Midwives in Health Sciences as a Sociocultural Phenomenon: Legislation, Training and Health (XV-XVIII Centuries).

Background and Objectives: The first inquisitorial processes were developed against Muslims and Jews. Then, they focused on women, especially those dedicated to care. Progressively, they were linked to witchcraft and sorcery due to their great assistance, generational and empirical knowledge. The health historiography of the 15th-18th centuries still has important bibliographic and interpretive gaps in the care provided by women. The main objective was to analyse the care provided by midwives in the legislative and socio-sanitary context of New Castile, in the inquisitorial Spain of the 15th-18th centuries. Materials and Methods: A historical review was conducted, following the Dialectical Structural Model of Care. Historical manuals, articles and databases were analysed. Results: The Catholic Monarchs established health profession regulations in 1477, including midwives. However, all legislations were annulled by Felipe II in 1576. These were not resumed until 1750. Midwives assumed a huge range of functions in their care commitment (teaching, care and religion) and were valued in opposing ways. However, many of them were persecuted and condemned by the Inquisition. They used to accompany therapeutic action with prayers and charms. Midwives were usually women in a social vulnerability situation, who did not comply with social stereotypes. Conclusions: Midwives, forerunners of current nursing and health sciences, overcame sociocultural difficulties, although they were condemned for it. Midwives achieved an accredited title, which was taken from them for two centuries. They acted as health agents in a society that demanded them while participating in a "witch hunt".

Wet Nurse or Milk Bank? Evolution in the Model of Human Lactation: New Challenges for the Islamic Population.

(1) Introduction: The establishment of milk banks in the Islamic world as well as donation to Islamic families in Western countries remains a challenge in the context of human lactation. Religious reservations established since the Qur'an and regulated at the legal-religious and medical level equate milk kinship with consanguinity, which prevents donation. The aim of the study was to analyse the evolution in the model of breastfeeding and care in Islamic society. (2) Methods: The methodology of comparative history was applied, following the structural-dialectical model of care. Historical manuals, articles and databases were analysed. (3) Results: Paediatric care in medical manuals from the 10th-15th centuries is similar to that practiced by the Muslim population today, some beneficial, some harmful; the wet nurse had to follow a series of dietary habits and have a series of physical, moral and educational characteristics in order to be hired. They constituted a beginning of pseudo-professionalisation, in a domestic-family framework. Human milk was used as a remedy for different health problems. (4) Conclusions: Islamic society and nursing have to evolve towards transnational care adapted to the needs of the population.

Queens and Wet Nurses: Indispensable Women in the Dynasty of the Sun King (1540-1580).

In Spain, the wet nurse had a prominent place in the Court of Philip II (1540-1580), suckling princes. The aim of this review is to identify the role of wet nurses in the Spanish monarchy and the survival of the infants, who were children of Philip II (16th century). A scoping review is presented, studying documents on wet nurses in the Spanish monarchy. The dialectical structural model of care (DSMC) is applied, and three thematic blocks are used to make up the historical-cultural model. Books, chapters and databases were analysed from Cuiden, Pubmed, Scopus, Science Direct and Google Scholar, from January-September 2021. These wet nurses were treated as ladies, as they came from wealthy families related to royalty. The services of wet nurses from neighbouring localities to the court were used. They had to be of good appearance and in excellent health. They were hired because of the need for survival of the infants, children of Philip II. The functions of the four wives of Philip II were relegated to reproduction, childcare, family and monarchical duties. They used empirical medicine in the form of prescriptions for beauty, hygiene and feminine care. The wet nurses were the driving force that promoted the health of babies through breastfeeding.

Gripe española de 1918 versus SARS-CoV-2: Comparativa a través de la historia / The Spanish flu pandemic of 1918 flu SARS-CoV-2: A comparison through history / A gripe espanhola de 1918 versus SARS-CoV-2: Uma comparação ao longo da história

Resumen Marco contextual: La humanidad ha tenido que enfrentarse a múltiples pandemias, estas se extendieron rápidamente produciendo altas tasas de morbimortalidad. Objetivo: Comparar el impacto sociosanitario de la gripe española de 1918 y el SARS-CoV-2. Metodología: Investigación histórico-descriptiva, relacionada con la gripe de 1918 y el SARS-CoV-2. Recopilación de información: protocolos sanitarios; análisis (organismos internacionales, libros y artículos científicos). Se realizó un análisis interpretativo por fechas y acontecimientos del periodo de estudio. Resultados: La gripe española ocurrió durante tres etapas, la primera en marzo de 1918 y la última en 1919. El SARS-CoV-2 comenzó en Wuhan (China) en diciembre de 2019; no obstante, tuvo su mayor propagación en marzo de 2020 y se prevé un nuevo rebrote. Hasta julio de 2020 la gripe española ha tenido mayor número de víctimas, ambas pandemias han tenido repercusión a nivel mundial y han causado la muerte a multitud de personas. Conclusión: El desconocimiento de estas patologías, la ausencia de tratamiento y vacuna y la escasez de recursos para la alta demanda de pacientes han sido un desafío global.

Abstract Background: Humanity has so far faced multiple pandemics, with swift propagation and high morbimortality rates. Objective: To compare the social and health impact of the Spanish flu of 1918 and SARS-CoV-2. Methodology: Historical-descriptive study on the 1918 flu and SARS-CoV-2. Data were collected on health protocols through the analysis of international organizations, books, and scientific articles. An interpretative analysis was performed based on the dates and events of the period under study. Results: The Spanish flu occurred in 3 stages, the first in March 1918 and the last in 1919. SARS-CoV-2 started in Wuhan, China, in December 2019 but spread worldwide in March 2020 and a new wave is expected. As of now, July 2020, the Spanish flu has had the highest number of victims, although both pandemics have had worldwide repercussions, accounting for many deaths. Conclusion: The lack of knowledge about these diseases, the absence of treatment and vaccines, as well as the scarcity of resources for the high rate of patients' needs have been a global challenge.

Resumo Enquadramento: A humanidade teve de enfrentar múltiplas pandemias, que se espalharam rapidamente e produziram altas taxas de morbilidade e mortalidade. Objetivo: Comparar o impacto socio-sanitário da gripe espanhola de 1918 e SARS-CoV-2. Metodologia: Investigação histórico-descritiva, relacionada com a gripe de 1918 e SARS-CoV-2. Recolha de informação: protocolos de saúde; análise: organizações internacionais, livros e artigos científicos. Foi realizada uma análise interpretativa por datas e eventos do período de estudo. Resultados: A gripe espanhola ocorreu durante três fases, a primeira em março de 1918 e a última em 1919. SARS-CoV-2 começou em Wuhan (China) em dezembro de 2019; teve a sua maior propagação em março de 2020 e espera-se um novo surto. Até julho 2020, a gripe espanhola tem tido o maior número de vítimas, embora ambas as pandemias tenham tido repercussões mundiais, com muitas pessoas a morrer. Conclusão: A falta de conhecimento sobre estas patologias, a ausência de tratamento e vacina, bem como a escassez de recursos para a grande procura de doentes, têm sido um desafio global.

Lactancia materna y feminismo: recorrido social y cultural en España / Breastfeeding and feminism: social and cultural journey in Spain / Breastfeeding and feminism: social and cultural journey in Spain

RESUMEN OBJETIVO Analizar la influencia de cambios socio-políticos, educativos y feministas de España en el mantenimiento de lactancia materna. MÉTODO Revisión histórico-descriptiva de documentación en bases de datos, Boletines Oficiales del Estado, del Ministerio de Sanidad y Consumo y Bienestar Social. RESULTADOS La lactancia materna es un fenómeno complejo influenciado por factores demográficos, biológicos, sociales y psicológicos. Ha cambiado a lo largo de la historia y, evolucionado con los movimientos feministas. La incorporación de la mujer al mercado laboral (s.XIX), produjo una modificación en el rol familiar y pareja. La sociedad del siglo XXI reclama a los poderes públicos la conciliación personal y laboral para la crianza de sus hijos. CONCLUSIONES E IMPLICACIÓN PARA LA PRÁCTICA Han sido múltiples los factores y procesos evolutivos para la situación socio-cultural de la mujer en la lactancia materna. Actualmente sigue siendo complicado compaginar gestación y crianza con el empleo, las redes formales e informales permiten avances en políticas sanitarias.

RESUMO OBJETIVO Analisar a influência das mudanças sócio-políticas, educativas e feministas em Espanha na manutenção do aleitamento materno. MÉTODO Revisão histórico-descritiva da documentação em bases de dados, Boletins Oficiais do Estado, do Ministério da Saúde e do Consumo e da Previdência Social. RESULTADOS O aleitamento materno é um fenómeno complexo influenciado por factores demográficos, biológicos, sociais e psicológicos. Ela mudou ao longo da história e evoluiu com os movimentos feministas. A incorporação das mulheres ao mercado de trabalho (século XIX), produziu uma modificação no papel da família e do casal. A sociedade do século XXI exige do poder público a conciliação pessoal e laboral para a educação dos seus filhos. CONCLUSÕES E IMPLICAÇÕES PARA A PRÁTICA Tem havido múltiplos factores e processos evolutivos para a situação sociocultural das mulheres em aleitamento materno. Hoje em dia, ainda é complicado combinar gravidez e educação com emprego, e as redes formais e informais permitem avanços nas políticas de saúde.

ABSTRACT OBJECTIVE To analyze the influence of socio-political, educational and feminist changes in Spain on the maintenance of breastfeeding. METHOD Historical-descriptive review of documentation in databases, Official State Bulletins, of the Ministry of Health and Consumer Affairs and Social Welfare. RESULTS Breastfeeding is a complex phenomenon influenced by demographic, biological, social and psychological factors. It has changed throughout history and evolved with the feminist movements. The incorporation of women to the labor market (19th century), produced a modification in the family and couple role. The society of the 21st century demands from the public authorities the personal and labor conciliation for the upbringing of their children. CONCLUSIONS AND IMPLICATION FOR PRACTICE There have been multiple factors and evolutionary processes for the socio-cultural situation of women in breastfeeding. Nowadays, it is still complicated to combine pregnancy and upbringing with employment, and formal and informal networks allow advances in health policies.

Lactancia materna: transición alimentaria durante la guerra y posguerra española (1936-1949) / Breastfeeding: food transition during the Spanish war and post-war period (1936-1949) / Amamentação: transição alimentar durante a guerra espanhola e o período pós-guerra (1936-1949)

Durante los años 1900 hasta 1936, la salud infantil comenzaba a ganar importancia en Europa. En España, la mortalidad infantil era elevada. Para contrarrestar esta situación, el estado propuso medidas sanitarias, educativas y alimentarias. OBJETIVO: Analizar la Guerra Civil Española (1936-1939), que continuó con los "años del hambre" durante la posguerra (1939-1949), conocidos por el racionamiento de alimentos y decadencia de la salud materno-infantil. MÉTODO: Estudio histórico descriptivo con fuentes primarias y secundarias. Que trata sobre, el contexto sociosanitario y la transición alimentaria, que vivieron los infantes durante la guerra y posguerra española (1936-1949). RESULTADOS: El gobierno realizó una promoción de la lactancia materna guiada por pediatras de la época, no obstante, la leche de fórmula ganó importancia, debido a la modificación de la estructura familiar básica. La figura clásica de la mujer se fracturó, en favor del trabajo en las fábricas o, en última instancia, como participantes activas en la guerra. CONCLUSIONES: Las instituciones sanitarias, se centraron en el cuidado de heridos, cuestión que repercutió en la atención del niño enfermo. Esta situación dio lugar a altas tasas de morbimortalidad infantil, las cuales se mantuvieron hasta el final de la posguerra

During the years 1900 to 1936, children's health began to gain importance in Europe. In Spain, infant mortality was high. To counteract this situation, the state proposed health, educational and food measures. OBJECTIVE: To analyze the Spanish Civil War (1936-1939), which continued with the "hungry years" of the post-war period (1939-1949), known for food rationing and the decline of mother and child health. Method. Historical descriptive study with primary and secondary sources. It deals with the socio-health context and the food transition experienced by infants during the Spanish war and post-war period (1936-1949). RESULTS: The government carried out a promotion of breastfeeding guided by pediatricians of the time, however, formula gained importance, due to the modification of the basic family structure. The classic figure of the woman was fractured, in favour of working in factories or, ultimately, as active participants in the war. CONCLUSIONS: Health institutions focused on the care of the wounded, an issue that impacted on the care of the sick child. This situation resulted in high rates of child morbidity and mortality, which continued until the end of the post-war period

Durante os anos de 1900 a 1936, a saúde das crianças começou a ganhar importância na Europa. Em Espanha, a mortalidade infantil foi elevada. Para contrariar esta situação, o Estado propôs medidas sanitárias, educativas e alimentares. OBJECTIVO: Analisar a Guerra Civil Espanhola (1936-1939), que continuou com os "anos de fome" do pós-guerra (1939-1949), conhecida pelo racionamento de alimentos e pelo declínio da saúde materna e infantil. MÉTODO: Estudo descritivo histórico com fontes primárias e secundárias. Trata do contexto sócio-sanitário e da transição alimentar vivida pelos bebés durante a guerra espanhola e o período pós-guerra (1936-1949). RESULTADOS: O governo realizou uma promoção da amamentação orientada por pediatras da época, mas a fórmula ganhou importância, devido à modificação da estrutura básica da família. A figura clássica da mulher foi fracturada, a favor de trabalhar em fábricas ou, em última análise, como participante activa na guerra. CONCLUSÕES: As instituições de saúde concentraram-se no cuidado dos feridos, uma questão que teve impacto no cuidado da criança doente. Esta situação resultou em elevadas taxas de morbilidade e mortalidade infantil, que se mantiveram até ao final do período pós-guerra

Woman, Mother, Wet Nurse: Engine of Child Health Promotion in the Spanish Monarchy (1850-1910).

In Spain, the wet nurse increased the survival of children through care and breastfeeding of other women's children. They had a great development together with the Spanish monarchy between 1850 and 1910. The aim is to identify the role of wet nurses in the Spanish monarchy and the survival of the royal infants (s. XIX-XX). A scoping review is presented to study documents about the wet nurse in the Spanish monarchy. Applying the dialectical structural model of care (DSMC). Recognizing five thematic blocks that shape the historical-cultural model. Books, decrees and databases were analyzed: Scopus, Scielo, Dialnet, Cuiden, Medline/Pubmed, CINAHL, Science Direct and Google Scholar, from January to July 2020. The selection process was rigorous because it was difficult to choose. They had to overcome medical and moral exams. The selected rural northern wet nurses emigrated to Madrid. The contract was regulated by laws and paid. Wet nurses were hired by the monarchy due to health problems of the biological mother and a need for greater offspring. The wet nurse wore a typical costume, a symbol of wealth. The northern wet nurses hired by the monarchists have been the engine that has promoted the health of infants through the breastfeeding process.

La nodriza pasiega: transición de la actividad biológica a la laboral (1830-1930) / The Pasician wet nurse: transition from biological activity to work (1830-1930) / A mãe Pasiege: transição da actividade biológica para a actividade laboral (1830-1930)

Las nodrizas son las encargadas de la lactancia, educación y cuidados de hijos ajenos. Estas mujeres han tenido un papel en la sociedad desde la Antigüedad. Esta figura adquirió especial relevancia en España durante 1830-1930 ligada a la monarquía. El contrato de sus servicios tenía como causa problemas de salud de la madre biológica, pero se convirtió en un privilegio. La elección de estas mujeres se basaba en exámenes realizados por médicos y sacerdotes, que garantizaran la buena salud física y moral. Las amas de leche norteñas comenzaron a ser demandadas, especialmente las procedentes del Valle del Pas, las cuales emigraron a las zonas urbanas, como Madrid. Estas mujeres eran consideradas más saludables y aptas para realizar este oficio debido a su estado físico de robustez y su vida en la naturaleza. El contrato tenía implícito un sueldo y estaba regulado por leyes (1904 Protección a la Infancia y Real Decreto 1910). Sus servicios se realizaban en casas de expósitos y en hogares de las familias, incluso de la realeza. Cabe destacar la importancia de la nodriza, en un periodo histórico con altas tasas de mortalidad infantil, ya que fomentaron la supervivencia de los recién nacidos

The wet nurses are in charge ofbreastfeeding, education and care of other people's children. These women have had a role in society since ancient times. This figure acquired special relevance in Spain during 1830-1930 linked to the monarchy. The contract for their services had as a cause health problems of the biological mother, but it became a privilege. The choice of these women was based on examinations carried out by doctors and priests, which guaranteed good physical and moral health. Northern women began to be sued, especially those from the Pas Valley, who migrated to urban, such as Madrid. These women were considered to be healthier and more suitable for this trade due to their robust physical condition and their life in nature. The contract had an implicit salary and was regulated by law (1904 Child Protection and Royal Decree 1910). Their services were carried out in houses of foundlings and in the homes of families, including royalty. It is worth noting the importance of the wet nurse, in a historical period with high infant mortality rates, as they encouraged the survival of newborns

As enfermeiras húmidas são responsáveis pela amamentação, educação e cuidados com os filhos de outras pessoas. Estas mulheres têm tido um papel na sociedade desde os tempos antigos. Este número adquiriu especial relevância em Espanha durante 1830-1930, ligado à monarquia. O contrato dos seus serviços tinha como causa problemas de saúde da mãe biológica, mas tornou-se um privilégio. A escolha destas mulheres baseou-se em exames realizados por médicos e padres, que garantiam uma boa saúde física e moral. As mulheres do Norte começaram a ser processadas, especialmente as do Vale do Pas, que migraram para zonas urbanas, como Madrid. Estas mulheres foram consideradas mais saudáveis e mais adequadas para este comércio devido ao seu robusto estado físico e à sua vida na natureza. O contrato tinha um salário implícito e era regulado por lei (1904 Protecção da Criança e Decreto Real de 1910). Os seus serviços foram realizados em casas de fundição e nas casas das famílias, incluindo a realeza. É de salientar a importância da enfermeira húmida, num período histórico com elevadas taxas de mortalidade infantil, uma vez que incentivavam a sobrevivência dos recém-nascidos