Folklore y "medicina tradicional". Rituales de sanación del "mal de ojo" en el municipio de Cehegín / Folklore and "traditional medicine". Rituals for healing the "evil eye" in the municipality of Cehegín / Folclore e "medicina tradicional". Rituais de cura para o "mau-olhado" no município de Cehegín

Objective: the article investigates the healing practices linked to the religious frameworkin the municipality of Cehegín, focusing on the symbolic analysis of the healing rituals of the "evileye". Methodology: an ethnographic approach was used based on the performance of a participantobservation lasting thirty-three hours and fifteen interviews with healers-shamans. Results: the results show the persistence of a series of ritual procedures linked to the prayer of the "evil eye" thatserve for issues as diverse as the training of healers or the determination of the etiology, diagnosis,symptomatology or remedy of the condition. Conclusions: the set of rituals carried out in the contextof study has as a link the use of liturgical structures that include prayers to Christian deities, andwhere symbolic elements such as the cross, the three, water or oil, serve to load semantic meaningthe ritual healing process.(AU)

Objetivo: el artículo investiga las prácticas de curación ligadas al marco creencial en elmunicipio de Cehegín, centrándose en el análisis simbólico de los rituales de sanación del “mal deojo”. Metodología: se utilizó un enfoque etnográfico basado en la realización de una observaciónparticipante de treinta y tres horas de duración y quince entrevistas a sanadores-ensalmadores. Resultados: los resultados muestran la persistencia de una serie de procedimientos rituales ligados alrezo del “mal de ojo” que sirven para cuestiones tan diversas como la capacitación de los sanadoreso la determinación de la etiología, diagnóstico, sintomatología o remedio del padecimiento. Conclusiones: el conjunto de rituales realizados en el contexto de estudio tiene como nexo de unión lautilización de estructuras litúrgicas que incluyen oraciones a deidades cristianas, y donde elementossimbólicos como la cruz, el tres, el agua o el aceite, sirven para cargan de sentido semántico el proceso ritual de curación.(AU)

Objetivo: o artigo investiga as práticas de cura vinculadas ao quadro de crenças no município de Cehegín, com foco na análise simbólica dos rituais de cura do “mau-olhado”. Metodologia:utilizou-se uma abordagem etnográfica a partir da realização de trinta e três horas de observaçãoparticipante e quinze entrevistas com benzedeiras-salmistas. Resultados: os resultados mostram apersistência de uma série de procedimentos rituais ligados à oração do “mau-olhado” que servempara questões tão diversas quanto a formação de curandeiros ou a determinação da etiologia, diagnóstico, sintomas ou remédio da doença. Conclusões: O conjunto de rituais realizados no contextode estudo tem como elo o uso de estruturas litúrgicas que incluem orações a divindades cristãs, eonde elementos simbólicos como a cruz, os três, água ou óleo, servem para carregar significadosemântico ao ritual processo de cicatrização

Impact of Dog-Assisted Therapy for Institutionalized Patients With Dementia: A Controlled Clinical Trial.

CONTEXT: Animal-assisted interventions have been used in recent years to complement other therapies of various types for dementia patients. OBJECTIVE: The study intended to evaluate the benefits of dog-assisted interventions for the emotional, behavioral, cognitive, and functional areas of the lives of dementia patients. DESIGN: The research team designed an experimental study that used dog-assisted therapy (DAT) as the intervention. SETTING: The study was conducted at the Enoc Center, a nursing home, in Azucaica, Toledo, Spain. PARTICIPANTS: Participants were 21 residents who had been living at the center for more than one year, were over 65 years old, and had symptoms associated with dementia or affective disorders. INTERVENTION: Participants were randomly divided into three groups: the control, intervention, and healthy groups. The intervention and healthy groups attended the DAT in addition to the center's regular therapies. The control group didn't attend the DAT but did attend the center's regular therapies. The program occurred over six months, with weekly sessions of 45 minutes in both cases. OUTCOME MEASURES: Participants were evaluated at baseline and postintervention using specific scales appropriate to an area: (1) cognitive-Mini-Mental Status Examination (MMSE), (2) functional-Modified Barthel Index, (3) affective-Yesavage Geriatric Depression Scale: Short Form and (4) behavioral-Neuropsychiatric Inventory Scale (NPI). RESULTS: The study revealed significant differences between the control group and the intervention group and between the control group and the healthy group in the cognitive, affective, and behavioral areas but not in the functional area. CONCLUSIONS: The program was beneficial for elderly institutionalized patients with dementia in the emotional, behavioral, and cognitive areas.

Valoración del recién nacido. Correlación del test de Apgar con la gasometría arterial al nacimiento / Assessment of the newborn. Correlation of the Apgar test with arterial blood gas at birth

Objetivo: Evaluar la correlación entre las puntuaciones del test de Apgar y los valores de la gasometría arterial al nacimiento. Metodología: Estudio descriptivo transversal de prevalencia realizado en el Hospital Universitario Rafael Méndez de Lorca (España). Los datos se obtuvieron del registro informático de datos clínicos, analizando como variable dependiente las puntuaciones del test de Apgar al minuto de vida, y como variables independientes el pH, la presión parcial de dióxido de carbono y el déficit de base, recogidos mediante gasometría de la arteria umbilical al nacimiento. El análisis estadístico adoptó un nivel de significación estadística de p <0,05 mediante la aplicación de pruebas paramétricas, como el coeficiente de correlación de Pearson, la t de Student para muestras independientes y la χ2 . Resultados: La muestra fue de 312 neonatos. Se observa una correlación significativa entre las puntuaciones del test de Apgar patológicas y la acidosis fetal (p= 0,006; odds ratio [OR]= 2,555), la hipercapnia (p= 0,004; OR= 2,675), el déficit de bases (p= 0,001; OR= 4,758) y la acidosis metabólica (p= 0,018; OR= 3,556) al nacimiento. Conclusiones: Se puede establecer una correlación entre el test de Apgar al minuto de vida y la gasometría arterial al nacimiento. Se observa una subestimación profesional en las puntuaciones de las acidosis respiratorias. (AU)

Objective: To evaluate the degree of correlation between the Apgar test scores and the arterial blood gas values at birth. Methodology: Observational, analytical, retrospective and prevalence study carried out at the Hospital Universitario Rafael Méndez (Spain) on a sample of 312 neonates. The data were obtained from the computerized registry of clinical data, analyzing the Apgar test scores at one minute of life as a dependent variable, and pH, pCO2 and base deficits collected by means of umbilical artery blood gases at birth as independent variables. Statistical analysis adopted a significance level of p <0.05 through the application of parametric tests such as Pearson's correlation coefficient, Student’s t-test for independent samples and χ2 . Results: A significant correlation is observed between pathological Apgar test scores and fetal acidosis (p= 0.006; Odds ratio [OR]= 2.555), hypercapnia (p= 0.004; OR= 2.675), base deficit (p= 0.001; OR= 4.758) and metabolic acidosis (p= 0.018; OR= 3.556) at birth. Conclusions: A correlation can be established between the Apgar test at minute of life and arterial blood gas at birth, observing a professional underestimation in the scores of respiratory acidosis. (AU)

[Impact of the duration of labor in the neonatal state measured by arterial blood gas at birth.] / Repercusión de la duración del parto en el estado neonatal medido a través de la gasometría arterial al nacimiento.

OBJECTIVE: The duration of labor has become a central axis of its clinical management, most of the studies that analyze its relationship with the neonatal state focus on indirect tests such as the Apgar test or admissions to the NICU. The aim of the study was to analyze the repercussions of the duration of labor on the condition of the neonates without added risk factors through a direct analysis test such as the umbilical artery blood gas test at birth. METHODS: An observational, analytical, retrospective, and prevalence study was conducted on a sample of 286 infants no previous risk factors obtained from the computerized clinical registry. For a confidence level of p<0.05, parametric tests such as Pearson's correlation coefficient and Chi-square were applied. RESULTS: Showed a significant negative correlation between umbilical artery pH values and delivery times (Dilation: R=-0.207; p=0.002 - Expulsive: R=-0.150; p=0.027 - Total delivery: R=-0.181; p=0.006). Presenting deliveries with times above the mean greater possibilities of fetal acidosis and hypercapnia in dilation (pH: OR=3.10; IC 1.64-5.51 - pCO2: OR=2.19; IC 1.23-3.89), the expulsive (pH: OR=2.24; IC 1.21-4.16 - pCO2: OR=1.77; IC 0.98-3.22) and the total duration (pH: OR=3.36, IC 1.84-6.13- pCO2: OR=2.53; IC 1.44-4.46). CONCLUSIONS: A significant association is was found between the prolongation of labor times and acidosis and neonatal hypercapnia.

OBJETIVO: La duración del parto se ha convertido en un eje central de su manejo clínico, la mayoría de estudios que analizan su relación con el estado neonatal se centra en pruebas indirectas como el test de Apgar o los ingresos en UCIN. El objetivo del estudio fue analizar las repercusiones de la duración del parto en el estado de los neonatos sin factores de riesgo añadidos a través de una prueba de análisis directo como es la gasometría de arteria umbilical al nacimiento. METODOS: Se diseñó un estudio observacional analítico, retrospectivo y de prevalencia realizado sobre una muestra de 286 neonatos sin factores de riesgo previos obtenida del registro clínico informático. Para un nivel de confianza de p<0,05 se aplicaron pruebas paramétricas como el coeficiente de correlación de Pearson y la Chi cuadrado. RESULTADOS: Mostraron una correlación significativa negativa entre los valores de pH de arteria umbilical y los tiempos del parto (Dilatación: R=-0,207; p=0,002 ­ Expulsivo: R=-0,150; p=0,027 - Totales de parto: R=-0,181; p=0,006). Presentando los partos con tiempos superiores a la media mayores posibilidades de acidosis fetal e hipercapnia en la dilatación (pH: OR=3,10; IC 1,64-5,51 - pCO2: OR=2,19; IC 1,23-3,89), el expulsivo (pH: OR=2,24; IC 1,21-4,16 - pCO2: OR=1,77; IC 0,98-3,22) y la duración total (pH: OR=3,36, IC 1,84-6,13- pCO2: OR=2,53; IC 1,44-4,46). CONCLUSIONES: Se constató una asociación significativa entre la prolongación de los tiempos del parto y la acidosis e hipercapnia neonatal.

Analysis of Factors Associated With Variability and Acidosis of the Umbilical Artery pH at Birth.

Background: Perinatal asphyxia is a significant contributing factor for neonatal morbidity and mortality. The aim of this study was to investigate the clinical factors associated with umbilical artery pH variability and fetal acidosis at birth. Methods: This is a single center cross-sectional study in a public regional hospital in southeastern Spain from January to December 2019. The reference population was 1.655 newborns, final sample of 312 experimental units with validated values of umbilical cord blood pH. Results: Factors such as gestational age at term ( X ¯ at - term : 7.26 ± 0.08- X ¯ no -at-term: 7.31 ± 0.05, p: 0.00), primiparity ( X ¯ primiparity : 7.24 ± 0.078- X ¯ multiparity : 7.27 ± 0.08, p: 0.01), induced labor ( X ¯ induced : 7.24 ± 0.07- X ¯ spontaneous : 7.26 ± 0.081, p: 0.02), vaginal delivery ( X ¯ vaginal :7.25 ± 0.08- X ¯ cesarean :7.27 ± 0.07, p: 0.01), and prolonged dilation duration ( X ¯ AboveAverage : 7.22 ± 0.07- X ¯ BelowAverage : 7.27 ± 0.08, p: 0.00), expulsion duration ( X ¯ AboveAverage : 7.23 ± 0.07- X ¯ BelowAverage : 7.26 ± 0.08, p: 0.01), and total labor duration ( X ¯ AboveAverage : 7.23 ± 0.07- X ¯ BelowAverage : 7.27 ± 0.08, p: 0.00) are associated with a decrease in umbilical artery pH at birth. However, only three factors are associated with acidosis pH (<7.20) of the umbilical artery at birth: the induction of labor [OR: 1.74 (95% CI: 0.98-3.10); p: 0.04], vaginal delivery [OR: 2.09 (95% CI: 0.95-4.61); p: 0.04], and total duration of labor [OR: 2.06 (95% CI: 1.18-3.57); p: 0.01]. Conclusions: Although several factors may affect the variability of umbilical artery pH at birth by decreasing their mean values (gestational age, primiparity, induced labor, vaginal delivery and prolonged: dilation duration, expulsion duration and total labor duration), only induction of labor, vaginal delivery and total duration of labor are associated with an acidosis (<7.20) of same.

Benefits of Dog-Assisted Therapy in Patients with Dementia Residing in Aged Care Centers in Spain.

(1) Background: Currently, the scientific evidence on the benefits of assisted therapy with dogs in dementia is not clear. In this study, we want to evaluate such benefits through a randomized controlled clinical trial in multiple centers across the country. (2) Methods: The participants were people over 65 years old with dementia, residing in senior centers in Spain (n = 334). The experimental group underwent assisted therapy with dogs based on the Comprehensive Cognitive Activation Program in Dementia, for 8 months, with weekly sessions of 45 min. Data were collected at the commencement, middle, and end of the program, to evaluate the aspects using the Mini-Examination Cognitive, the modified Bartell Index, the Cornell Scale for Depression in Dementia and the Neuropsychiatric Inventory. (3) Results: The results show significant improvements in the experimental group versus the control group in the affective (T1 = p 0.000; T2 = p 0.000) and behavioral (T1 = p 0.005; T2 = p 0.000) aspects, with the affective aspect displaying greater progress in participants with additional depressive (p = 0.022) or anxiety (p = 0.000) disorders, shorter institutionalization periods (r = -0.222, p = 0.004), and those undergoing complementary psychotherapy (p = 0.033) or alternative therapy (p = 0.011). (4) Conclusions: Dog therapy is effective in improving the affective and behavioral aspects of institutionalized patients with dementia.

Etno-obstetricias hospitalarias mixtas: Redes clínicas de transición hacia la humanización asistencial / Ethno-obstetrics combinations in hospitals: Clinical networks of transition towards healthcare humanization / Ethno-obstetrícias hospitaleiro mixed: Redes clínicas de transição para a humanização em saúde

OBJETIVO: El estudio analiza el grado de implementación de las nuevas coordenadas asistenciales humanistas dadas para la asistencia de los partos hospitalarios de bajo riesgo en España y su influencia en la generación de nuevas redes clínicas de cuidado. METODOLOGÍA: Se utilizó un enfoque etnográfico basado en la observación participante en un paritorio de un hospital del sistema sanitario estatal español, y en la realización de una serie entrevistas semiestructuradas a madres atendidas en dicho centro, se acumularon ochocientas setenta y cuatro horas de observación y veinte entrevistas. RESULTADOS: Los resultados muestran una metamorfosis hacia redes clínicas de asistencia del parto en clave humanista, transformación dibujada sobre el fondo de una dinámica asistencial todavía medicalizada. CONCLUSIONES: Se puede concluir que se están generando nuevas redes asistenciales mixtas a medio camino entre el intervencionismo y la humanización asistencial. Redes sujetas aún a las idiosincrasias y filosofías de los diferentes profesionales, pero que suponen un importante paso hacia una humanización percibida todavía como una trasgresión al orden clínicamente establecido

OBJECTIVE: This study analyzes the degree of implementation of the new humanist care guidelines for low risk childbirth at hospitals in Spain and their influence on the creation of new clinical care networks. METHODOLOGY: An ethnographic approach was used based on participant observation at a delivery room of the Spanish public healthcare system and on a series of semi structured interviews with mothers attended to at given center, resulting in eight hundred and seventy-four hours of observation and twenty mothers interviewed. RESULTS: Results show a shift towards networks of clinics offering humanist driven childbirth assistance, a transformation taking place over a background of a still medicalized care dynamics. CONCLUSIONS: One can conclude that new mixed care networks are being generated halfway between interventionism and assistance humanization, such networks being still subject to the idyossincrasies and philosophies of the different professionals involved, yet allowing to believe in an important step being taken towards a humanization that some may still regard as a transgression to the clinically established order

OBJETIVO: O estudo analisa o grau de implementação das novas coordenadas de assistência humanística dadas para a assistência de partos hospitalares de baixo risco em Espanha e sua influência na geração de novas redes de atendimento clínico. METODOLOGIA: Utilizou-se uma abordagem etnográfica baseada na observação participante em uma enfermaria do sistema de saúde do Estado espanhol e, na realização de uma série de entrevistas semi-estruturadas com mães atendidas naquele centro, foram acumuladas oitocentos e setenta e quatro horas de observação e vinte entrevistas. RESULTADOS: Os resultados mostram uma metamorfose para redes clínicas de assistência ao parto em uma chave humanista, uma transformação traçada sobre o pano de fundo de uma dinâmica assistencial ainda medicalizada. CONCLUSÕES: Pode-se concluir que novas redes de atenção mista estão sendo geradas a meio caminho entre o intervencionismo e o humanização da assistência. Redes ainda sujeitas às idiossincrasias e filosofias de diferentes profissionais, mas que representam um passo importante para um humanização ainda percebido como uma transgressão da ordem clinicamente estabelecida

Por una antropología del recuerdo. Historia oral de los cuidados durante la Guerra Civil / For an anthropology of memory. Oral history of care during the Civil War

OBJETIVO: reconstruir las condiciones sociosanitarias experimentadas durante la Guerra Civil a través de la historia oral de sus últimos testigos vivos, los nonagenarios que entonces eran niños. METODOLOGÍA: se empleó un enfoque fenomenológico utilizando como diseño de investigación los testimonios focalizados recogidos a través de entrevistas semiestructuradas realizadas a seis nonagenarios que durante la Guerra Civil presentaban entre seis y diez años. Resultados principales: los informantes hacen una reconstrucción oral del recuerdo centrado en aspectos como las experiencias traumáticas (bombardeos, reclutamientos, ejecuciones), las condiciones sociales (hambre, refugiados, educación), el cuidado, y la vivencia de la infancia. Conclusión principal: los relatos muestran las dramáticas situaciones vividas durante este complicado periodo de la historia de España, experiencias que, sin embargo, no lograron robar totalmente la infancia a aquellos niños que ahora son nonagenarios

OBJECTIVE: the objective of the article has been to reconstruct the social and health conditions experienced during the Civil War through the oral history of its last living witnesses, the nonagenarians who were then children. METHODS: A phenomenological approach was used, using as research design the focused testimonies collected through semi-structured interviews carried out with six nonagenarians who were between six and ten years old during the Civil War. RESULTS: the informants make an oral reconstruction of the memory focused on aspects such as traumatic experiences (bombings, recruits, executions), social conditions (hunger, refugees, education), care, and the experience of childhood. CONCLUSIONS: the stories show the dramatic situations experienced during this complicated period in the history of Spain, experiences that, however, did not completely steal childhood from those children who are now in their early thirties

Hermenéutica de lo fáctico. La hierofanía de lo sagrado como forma de instrucción en la obra "Arte de Enfermería para la Asistencia teórico-práctica de los Pobres enfermeros que se acogen a la de los Hospitales de la Sagrada Religión de N.P.S Juan de Dios (1833) / Hermeneutics of the factic. The Hierophany of the Sacred as a form of instruction in the work "Art of Nursing for the theoretical-p ractical assistance of the poor nurses who take refuge in the Hospitals of the Sacred Religion of N.P.S Juan de Dios (1833) / Hermenêutica do factic. A Hierofania do Sagrado como forma de instrução na obra "Arte de Enfermagem para a assistência teórico-prática das enfermeiras pobres que se refugiam nos Hospitais da Sagrada Religião de N.P.S Juan de Dios (1833)

Desde el punto de vista de la hierofanía de lo sagrado, presente en la obra "Arte de Enfermería para la Asistencia teórico-práctica de los Pobres Enfermos que se acogen a la de los Hospitales de la Sagrada Religión de N.P.S Juan de Dios" (1833), se desvela la conciencia mítico-religiosa del espacio sagrado destinado a la formación de los hermanos enfermeros de la Orden de San Juan de Dios. Para ello se parte de un análisis historiográfico del contexto sociocultural del texto, para adentrarse a continuación en aproximaciones gnoseológicas que nos acercan al paradigma asistencial y educativo que emana de éste. El objetivo es hacer «conciencia histórica» desde la hermenéutica de lo fáctico, analizar la «palabrea» abordando las relaciones inmanentes entre concepto y palabra, entre pensamiento y lenguaje, considerando las conexiones conceptuales como espacios significativos de explicación. En conclusión, se pretende escudriñar la influencia de la Orden a través de sus escritos, contrastando la influencia del desarrollo de un arquetipo de instrucción-profesionalización en la popularización-democratización del arte de cuidar

The hierophany of the sacred, present in the work "Art of Nursing for the Theoretical-Practical Assistance of the Poor Sick who take refuge in the Hospitals of the Sacred Religion of NPS Juan de Dios" (1833), reveals the mythical-religious consciousness of the sacred space destined for the formation of the nursing brothersof the Order of San Juan de Dios. To do this, we start with a historiographic analysis of the sociocultural context of the text, to go further into gnoseological approaches that bring us closer to the welfare and educational paradigm that emanates from it. The objective is to make "historical awareness" from the hermeneutics of the factual, to analyze the "palabrea" by addressing the immanent relations between concept and word, between thought and language, considering the conceptual connections as meaningful spaces of explanation. In conclusion, it is intended to scrutinize the influence of the Order through his writings, contrasting the influence of the development of an archetype of instruction-professionalization in the popularization-democratization of the art of caring

Do ponto de vista do hierophany do sagrado, presente na obra "Arte de Enfermagem para a assistência teórico e prático dos Pobres doente beneficiando dos Hospitais da religião sagrada do NPS Juan de Dios" (1833), revela a consciência mítico-religiosa do espaço sagrado destinado à formação dos irmãos de enfermagem da Ordem de São João de Deus. Para tanto, partimos de uma análise historiográfica do contexto sociocultural do texto, para aprofundar as abordagens gnosiológicas que nos aproximam do paradigma de bem-estar e educação que emana dele. O objetivo é fazer da "consciência histórica" a partir da hermenêutica do factual, analisar a "palabrea", abordando as relações imanentes entre conceito e palavra, entre pensamento e linguagem, considerando as conexões conceituais como espaços significativos de explicação. Em conclusão, pretende-se escrutinar a influência da Ordem através de seus escritos, contrastando a influência do desenvolvimento de um arquétipo de profissionalização-instrução na popularização-democratização da arte de cuidar

Culturas cosmopolitas del parto. Contrastando sus bases antropológicas desde la perspectiva bioética / Culturas cosmopolitas do parto. Contrastando suas bases antropológicas desde uma perspectiva bioética / Cosmopolitan cultures of childbirth. Contrasting its anthropological bases from the bioethical perspective

Resumen: El objetivo del presente artículo ha sido explorar, desde la perspectiva ética, las principales características y bases antropológicas del parto, tratando de dilucidar, desde un posicionamiento personalista, qué patrones son más consecuentes con el respeto de la dignidad materna y los principios básicos de la bioética. La metodología elegida fue el análisis documental, mediante el uso de diferentes bases de datos del ámbito de las ciencias médicas, sociales y antropológicas. Los resultados muestran abordajes bioéticamente antagónicos, situándose, de una parte, dos reduccionismos ontológicos de corte biologicista: el parto medicalizado y el parto natural, y, de otra, un abordaje holístico: el parto humanizado. Los dos primeros rompen con el principio de autonomía y no maleficiencia, al quedar el destino de las madres marcado por su fisiología, naturaleza que, desde la perspectiva medicalizada, es representada desde las nociones de "riesgo" y "fragilidad", quedando las madres expuestas a múltiples intervenciones clínicas iatrogénicas; mientras que, desde la cosmovisión naturista, es percibida desde la noción de "infalibilidad", lo que las convierte en rehenes de su supuesta perfección anatómica. Conflictos éticos que no surgen en el modelo humanista, al representar éste a las madres como sujetos sociales globales, que exceden cualquier reduccionismo atomista.

Resumo: O objetivo do presente artigo foi explorar, desde uma perspectiva ética, as principais características e bases antropológicas do parto, tratando de elucidar, desde um posicionamento personalista, que padrões são mais consistentes com o respeito da dignidade materna e os princípios básicos da bioética. A metodologia eleita foi a análise documental, mediante o uso de diferentes bases de dados do âmbito das ciências médicas, sociais e antropológicas. Os resultados mostram abordagens bioeticamente antagônicas, situando-se de um lado dois reducionismos ontológicos de corte biologicista, o parto medicalizado e natural, e de outro uma abordagem holística, o parto humanizado. Os dois primeiros rompem com o princípioi da autonomia e não maleficência, ao deixar o destino das mães marcado por sua fisiologia, natureza que, desde uma perspectiva medicalizada, está representada pela noção de risco e fragilidade, ficando as mães expostas a múltiplas intervenções clínicas iatrogênicas; enquanto que, desde uma cosmovisão naturista, é percebida desde a noção de infalibilidade, o que converte as mães em reféns de sua suposta perfeição anatômica. Conflitos éticos que não surgem no modelo humanista, ao representar este às mães como um sujeito social global que excede qualquer reducionismo atomista.

Abstract: The objective of this article has been to explore, from an ethical perspective, the main anthropological characteristics and bases of childbirth, trying to elucidate, from a personalist position, which patterns are more consistent with respect for maternal dignity and basic principles of bioethics. The methodology chosen was the documentary analysis, through the use of different databases in the field of medical, social and anthropological sciences. The results show bioethically antagonistic approaches, placing, on the one hand, two ontological reductions of a biological nature: medicalized and natural birth, and, on the other, a holistic approach: humanized birth. The first two break with the principle of autonomy and non-maleficiency, as the fate of the mothers is marked by their physiology, a nature that, from a medicalized perspective, is represented from the notions of "risk" and "fragility", leaving the mothers exposed to multiple iatrogenic clinical interventions; while, from the naturist worldview, it is perceived from the notion of "infallibility", which makes them hostages of their supposed anatomical perfection. Ethical conflicts that do not arise in the humanist model, when it represents mothers as global social subjects, who exceed any atomistic reductionism.

¿Némesis obstétrica o disminución del riesgo? A debate bioético el abordaje intervencionista en los partos de bajo riesgo / Obstetric nemesis or decrease risk? A discussion bioethical the approach interventionist in low-risk deliveries / Nemesis obstétrica ou diminuição do risco? A debate bioético a abordagem intervencionista em partos de baixo risco

Resumen: Desde hace décadas el parto de bajo riesgo ha sido abordado, fundamentalmente en el ámbito clínico-hospitalario, desde una perspectiva intervencionista, caracterizada por la medicalización, tecnificación y mecanización asistencial. En este contexto se sitúa el presente estudio, cuyo objetivo ha sido explorar las limitaciones bioéticas de este paradigma asistencial intervencionista, mediante el análisis de su pragmatismo clínico frente a otros abordajes más humanistas. Para ello se ha llevado a cabo un profundo análisis documental en diferentes bases de datos del ámbito de las ciencias médicas y sociales, seleccionando tanto artículos de difusión científica como libros, declaraciones, estrategias y guías de práctica clínica. Los resultados muestran un patrón asistencial medicalizado, que parece incrementar las intervenciones no justificadas y con ello los efectos iatrogénicos en los partos de bajo riesgo. Se concluye que estamos ante una cultura del nacimiento que, en cierta medida, vulnera los principios bioéticos fundamentales, al subyugar la dignidad de la corporalidad femenina a intereses económicos contingentes e ideologías transhumanistas, biopolíticas y tayloristas cosificadoras.

Abstract: For decades in low-risk deliveries has been addressed, mainly in the clinical-hospital setting, from an interventionist perspective characterized by medicalization, mechanization and machining care. In this context the present study lies, whose aim was to explore the bioethical limitations of this interventionist paradigm of care through an analysis of its clinical pragmatism compared to other approaches more humanistic. For this it has conducted a thorough analysis of documents in different databases in the field of medical and social sciences, selecting both items of scientific diffusion as books, statements, strategies and clinical practice guidelines. The results show a medicalized care pattern appears to increase the iatrogenic effects in low-risk deliveries. We conclude that this is a culture of birth which, to some, it violates basic bioethical principles to subjugate the dignity of female corporeality to contingent economic interests and transhumanists, biopolitics and taylorist ideologies reifying.

Resumo: Por décadas o parto de baixo risco tem sido abordado, fundamentalmente no campo clinico-hospitalar, a partir de uma perspectiva intervencionista caracterizada pela medicalização, tecnificação e mecanização assitencial. Nesse contexto se situa o presente estudo, cujo objetivo tem sido explorar a limitações bioéticas desse paradigma assistencial intervencionista através da análise de seu pragmatismo clínico frente à outras abordagens mais humanistas. Para isto, fora realizada uma profunda análise documental em diferentes bases de dados no campo das ciências médicas e sociais, selecionando tanto artigos de divulgação científica como livros, declarações, estratégias e guias de prática clínica. Os resultados mostram um padrão assistencial medicalizado que parece intensificar as intervenções não justificadas e, por conseguinte, os efeitos iatrogénicos em partos de baixo risco. Conclui-se estamos diante de uma cultura de nascimento que, em certa medida, viola os princípios bioéticos fundamentais ao subjugar a dignidade da corporalidade feminina por interesses econômicos contingentes e ideologias transumanistas, biopolíticas e tayloristas reificantes.

Hablan las madres. La parte menos contada del aborto voluntario / Mother talk. Part unless told of voluntary abortion

El objetivo del artículo ha sido explorar las experiencias ligadas al síndrome postaborto en madres que se han sometido a un aborto voluntario. Se utilizó un enfoque fenomenológico de carácter cualitativo que recogiera las experiencias de las madres que se habían sometido a una interrupción voluntaria de su embarazo. La técnica de investigación fueron las entrevistas semiestructuradas realizadas a mujeres que habían contactado con diferentes asociaciones de ayuda de la Región de Murcia en busca de apoyo tras experimentar síntomas compatibles con el síndrome postaborto. Los testimonios hablan de mujeres que se aferran a argumentos utilitaristas o feministas para autojustificar la decisión de abortar, hablan de un sistema, en cierta medida, mercantilista que no parece tener una intencionalidad real de dar verdaderas opciones de vida. Muestra una experiencia que lejos de vivirse como un acto de libertad femenino se vive de manera traumática, desarrollándose toda una cascada sintomática fruto del sentimiento de pérdida. En este contexto, el recurso a lo espiritual se torna en la mejor herramienta para expiar la culpa. La experiencia de abortar no mejora la vida de las mujeres, muy lejos de ello supone un trauma difícil de olvidar que puede ser evitado con un asesoramiento adecuado que no aboque a las madres a la tragedia del aborto

The aim of the study was to investigate the experiences linked to the post-abortion syndrome in mothers who have had a voluntary abortion. A phenomenological qualitative approach to collect the experiences of mothers who had voluntarily interrupted their pregnancy was used. The research technique was the semistructured interviews with women who had contacted different association’s help of the Murcia region for support after experiencing symptoms consistent with post-abortion syndrome. The testimonies show feminist or utilitarian arguments to justify the decision to abort, they talk about a system, to some extent, mercantilist that has no real intention of giving real life choices. Experience shows that far from lived as an act of female freedom is experienced traumatically, developed symptoms following the sense of loss. In this context, the resource spiritual becomes the best tool to expiate guilt. The experience of abortion does not improve the lives of women; far from it is a trauma that can be avoided with proper advice to avoid the tragedy of abortion

[Mothers Talk. Part Unless Told of Voluntary Abortion]. / Hablan Las Madres. la Parte Menos Contada Del Aborto Voluntario.

The aim of the study was to investigate the experiences linked to the post-abortion syndrome in mothers who have had a voluntary abortion. A phenomenological qualitative approach to collect the experiences of mothers who had voluntarily interrupted their pregnancy was used. The research technique was the semistructured interviews with women who had contacted different association's help of the Murcia region for support after experiencing symptoms consistent with post-abortion syndrome. The testimonies show feminist or utilitarian arguments to justify the decision to abort, they talk about a system, to some extent, mercantilist that has no real intention of giving real life choices. Experience shows that far from lived as an act of female freedom is experienced traumatically, developed symptoms following the sense of loss. In this context, the resource spiritual becomes the best tool to expiate guilt. The experience of abortion does not improve the lives of women; far from it is a trauma that can be avoided with proper advice to avoid the tragedy of abortion.