Exploring Gene-Diet Interactions for Mother-Child Health: A Systematic Review of Epidemiological Studies.

BACKGROUND: Maternal-child health suggests the critical impact of maternal nutrition during the pre-conception and gestational periods, with some genetic variants also playing a significant role. Our systematic review provides an overview of epidemiological studies exploring the interactions between genetic variants, maternal dietary habits, and neonatal and/or maternal pregnancy outcomes. METHODS: From its inception until June 2023, we conducted a comprehensive literature search on PubMed, Embase, and Web of Science databases. RESULTS: On a total of 29 epidemiological studies, 11 studies were conducted to explore the interplay between genetic variants and dietary factors, focusing on the risks associated with gestational diabetes mellitus, hypertensive disorders of pregnancy, recurrent spontaneous abortion, recurrent pregnancy loss, iron deficiency anemia, and gestational weight gain. Concerning neonatal outcomes, six studies investigated the interplay between genetic variants, dietary factors, and anthropometric measures, while eight studies delved into abnormal embryonic development, two studies focused on preterm birth, and two studies explored other neonatal outcomes. CONCLUSIONS: Deeply understanding gene-diet interactions could be useful in developing highly personalized approaches to maternal and child nutrition, as well as in exploring the potential implications in disease prevention and the promotion of the long-term well-being of both mothers and their offspring.

Midwives' views about the effects of climate change on maternal and child health: A qualitative study.

BACKGROUND: Midwives have important responsibilities to protect the health of mothers and children from the negative effects of climate change. AIM: This research was conducted to determine how midwives perceived climate change, the effects of climate change on maternal and child health, and what midwives could do to combat these effects. METHODS: The research was designed as a case study, one of the qualitative research designs. The research sample consisted of 11 midwives selected by snowball sampling, which is one of the non-random sampling methods. FINDINGS: The data obtained were collected under five main themes. The themes were determined as "(I) the causes of climate change, (II) concerns about the consequences of climate change, (III) the effects of climate change on mother-child health, (IV) measures to mitigate the effects of climate change, and (V) midwives' role in protecting mother-child health against the effects of climate change." CONCLUSION: Midwives are knowledgeable about climate change. They are aware of the effects of climate change on maternal and child health and they are doing some practices in this regard (breastfeeding, promoting the regulation of fertility and adequate/balanced nutrition, etc.). Midwives are aware of the importance of the midwifery profession in raising awareness of the individual and society, in addressing the effects of climate change on human health and in reducing the negative effects of climate change on health, and they want to take action at the national level (with the support of the midwifery organization and the state) for the sustainability of health.

Reducing health disparities: Adherence to referrals for further diagnosis among asylum seeking children.

OBJECTIVE: Asylum-seeking children are most vulnerable to health problems and non-utilization of health amenities. The aim of the study was to compare adherence with referrals for further diagnostic tests among asylum-seeking children and native Israeli children. DESIGN: A retrospective cohort study. SAMPLE: The study was conducted among 3508 children born in 2016-2017, with two randomized sample groups: Israeli children (n = 243) and asylum-seeking children (n = 271). Data were retrieved from the children's medical files. MEASUREMENTS: Referrals for further diagnostic tests were defined as written referrals by a public health nurse or pediatrician. Data collected included the child's and mother's details, as well as data on referrals. A multiple logistic regression test was performed to detect risk variables for non-adherence to referrals. RESULTS: No differences were found between the groups regarding adherence to referrals for further diagnosis. Having medical insurance did not explain adherence to referrals. Asylum-seeking children have more need for further follow-up than do Israeli children. CONCLUSION: Asylum-seeking children and Israeli children respond similarly to the preventive health services offered with equal accessibility. Public health nurses have an essential role in encouraging adherence to screening tests and to referrals for further diagnostic tests and in mitigating health disparities among asylum-seeking children.

Total Hemoglobin Trajectories from Pregnancy to Postpartum in Rural Northeast Brazil: Differences between Adolescent and Adult Women.

This study examines total hemoglobin (THB) trajectories during pregnancy and postpartum and associated factors among adolescents and adults from a low-income community. This is an observational, longitudinal study, part of the Adolescence and Motherhood Research (AMOR) project, performed between 2017 and 2019 in the Trairi region of Rio Grande do Norte state, Brazil. The THB levels of 100 primigravida adolescents and adults were monitored up to 16 weeks of gestation, in the third trimester, and 4-6 weeks postpartum, along with socioeconomic characteristics, anthropometrics, and health-related variables. Mixed-effect linear models evaluated the trajectories of THB and the associated factors. THB levels decreased between first and second assessments and increased between the second and postpartum assessments. For the adolescent cohort, the rebound in THB concentration between the third trimester and postpartum was not enough to make up for the initial losses, as occurred in the adult cohort. For the adult group, higher THB levels were associated with pregnancy planning and good self-rated health. Race was marginally associated to THB levels, with black/brown women presenting higher concentrations in the adolescent and lower concentration in the adult group. Special attention to prenatal care among pregnant adolescents should consider their higher risk of anemia and its negative effects.

Persistent Immune Activation in Human Immunodeficiency Virus-Infected Pregnant Women Starting Combination Antiretroviral Therapy After Conception.

This study evaluated the impact of human immunodeficiency virus (HIV) and combination antiretroviral therapy (cART) on immune activation during pregnancy in a Zambian cohort of HIV-exposed but uninfected children followed up from birth. Activated CD8+ T cells (CD38+ and HLA-DR+) were compared among HIV-uninfected (n = 95), cART experienced HIV-infected (n = 111), and cART-naive HIV-infected (n = 21) pregnant women. Immune activation was highest among HIV-infected/cART-naive women but decreased during pregnancy. Immune activation HIV-infected women who started cART during pregnancy was reduced but not to levels similar to those in HIV-uninfected women. The effects of elevated maternal immune activation in pregnancy on subsequent infant health and immunity remain to be determined.

Estimates of fluid intake, urine output and hydration-levels in women from Somaliland: a cross-sectional study.

The study objective was to measure fluid intake and associations with background characteristics and hydration biomarkers in healthy, free-living, non-pregnant women aged 15-69 years from Hargeisa city. We also wanted to estimate the proportion of euhydrated participants and corresponding biomarker cut-off values. Data from 136 women, collected through diaries and questionnaires, 24h urine samples and anthropometric measurements, were obtained with a cross-sectional, purposeful sampling from fifty-two school and health clusters, representing approximately 2250 women. The mean (95 % CI) 24 h total fluid intake (TFI) for all women was 2⋅04 (1⋅88, 2⋅20) litres. In multivariate regression with weight, age, parity and a chronic health problem, only weight remained a predictor (P 0.034, B 0.0156 (l/kg)). Pure water, Somali tea and juice from powder and syrup represented 49⋅3, 24⋅6 and 11⋅7 % of TFI throughout the year, respectively. Mean (95 % CI) 24 h urine volume (Uvol) was 1⋅28 (1⋅17, 1⋅39) litres. TFI correlated strongly with 24 h urine units (r 0.67) and Uvol (r 0.59). Approximately 40 % of the women showed inadequate hydration, using a threshold of urine specific gravity (Usg) of 1⋅013 and urine colour (Ucol) of 4. Five percent had Usg > 1⋅020 and concomitant Ucol > 6, indicating dehydration. TFI lower cut-offs for euhydrated, non-breast-feeding women were 1⋅77 litres and for breast-feeding, 2⋅13 litres. Euhydration cut-off for Uvol was 0⋅95 litre, equalling 9⋅2 urine units. With the knowledge of adverse health effects of habitual hypohydration, Somaliland women should be encouraged to a higher fluid intake.

Violência obstétrica e trauma no parto: o relato das mães / Obstetric violence and birth trauma: the mothers' report / Violencia obstétrica y trauma en el parto: relatos de madres

Resumo O presente trabalho é parte de pesquisa mais ampla sobre experiências de pais e mães acerca do parto, a partir de um estudo de caso coletivo no qual foram analisados 30 relatos de parto, publicados em blogs pessoais sobre experiências de gestação, parto e parentalidade, dos quais 15 foram escritos por mulheres e 15, por homens. O objetivo deste estudo foi investigar a experiência denominada violência obstétrica no relato de mães. Assim, nele foram analisados os relatos de cinco mulheres, as únicas que fizeram referência a tal fenômeno. Os resultados apontaram para a falta de suporte do ambiente como um fator constitutivo da experiência de violência obstétrica, e para a escrita dos relatos como recurso de elaboração dessa experiência traumática. Concluímos que procedimentos médicos como a episiotomia, a anestesia e a cesariana, quando realizados de forma rotineira, sem compartilhamento de decisões e sem amparo psíquico, constituem formas de ritualização para manter inconsciente a representação sexual do parto. Tais formas de ritualização conduzem à iatrogenia no parto, causando prejuízos psíquicos à saúde materno-infantil.(AU)

Abstract This paper is part of a broader research on parents' experiences of childbirth conducted by means of a collective case study that analyzed 30 childbirth reports - 15 written by women and 15 by men - published in personal blogs about gestation, childbirth, and parenthood experiences. This study aimed to investigate the experience of the so-called "obstetric violence" based on the reports of five mothers - the only ones whose reports referred to this phenomenon. The results show that the lack of support is a constitutive factor of the experience of obstetric violence, and that mothers dwelled on writing reports as a means to elaborate this traumatic experience. When routinely performed and without shared decision-making or psychological support, medical procedures such as episiotomy, anesthesia, and cesarean section represent a form of ritualization to keep the sexual representation of childbirth unconscious. Such ritualization leads to iatrogenesis in childbirth, harming the mother-child mental health.(AU)

Resumen El presente trabajo es parte de una investigación más amplia sobre las experiencias de padres y madres acerca del parto, tomando como punto de partida un estudio de caso colectivo, en el cual se analizaron 30 relatos de partos, publicados en blogs personales sobre experiencias de la gestación, el parto y la parentalidad, siendo 15 escritos por mujeres y 15 por hombres. El objetivo específico de este estudio fue investigar la experiencia de la llamada "violencia obstétrica" en el relato de madres. Para ello, se analizaron los relatos de cinco mujeres, las únicas que hicieron referencia a tal fenómeno. Los resultados apuntan a una falta de soporte del ambiente como un factor de la experiencia de violencia obstétrica y motivador para la escrita de los relatos. Se concluye que los procedimientos médicos como la episiotomía, la anestesia y la cesárea, cuando realizados de forma rutinera sin el intercambio de decisiones y el amparo psíquico, constituyen una forma de ritualización para mantener inconsciente la representación sexual del parto. Tal forma de ritualización implica la iatrogenia en el parto, causando daños psíquicos a la salud materno-infantil.(AU)

Exposure to Perflouroalkyl acids and foetal and maternal thyroid status: a review.

BACKGROUND: Exposure to perfluorinated-alkyl-acids (PFAAs) is ubiquitous. PFAAs are hormone-disrupting compounds that are strongly suspected to affect mother-child-health such as fetal growth. Thyroid disruption is a plausible mechanism of action. We aim to summarize the epidemiological evidence for the relation between prenatal and postnatal exposure to PFAAs and disruption of thyroid homeostasis in mothers and/or infants. METHOD: Fifteen original publications on PFAAs concentrations and thyroid hormones (TH) in pregnant women and/or infants were found upon a literature search in the PubMed database. Information on exposure to seven PFAAs congeners [Perfluorooctane sulfonate (PFOS), Perfluorooctanoate (PFOA), Perfluorohexane sulfonate (PFHxS), Perfluorononanoic acid (PFNA), Perfluorodecanoic acid (PFDA), Perfluoroundecanoic acid (PFUnA), and Perfluorododecanoic acid (PFDoA)] and thyroid stimulating hormone (TSH), free and total thyroxine (FT4 and TT4), free and total triiodothyronine (FT3 and TT3), T3RU (Free triiodothyronine resin uptake) and FT4-index (FT4I) levels were recorded. We evaluated sampling of maternal TH by trimester, and infant TH by sex stratification. Reported associations between mother or infant PFAAs and TH were not uniformly assessed in the selected studies. RESULTS: Ten out of the fifteen studies examined maternal PFAAs concentration and TSH level. Seven studies showed significant associations between TSH and exposure to six PFAAs congeners, most of them were positive. Maternal T4 and T3 were investigated in nine studies and five studies found inverse associations between exposure to six PFAAs congeners and TH (TT3, TT4, FT3, FT4 and FT4I) levels. Eight of the fifteen studies investigated PFAAs concentrations and infant TSH. Infant TSH level was significantly affected in four studies, positively in three studies. Nine studies investigated infant T4 and T3 and seven studies found significant associations with PFAAs exposure. However, both inverse and positive significant associations with infant TH were found eliciting no clear direction. CONCLUSION: Results indicate a mainly positive relationship between maternal PFAAs concentrations and TSH levels, and suggestion of an inverse association with T4 and/or T3 levels. Associations of infant TH with PFAAs concentration were less consistent.

Maternal Adverse Childhood Experience and Infant Health: Biomedical and Psychosocial Risks as Intermediary Mechanisms.

OBJECTIVE: To assess the mechanisms accounting for the transfer of risk from one generation to the next, especially as they relate to maternal adverse childhood experiences and infant physical and emotional health outcomes. STUDY DESIGN: Participants were 501 community mother-infant dyads recruited shortly after the birth and followed up at 18 months. Mothers retrospectively reported on their adverse childhood experiences. The main outcome measures were parent-reported infant physical health and emotional problems. Potential mechanisms of intergenerational transmission included cumulative biomedical risk (eg, prenatal and perinatal complications) and postnatal psychosocial risk (eg, maternal depression, single parenthood, marital conflict). RESULTS: Four or more adverse childhood experiences were related to a 2- and 5-fold increased risk of experiencing any biomedical or psychosocial risk, respectively. There was a linear association between number of adverse childhood experiences and extent of biomedical and psychosocial risk. Path analysis revealed that the association between maternal adverse childhood experiences and infant physical health operated specifically through cumulative biomedical risk, while the relationship between adverse childhood experiences and infant emotional health operated specifically through cumulative psychosocial risk. This pattern was not explained by maternal childhood disadvantage or current neighborhood poverty. CONCLUSIONS: Maternal adverse childhood experiences confer vulnerability to prenatal, perinatal, and postnatal psychosocial health. The association between adverse childhood experiences and offspring physical and emotional health operates through discrete intermediary mechanisms.

Maternal and Child Characteristics Associated With Mother-Child Interaction in One-Year-Olds.

Mothers' interactions with their young children have predicted later child development, behavior, and health, but evidence has been developed mainly in at-risk clinical samples. An economically and racially diverse sample of pregnant women who were not experiencing a high-risk pregnancy were recruited to participate in a community-based, longitudinal study of factors associated with child cognitive and social-emotional development during the first 3 years. The purpose of the present analysis was to identify associations between the characteristics of 1125 mothers and their 1-year-olds and the mothers' and children's scores on the Nursing Child Assessment Teaching Scale (NCATS). A multivariable approach was used to identify maternal and child characteristics associated with NCATS scores and to develop prediction models for NCATS total and subscale scores of mothers and children. Child expressive and receptive communication and maternal IQ, marital status, age, and insurance predicted NCATS Mother total score, accounting for 28% of the score variance. Child expressive communication and birth weight predicted the NCATS Child total score, accounting for 4% of variance. Child's expressive communication and mother's IQ and marital status predicted NCATS mother-child total scores. While these findings were similar to reports of NCATS scores in at-risk populations, no previous teams examined all of the mother and child characteristics included in this analysis. These findings support the utility of the NCATS for assessing mother-child interaction and predicting child outcomes in community-based, non-clinical populations. © 2017 Wiley Periodicals, Inc.

Gravidez Indesejada e Tentativa de Aborto: práticas e contextos / Embarazo no deseado y tentativa de aborto: prácticas y contextos / Unwanted pregnancy and abortion attempt: practices and contexts

Resumo: O objetivo deste artigo é explorar aspectos da gravidez indesejada e da tentativa de aborto revelados numa avaliação da assistência pré-natal. Realizou-se uma pesquisa quanti-qualitativa, com 1035 puérperas da Região Metropolitana da Grande Vitória, Espírito Santo, Brasil, internadas para o parto em maternidades de referência do Sistema Único de Saúde. No inquérito populacional, coletaram-se dados sociodemográficos, bem como sobre sentimentos e expectativas diante da gravidez. Na etapa qualitativa, realizaram-se entrevistas semiestruturadas. Os resultados evidenciaram a tentativa de aborto inseguro em consequência da gravidez indesejada. Foram reveladas vulnerabilidades entre as pesquisadas, que demonstraram conhecimento popular sobre riscos do aborto para o bebê. Compreende-se que as mulheres se arriscam por meio do aborto induzido, revelando conflitos morais que persistem na sociedade brasileira, especialmente acerca do direito à vida e do direito à autonomia da mulher.

Resumen: El objetivo de este artículo es explorar aspectos del embarazo no deseado y de la tentativa de aborto revelados en una evaluación de la asistencia pre-natal. Se realizó una investigación cuanti-cualitativa, con 1035 puérperas de la Región Metropolitana de la Gran Vitória, Espírito Santo, Brasil, internadas para el parto en maternidades de referencia del Sistema Único de Salud. En la encuesta poblacional se recolectaron datos sociodemográficos, así como acerca de sentimientos y expectativas frente al embarazo. En la etapa cualitativa fueron realizadas entrevistas semiestructuradas. Los resultados evidenciaron la tentativa de aborto inseguro en consecuencia del embarazo no deseado. Se revelaron vulnerabilidades entre las participantes de la investigación, que demostraron conocimientos populares acerca de los riesgos del aborto para el bebé. Se comprende que las mujeres se arriesgan por medio del aborto inducido, revelando conflictos morales que persisten en la sociedad brasileña, especialmente con relación al derecho a la vida y a la autonomía de la mujer.

Abstract: The aim of this article is to explore aspects of unwanted pregnancy and abortion attempts revealed in an evaluation of prenatal care. We conducted a quantitative and qualitative study with mothers in 1035 in the Metropolitan Region of Vitória, Espírito Santo, Brazil, admitted for labor in Unified Health System reference hospitals. The population survey collected demographic data, as well as data regarding feelings and expectations toward pregnancy. In the qualitative stage, semi-structured interviews were conducted. The results showed the attempt of unsafe abortion as a result of an unwanted pregnancy. Vulnerabilities were revealed among the sample of women, who demonstrated popular knowledge about abortion risks to the baby. It is understood that the women face the risk of an induced abortion, revealing moral conflicts that persist in Brazilian society, especially about the right to life and the right to women's autonomy.

Autonomía femenina y factores asociados al uso de servicios maternos en Colombia (2010) / Feminine Autonomy and factors associated with the use of maternity services in Colombia (2010)

En este artículo analizamos empíricamente los factores que inciden en la decisión del uso de atención materna en Colombia para el 2010. Estimamos un modelo logístico-binomial para explicar la asistencia de las mujeres a controles prenatales y la atención médica en el parto, utilizando una submuestra de la Encuesta Nacional de Demografía y Salud de 2010. Entre las variables consideradas están la edad de la mujer, el número de hijos o hijas, el índice de riqueza del hogar, el nivel educativo de la mujer y su cónyuge, algunas dimensiones de autonomía femenina, entre otros. Los resultados indican que el nivel educativo, la región de residencia y la participación de la mujer en las decisiones sobre su salud y el uso de anticonceptivos, son las variables que más influenciaron en la probabilidad de emplear servicios maternos.

In this article, we analyze empirically the factors that make an impact on the decision of using maternity health assistance in Colombia for the year 2010. We estimate a logistic-binomial model to explain to the women the importance of their attendance to prenatal control and of medical assistance during labor using a sub-sample of the 2010 National Survey on Demography and Health. Among the variables considered are the woman's age, the number of children, the household's purchasing power, the educational level of the woman and her spouse, some dimensions of feminine autonomy and others. The results indicate that the educational level, the region where they live and the woman's participation in the decisions regarding her health and the use of contraceptives, are the variables that had the strongest impact on the probability of them using maternity services.

Acesso à assistência odontológica no acompanhamento pré-natal / Access to dental care during prenatal assistance

Objetivou-se avaliar a resposta autopercebida da assistência odontológica no acompanhamento pré-natal do Sistema Único de Saúde (SUS) da Região Metropolitana da Grande Vitória, Espírito Santo, Brasil. Foram entrevistadas 1032 puérperas e copiados 1006 cartões de gestantes. A autopercepção da puérpera foi medida pelo Oral Health Índex Profile-14. Quando identificado o impacto, considerou-se adequada a assistência odontológica prestada nos níveis educativo, preventivo e curativo. Na ausência de impacto, foi considerada adequada a assistência nos dois níveis iniciais. Testes de qui-quadrado verificaram a associação entre a assistência pré-natal e a odontológica. A prevalência de impacto da saúde bucal na qualidade de vida foi 14,7%. A assistência odontológica recebida pelas puérperas no nível educativo foi 41,3%, no nível preventivo 21,0% e no nível curativo 16,6%. A realização de seis ou mais consultas pré-natais e de atividades educativas estiveram fortemente associadas à assistência odontológica adequada (p < 0,05). O acesso a serviços odontológicos é facilitado quando gestantes frequentam mais os serviços de saúde e realizam atividades educativas no pré-natal. Portanto, medidas educativas parecem sinalizar a melhoria da assistência pré-natal no SUS.

This study sought to evaluate the self-perceived response to dental care during prenatal assistance in the Unified Health System (SUS) in the Metropolitan Region of Vitória, Espírito Santo, Brazil. 1032 postpartum women were interviewed and 1006 prenatal records copied. Postpartum women's self-perceived response was measured by the Oral Health Index Profile-14. When an impact was identified, dental care rendered in educational, preventive and curative terms was considered adequate. When there was no impact, assistance was considered adequate in educational and preventive terms. The Chi-square test revealed an association between prenatal care and dental care. Oral health impact on quality of life was 14.7%. Dental care received by mothers in educational terms was rated at 41.3%, while in preventive terms it was 21% and in curative terms it was 16.6%. Six or more prenatal appointments coupled with educational activities was closely associated with adequate dental care (p < 0.05). Access to dental care is facilitated when pregnant women attend health services and become involved in educational activities during the prenatal period. Consequently, educational measures appear to indicate an improvement in prenatal care in the SUS.

Madres y niños en las políticas del Servicio Nacional de Salud de Chile (1952-1964) / Mothers, children, and the policies of Chile's Servicio Nacional de Salud (1952-1964)

El objetivo de este artículo es describir y analizar el desarrollo de los primeros años de funcionamiento del Servicio Nacional de Salud en Chile, fundado en 1952, y la importancia que cobró en este contexto el Programa de Salud Materno Infantil. Se identifican los avances y dificultades en esta etapa del Servicio, y se analiza cómo el Programa representó la continuidad de diversas políticas de protección sanitarias a madres y niños (implementadas en el país desde la década de 1920), y el mejoramiento, ampliación y creación de nuevas políticas en el marco de una medicina social. Se documentan los logros alcanzados por el Programa, pero también sus limitaciones, que expresan no solo los problemas del Servicio sino también los problemas sociales y económicos que aquejaban al país.

This description and exploration of the early years of Servicio Nacional de Salud, founded in 1952, analyzes the agency's progress and challenges, as well as the role of the Programa de Salud Materno-Infantil. The latter program lent continuity to a variety of sanitary protection policies for mothers and children dating to the 1920s, while also improving and expanding on existing policies and devising new ones within the framework of social medicine. The program recorded successes but also encountered limitations, which derived not only from agency-specific problems but also from the social and economic ills afflicting the country as a whole.

A higienização das parteiras curiosas: o Serviço Especial de Saúde Pública e a assistência materno-infantil (1940-1960) / The health education of folk midwives: the Serviço Especial de Saúde Pública and mother-child assistance (1940-1960)

Discute as ações de treinamento e controle das parteiras curiosas promovidas pelo Serviço Especial de Saúde Pública, confiadas aos programas de higiene pré-natal e da criança, implantados entre as décadas de 1940 e 1960. Para os sanitaristas, o treinamento e controle das parteiras curiosas atuantes nas comunidades rurais brasileiras eram importantes para o sucesso do projeto de implantação de serviços sanitários locais de assistência materno-infantil. Ao atuar diretamente junto às parteiras curiosas, pretendia-se não somente lhes impor rigorosos padrões higiênicos na realização de partos e nos cuidados com os recém-nascidos, mas, sobretudo, recorrer a sua influência e seu prestígio naquelas comunidades para popularizar ações de saneamento.

The article addresses an endeavor by Serviço Especial de Saúde Pública (Sesp) to train folk midwives who worked in rural communities and to exercise control over these women's activities. The task was entrusted to the agency's prenatal and child hygiene programs, established between the 1940s and 1960s. The agency believed this training and control initiative would be of major importance in helping ensure the success of its project to establish local sanitary services offering mother-child assistance. The goal of working directly with the folk midwives was not only to force them to employ strict hygiene standards when delivering and caring for newborns but especially to use their influence and prestige within these communities to convince the general population to adopt good health practices.

The Life and Works of Han Shin Gwang: a Midwife and Nurse of Korean Modern Times / 의사학

Han Shin Gwang, born in an early Christian family in Korea in 1902, could get western education different from the ordinary Korean girls in that period. She participated in the 1919 Samil Independence Movement in her teens, and got nursing and midwifery education in a missionary hospital. She got a midwife license and worked as a member in an early mother-and-child health center. She organized 'Korean Nurses' Association' in 1924 and focused on public health movement as the chairwoman. She actively participated in women's movement organizations, and Gwangjoo Student's Movement. She was known to be a representative of leading working women, and wrote articles on woman's right, the needs and works of nurses and midwives. From late Japanese colonial period, she opened her own clinic and devoted herself to midwifery. After the Korean Liberation in 1945, she began political movement and went in for a senate election. During the Korean War, she founded a shelter for mothers and children in help. After the War, she reopened a midwifery clinic and devoted to the works of Korean Midwives' Association. Han Shin Gwang's life and works belong to the first generation of Korean working women in modern times. She actively participated in women's movement, nurses' and midwives professional movement, Korea liberation movement, and mother-and-child health movement for 60 years. Her life is truly exemplary as one of the first generation of working women in modern Korea, distinguished of devotion and calling.