothers of England object': Public Health, Privacy and Professional Ethics in the Early Twentieth-century Debate over the Notification of Pregnancy.

SummaryAmid wider efforts to improve maternal and infant health in Britain around the First World War, public health officials debated making pregnancy a notifiable condition. Although the policy never entered national legislation, a number of local authorities introduced ‘notification of pregnancy’ schemes in various guises, with at least one surviving until the 1950s. Resistance from private practitioners to infectious diseases notification in the later nineteenth century has been well documented. We know less about opposition to the extension of this measure to maternal and infant welfare, especially from newly professionalising female health occupations. Conflict over notification of pregnancy drew midwives, in particular, into longstanding arguments over the powers of municipal authorities, family privacy and professional ethics. The controversy was the key battleground in negotiations over the organisation of ‘antenatal care’ as occupational groups of varying degrees of authority sought to define their roles and responsibilities within the emerging health services.

Prevalence and risk factors for pelvic organ prolapse in female citizens of Baku

Aim. Study of prevalence and risk factors of pelvic organ prolapse in females in Baku.
 Methods. Statistical observation unit was a woman aged 45-74 years. The sample size (710 women) was determined taking into account probable prevalence of pelvic organ prolapse (20% according to literature) and margin of error (3%). All women were invited to maternity welfare centre, and a thorough examination was performed after their written consent was obtained.
 Results. The proportion of women aged 45-49, 50-54, 55-59, 60-64, 65-69, and 70-74 years was 26.5±1.7, 24.9±1.6, 23.1±1.6, 10.9±1.2, 8.2±1.0 and 6.4±0.9%, respectively. Prevalence of obesity in the named groups was 31.9, 34.5, 35.4, 36.4, 27.8 and 34.8%. Proportion of women with secondary and specialized secondary education was 58.5, 58.8, 53.7, 51.9, 51.7 and 67.4% resepctively. Among women of the corresponding age groups, physical work was recorded in 47.9, 53.7, 59.8, 58.4, 13.8 and 17.4% of cases, respectively. In past medical history, no surgeries were observed in 68.1, 77.4, 73.2, 77.9, 84.5 and 84.8% of cases, resepectively. Some women had no labour in past medical history (2.1, 2.3, 2.5, 2.6, 3.5 and 4.3% in the same age groups). Statistically significantly prevalence of pelvic organ prolapse increases among those aged 60 years and older (51.6±3.6% at age 45-49 years and ≥76.6±4.8% at age 60 years and older, р=0.001), with a body mass index less than 25.0 and more than 30 kg/м2 (69.7±3.3 and 66.7±3.0%, р=0.01), with high parity and remarkable family history (63.0±2.6, р=0.01), severe connective tissue dysplasia (72.6±2.5%, р=0.001), in postmenopausal period (63.8±2.0%, р=0.01), and depending on education level (88.0±2.4% among those with pre-secondary education: р=0.001). Relative risk of pelvic organ prolapse in the population of Baku is lower compared to the literature data in the background of obesity, but is higher in the background of positive family history and depending on the amount of deliveries (p=0.05).
 Conclusion. In Baku 59.9±1.8% of women aged 45-75 years have pelvic organ prolapse of different severity, incomplete uterine and vaginal prolapse are more prevalent (41.3±1.8 per 100 women); prevalence of pelvic organ prolapse is higher in women aged 60 years or older compared to those aged 45-49 (76.6±4.8% vs 51.6±3.6%, р=0.001).

Lost in translation: managing medicalised motherhood in post-World War Two Australian migrant accommodation centres

ABSTRACTWomen who began their lives as ‘New Australians’ in migrant centres, arriving from refugee camps and war-ravaged homelands, brought with them a range of interpretations of good health and its management. In post-WWII Australia, the medicalisation of maternity and infant welfare intensified in the context of a renewed anxiety about population and recent medical developments. This article investigates the systems and quality of care given to pregnant women, infants and new mothers in government funded accommodation centres. This care was delivered in the highly politicised context of a mass migration scheme sold to the host population as coming at minimum social and economic cost. We assess the impact of this political context on the care that was provided and reveal health care settings to be crucial sites for the examination of the complex biopolitics of gendered citizenship within the mass migration scheme.

Humanized practices of obstetric nurses: contributions in maternal welfare.

To analyze the practice of obstetric nurses operating in a prenatal/delivery/postpartum unit of a university hospital in Mato Grosso and the maternal welfare resulted from the care provided in this scenario. Study with a quantitative approach, carried out in a prenatal/delivery/postpartum unit of a university hospital in Cuiabá, Mato Grosso. The data were collected through the Scale of Maternal Welfare in Delivery Situation 2, and the study included 104 recent mothers in the period from June to September 2016. The data were analyzed in Epi Info version 7. The results indicate that the practice of obstetric nurses is based on the humanization of labor and childbirth, however, the presence of invasive and unnecessary practices in the service did not influence the level of maternal welfare, which was optimum for 76% of the women. The lack of information might make the women less critical and, therefore, influence the evaluation of the care received.

イギリスにおける1918年母子福祉法と「未婚の母」(第444回例会報告)

イギリスにおける1918年母子福祉法と「未婚の母」(第444回例会報告)

Cost of introducing group prenatal care (GPC) in Bangladesh: a supply-side perspective

BackgroundProgress towards Millennium Development Goals (MDG) 5 is uneven across different countries. Maternal and neonatal deaths occur mainly in developing countries especially in rural areas and among the poor communities due to underutilization of maternal services. It is evident that group prenatal care (GPC) model could improve health-care utilization among pregnant women that suit in developing countries. The GPC model has introduced in a public facility in the context of Bangladesh, and this study intended to estimate the incremental cost of introducing GPC model over the existing government health-care facility.MethodsActivity-based costing method was employed for analysis of cost during 2015–2016 in a selected Maternal and Child Welfare Centre (MCWC) in Bangladesh. Cost information was collected by applying ingredients approach considering supply-side perspective.ResultsThe total cost of integrating GPC model over the government service delivery system was estimated to be BDT 1,186,868 (US$15,216.3). The proportion of cost for the start-up period and implementation cost covered approximately 24% and 76% of the total intervention costs, respectively. Considering the total number of per session beneficiary (N = 844), the average cost of the per-beneficiary per-GPC session was BDT 1406 (US$18.0) while cost per beneficiary (N = 300) was estimated to be BDT 3956 (US$50.7) and cost per session (N = 125) was BDT 9495 (US$121.7).ConclusionsIt appears from the findings that the built-in interventions of GPC model are doable in the existing government settings at the grass-root level and perhaps at a lower cost if adjusted with the existing government and NGO functionaries.

Effects of prenatal music stimulation on state/trait anxiety in full-term pregnancy and its influence on childbirth: a randomized controlled trial

Background: Many researchers have pointed out the strong relationship between maternal psychological well-being and fetal welfare during pregnancy. The impact of music interventions during pregnancy should be examined in depth, as they could have an impact on stress reduction, not only during pregnancy but also during the course of delivery, and furthermore induce fetal awareness. Objective: This study aimed to investigate the effect of music on maternal anxiety, before and after a non-stress test (NST), and the effect of music on the birthing process. Material and method: The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) stimulation during an NST. The primary outcome was considered as the maternal state anxiety score before and after the NST, and the secondary outcome was the birthing process. Results: Before their NST, full-term pregnant women who had received music intervention were found to have a similar state-trait anxiety score to those from the control group, with 38.10 ± 8.8 and 38.08 ± 8.2, respectively (p = .97). After the NST, the mean state-trait anxiety score of each group was recorded, with results of 30.58 ± 13.2 for those with music intervention, and 43.11 ± 15.0 for those without music intervention (p < .001). In the control group, the NST was followed by a statistically significant increase in the state-trait anxiety score (38.08 ± 8.2 versus 43.11 ± 15.0, p < .001). However, listening to music during the NST resulted in a statistically significant decrease in the state-trait anxiety score of the study group (38.10 ± 8.8 versus 30.58 ± 13.2, OR = 0.87, p < .001). Furthermore, the first stage of labor was shorter in women who received music stimulation (OR = 0.92, p < .004). They also presented a more natural delivery beginning (spontaneous) and less medication (stimulated and induced) than those who were not stimulated musically, with statistically significant differences (p < .01). Conclusions: Prenatal music intervention could be a useful and effective tool to reduce anxiety in full-term pregnant women during an NST and improve the delivery process by reducing the first stage of labor in nulliparous women.

Cross-Cultural Validation of the Child Abuse Potential Inventory in Finland: Preliminary Findings of the Study Among Parents Expecting a Baby

ABSTRACTIn order to decrease physical child abuse, measures to recognize parents' abuse potential are needed. In this article, cross-cultural validation of the Child Abuse Potential (CAP) Inventory, an American measure was used to screen child abuse potential in families. Data were collected in 2012 from Finnish families expecting a baby at maternity and child welfare clinics. The data come from 380 families, including 375 mothers and 303 spouses. The validation was conducted separately for mothers and spouses and was based on basic psychometric properties, such as reliability estimates, abuse scale construct validity, and the abuse scale factor structure. The internal consistency of the abuse scale was high among both the mothers and the spouses. There were some differences in abuse construct validity and the abuse scale factor structure compared to the original measure, which was written in English and tested in an American sample. Those differences were, however, similar to those found by other studies that used translated versions of the inventory. In summary, the CAP Inventory was found to be a valid screening tool for professionals to assess parents' child abuse potential in Finnish service settings, and therefore its implementation is recommended in maternity and child welfare clinics. The validation supports the cross-cultural use of the CAP Inventory and future research on the subject.

Finnish Innovations in Medicine and Social Sphere

The article presents data collected during the tour dedicated to the medical and social institutions of Finland about new solutions and Finnish innovations in medicine and the social sphere. The article describes the principles of the Finnish health care system, including the work of maternal and child welfare clinics, as well as common European approaches in geriatrics. Thе article describes the features of geriatric services in Finland. It reflects the role of the municipal social services to provide residents of barrier-free environment in their regions. The article presents the facts from the personal experience exploring the Finnish system of medical and social support to older generation focused on the application of the latest scientific developments. The article presents innovative products for comfortable living of older people, including a traveling exhibition of technologies for older people, specialized furniture and household items available in the functional building DoMedi and others. This article describes the function of public and private Finnish services and the Finnish Centre for Elderly, including a Finnish non-profit organization Valli. The article presents the features of a private home for the elderly “Wilhelmiina” in Helsinki and scientific developments behalf Miyna Sillanpää Foundation. The article describes the innovative products, created in the Health Innovation Village at the Finnish office of GE: vacuum therapy device for the treatment of edema, a portable device for the treatment of depression, a sensor for measuring the electrical activity of muscles. The paper presents the solutions offered by the Finnish university hospitals, including personalized medicine technology for patients with cancer, developed at the Institute of Molecular Medicine, University of Helsinki. The article describes the work of one of the divisions of the institute - Biobank. The article describes the general approach to reform the health care system in Finland.

Knowledge and utilization of the partograph: A cross-sectional survey among obstetric care providers in urban referral public health institutions in northwest and southwest Cameroon.

BackgroundThe enormous challenge to maternal well-being with associated maternal wastages during labour has remained an unsurmountable problem in Cameroon which reflects the current high maternal mortality rate. Evidence abounds that cost-effective and affordable health interventions like the use of the partograph will contribute to curb the alarming number of intrapartum maternal deaths. However, little is known about the level of knowledge and utilization of this simple life-saving tool in the North–and South–West Regions, Cameroon.MethodsUsing a self-administered structured questionnaire, a cross-sectional study was conducted from January 4th–March 25th 2016 among non-physician obstetric care providers (OCPs) across urban public health institutions in these regions. Logistic regression models were used to identify factors associated with good knowledge and routine utilization of the partograph.ResultsOf the 79 eligible participants, 71 (89.9%) took part in the study. The mean age of the respondents was 37.9±10.0 years with majority being female (85.9%). Less than one-third (29.6%) of the respondents had good knowledge on the partograph and only 23 (32.4%) routinely used it in monitoring labour. OCPs working in Maternal and Infant Welfare Clinics were about 4 times more likely than those working in Regional/District Hospitals to have good knowledge on the partograph [AOR = 3.88 (95% CI:1.07–14.04)], p = 0.04. Little or no knowledge of the partograph and poor staff strength in the study centres were factors militating against its routine use.ConclusionsThe knowledge and use of the partograph in this study is sub-optimal. Regular in-service training of OCPs superimposed with periodic workshops and seminars, provision of reasonable staff numbers, and mandatory institutional policies on routine use of the partograph are recommended as vital first steps towards ensuring the safety of women in labour in the North–and South–West Regions of Cameroon.

The family health, functioning, social support and child maltreatment risk of families expecting a baby.

To describe the family health, functioning, social support and child maltreatment risk and associations between them in families expecting a baby. Finland was one of the first countries in banning corporal punishment against children over 30years ago. Despite of this, studies have shown that parents physically abuse their children. In addition, professionals struggle in intervention of this phenomenon. Abusive parents should be recognised and helped before actual violent behaviour. A follow-up case-control study, with a supportive intervention in the case group (families with a heightened risk) in maternity and child welfare clinics. The baseline results of families are described here. Child maltreatment risk in families expecting a baby was measured by Child Abuse Potential Inventory. The health and functioning was measured by Family Health, Functioning and Social Support Scale. Data included 380 families. A total of 78 families had increased risk for child maltreatment. Heightened risk was associated with partners' age, mothers' education, partners' father's mental health problems, mothers' worry about partners' drinking and mothers' difficulties in talking about the family's problems. Risk was associated with family functioning and health. Families with risk received a less support from maternity clinics. Families with child maltreatment risk and related factors were found. This knowledge can be applied for supporting families both during pregnancy and after the baby is born. Professionals working with families in maternity clinics need tools to recognise families with risk and aid a discussion with them about the family life situation. The Child Abuse Potential, as a part of evaluating the family life situation, seems to prove a useful tool in identifying families at risk. The results offer a valid and useful tool for recognising families with risk and provide knowledge about high-risk family situations.

Socioeconomics Factors Associated with the Utilization of Primary Health Services of Mothers and Children at Nunukan District, North Kalimantan

Background : One of the main health development agenda in Indonesia 2015 to 2019 is reduction in maternal mortality ratio and infant mortality rate, and improve access and quality of maternal and child health services. However, variance in socioeconomics status between individual and between rural-urban have caused to difference in utilization of health service. This study aimed to analyze socioeconomics factors associated with the utilization of primary health services of mothers and children at Nunukan District, North Kalimantan. Subje cts and Met hod : This was an analytic observational study with cross-sectional design. The study was conducted at six community health centers in Nunukan, North Kalimantan, from October to November, 2017. A total sample of 208 mothers was collected using multistage random sampling. The dependent variables were antenatal care (ANC) service, place of birth delivery, and basic immunization. The independent variables were maternal education, maternal employment status, family income, family welfare, and residence. The data were collected by questionnaire and analyzed by path analysis. Results : Utilization of ANC increased with better family welfare (b= 1.42; 95% CI= 0.34 to 2.49; p=0.010). Use of basic immunization increased with higher maternal education (b= 0.71; 95% CI= 0.06 to 1.35; p= 0.032). Place of birth delivery at formal health facility increased with living in urban area (b= 3.2; 95% CI= 1.97 to 4.44; p <0.001), maternal employment (b= 2.34; 95% CI= 0.77 to 3.91; p=0.003), and regular ANC (b=1.04; 95% CI= -0.10 to 2.18; p=0.074). Family income increased with higher maternal education level (b= 1.21; 95% CI= 0.50 to 1.92; p= 0.001) and maternal employment (b= 2.54; 95% CI= 1.67 to 3.41; p <0.001). Family welfare increased with living in urban area (b= 1.4; 95% CI= 0.09 to 2.68; p=0.035) and higher family income (b=2.5; 95% CI= 0.44 to 4.54; p= 0.017). Maternal employment status increased with higher maternal education level (b= 2.45; 95% CI= 1.63 to 3.26; p <0.001). Conclusion : Utilization of ANC directly increases with better family welfare. Utilization of basic immunization increases with higher maternal education. Place of birth delivery at formal health facility increases with living in urban area, maternal employment, and regular ANC. Keyword : social economics factors, ANC, place of birth delivery, basic immunization, mother, children Correspondence: Yunita Kristiani. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A Surakarta, 57126, Central Java. Email: y.ithakristiani@gmail.com. Mobile: 085393313553. Journal of Maternal and Child Health (2017), 2(4): 371-384 https://doi.org/10.26911/thejmch.2017.02.04.08

Maternal Risk Factors affecting Low Birth Weight babies: A case control study from tertiary care teaching hospital in rural Southern India

Background: Low birth weight which is below 2.5 kg is a major factor affecting the infant survival, health and development. Low birth weight infants are at a greater risk of having a disability and for diseases such as cerebral palsy, visual problems, learning disabilities and respiratory problems. To reduce the low birth weight deliveries, we studied the maternal factors which adversely affect the fetus in utero and their impact on fetus. Aim and objectives: 1) To study the maternal risk factors affecting the low birth weight babies. 2) To compare the incidence of low birth weight babies in a rural medical college population. Methodology: A prospective case control study was carried out on low birth weight pregnancies deliveries during a one year period in a tertiary care hospital. Maternal factors like age, parity, pre pregnancy weight, height, bad obstetric history, sex of the child, birth interval, literacy, income, maternal diseases, and family structure were compared with same number of controls. Cases of multiple pregnancies and stillbirths were excluded. Result : Frequency of low birth weight babies had significant association with mother’s weight and age, primi, birth interval, bad obstetric history, percapita income and illiteracy. Factors which failed to show a significant relation with low birth weight were mother’s height, sex of child, number of antenatal visits, family structure and maternal diseases complicating pregnancy. Conclusion: To reduce the incidence of low birth weight babies action is called for not only in obstetrical field but also in the wider sphere of maternal welfare.

Reproducing the British Caribbean: Sex, Gender, and Population Politics after Slavery by Juanita DeBarros (review)

Reviewed by: Reproducing the British Caribbean: Sex, Gender, and Population Politics after Slavery by Juanita DeBarros Katherine Paugh Juanita DeBarros. Reproducing the British Caribbean: Sex, Gender, and Population Politics after Slavery. Chapel Hill: University of North Carolina Press, 2014. 296 pp. $32.95 (978-1-4696-1605-6). This fascinating study of the history of reproduction traces efforts by imperial and local government officials and agencies, as well as philanthropic organizations, to tailor the size and health of populations in the British Caribbean colonies to political and economic demands. The book traces an intriguing evolution in the aims of population policy. In the mid-nineteenth century, in the immediate aftermath of the emancipation of enslaved Afro-Caribbeans, many colonial officials and wealthy landowners saw the promotion of reproduction among both Afro-Caribbeans and East Indian indentured laborers as an antidote to the declining profitability of Caribbean plantations. Consequently, during the late nineteenth and early twentieth centuries, schemes to promote formal training for midwives emerged alongside philanthropic “baby saving leagues” aimed at promoting hygienic practices among working class mothers. These maternal and child welfare initiatives were initially staffed primarily by white British women. Single women who were older and of “less attractive appearance” were seen as particularly qualified to provide the asexual yet maternalistic care of a “benevolent colonialism” (pp. 96, 100). By the early twentieth century, however, the growth of pan-Africanism and the rising influence of creole politicians and labor leaders led to the growing involvement of middle class women of color with philanthropic organizations such as the Garveyite Black Cross Nurses. This opportunity to publicly espouse a “maternalist” perspective aimed at racial uplift helped to cement these women’s status in colonial society (p. 123). This focus on racial uplift, ironically, coincided with a growing interest in eugenics among some colonial officials and medical experts during the early twentieth century and the concomitant assertion that reproductive policy should focus on cultivating only the best “stock” while discouraging childbearing among the unworthy. By the mid-1930s, in the context of violent protests that swept through the Caribbean, concerns about overpopulation among Afro-Caribbean workers escalated into a proposal by a government committee in Bermuda for the compulsory sterilization of the parents of illegitimate children. This proposal was bashfully deferred by colonial officials and angrily condemned by radical advocates for the Caribbean working class. Nonetheless, the report of the Moyne commission, a British government inquiry to investigate the causes of protests in the region, emphasized the problems created by overpopulation. De Barros thus skillfully connects the political and economic history of the Caribbean with key shifts in the aims, strategies, and personnel of colonial and imperial organizations focused on shaping reproduction. The tendency of colonial officials to associate the size and health of Caribbean populations with the effects of moral and sexual vice is also a theme that runs throughout the book. The supposed lack of civilized sexual mores in the Caribbean was, in fact, marshaled by colonial officials at various times to explain both underpopulation and overpopulation. The civilizing mission of British colonialism thus provided a sustained and adaptable rationale for governmental [End Page 157] intervention in Afro-Caribbean reproduction. Disease, too, was frequently seen as a consequence of colonial barbarism with unfortunate consequences for Caribbean populations. DeBarros discusses medical discourses surrounding cholera, hookworm, malaria, and venereal disease, in which the language of hygiene was employed by both colonial officials and London-based experts in tropical medicine to condemn the “racial habits” of Afro-Caribbeans (p. 155). Yet significantly, some Caribbean physicians who gathered at a multiethnic regional conference in 1921 rejected racialized ideas about hygiene, arguing that in fact unsanitary habits in the Caribbean were more attributable to social and working conditions in the region. Overall, the book focuses on governmental and philanthropic interventions in the Caribbean, and on the perspectives of the colonial officials and medical personnel who carried out these interventions. Through their stories, we catch glimpses of the practices of those working people who were targets of intervention. We hear, for example, of the objections of a public health educator in Guyana to the local practice of giving infants tea in their mothers’ absence, and...

The Role of the Central and Kuibyshev Institutes of Maternal and Child Welfare in the Creation of Maternal and Child Health Care Service in the USSR (1922–1940)

The article focuses on the role of the State Research Institute of Maternal and Child Welfare as the lead establishment and of the Kuibyshev Regional Scientific-Practical Institute of Maternal and Child Welfare in the creation of maternal and child health care service in the Soviet Union during 1922–1940. It also presents the scientific-practical, educational, organizational-methodological activities of the central and peripheral institutions, their comparative characteristics and contribution to the creation of a broad network of institutions for maternal and child welfare (nurseries, maternity welfare centres, baby food centers, social-legal offices) and the reduction of morbidity and mortality of infants and young children.

Reproducing the British Caribbean: Sex, gender, and population politics after slavery by Juanita De Barros (review)

Reviewed by: Reproducing the British Caribbean: Sex, gender, and population politics after slavery by Juanita De Barros Meleisa Ono-George Reproducing the British Caribbean: Sex, gender, and population politics after slavery By Juanita De Barros. Chapel Hill: University of North Carolina Press, 2014. In her most recent book, Reproducing the British Caribbean, Juanita De Barros explores the politics of reproduction and public health in the immediate post-slavery Caribbean. Covering the period from the abolition of slavery in 1834 to the 1930s labour riots, De Barros demonstrates how racial and gendered discourses of Afro-Caribbean men and women, and to a lesser extent Indo-Caribbean peoples, shaped colonial concerns and policies around the size and the health of the population. In addition, this well researched book tracks not only how these discourses informed the policies and programs on infant and maternal welfare that developed in the British Caribbean colonies of Jamaica, Trinidad and Guyana, but also how various local actors contributed to these initiatives. De Barros begins by examining popular debates around population between the abolition of slavery in the British Caribbean (1834) and the 1850s cholera epidemic that spread throughout the region. Abolitionist and colonial officials had hoped that emancipation would bring about the “natural increase” of the population following abolition. However, by the late 1840s and 1850s, the high mortality rate signaled to them that the population was in decline, despite the ending of slavery, and that abolition had failed to uplift the population. The same racial and gendered attitudes that shaped perceptions of abolition also informed how colonial officials and elites attempted to address the perceived population decline. As part of their efforts to ensure a continued source of labour, colonial officials initiated programs to tackle infant mortality, what they discussed as one of the major causes of the post-slavery population decline. Attitudes around the perceived high rate of infant mortality amongst the Afro-Caribbean population, as De Barros shows, drew upon long-standing racializations of Black women as bad mothers and Black men as neglectful fathers. Such attitudes were also informed by nascent ideas around medicine and public health. De Barros considers the involvement of colonial officials, physicians and researchers, nurses and midwives from Britain and other parts of the empire, but also locally, in the shaping and development of policies around population and reproduction. She explores the efforts of colonial officials to introduce a state-sponsored midwifery program to train local midwives, who then provided educational programs on pregnancy and infant care to poor Caribbean women. In addition to state-sponsored efforts, middle-class and elite women of African descent were also involved in baby-saving leagues that sought to educate poor non-White women on modern and hygienic child-rearing practices. Understandings of race and sexuality were intrinsic within these programs, as De Barros reveals. For instance, recruiters purposely sought out single, “less attractive” White British nurses, women they saw as “nonsexual,” to train non-White midwives in the British Caribbean islands. These desexualized British nurses were thought to stand as symbols of colonial authority and righteousness, in contrast to the overt sexualized imaginings of Black and Coloured women that they would train. As De Barros shows, these British nurses were “enmeshed in the nets of imperial power” and were necessary instruments of empire. British and Caribbean people were not the only ones concerned with the “crisis” in population decline or involved in efforts to find a solution. Working with a growing class of creole physicians and middle-class professionals, American physicians and researchers targeted tropical diseases, including hookworm and malaria, as well as venereal disease as a means of curbing high mortality and poor health in the island, especially amongst the young. However, despite the advancements in medicine, these officials continued to blame population decline and the state of health on the familial and sexual practices of poor Caribbean peoples. As De Barros shows, up into the 1930s and the West India Commission, racialized and gendered attitudes around sex and reproduction continued to inform discussions and the solutions proposed to address these concerns around the size and health of the population. This book makes a most welcome contribution to the study of...

Comportamiento materno y bienestar de la coneja doméstica y silvestre y su camada

Maternal behaviour and welfare of the domestic and wild rabbit doe and its litter The European rabbit (Oryctolagus cuniculus), in addition to its faunal interest in the western Mediterranean, is a relevant species which in several European countries is the basis of a meat-oriented, industrial livestock subsector, while in many developing countries rabbits are raised under alternative systems aimed at income integration and food security. In addition to meat production, other productive ori