[Reminiscence on the municipal out-of-hospital maternity unit and the motherhood home in Novi Sad].

INTRODUCTION: In the mid-twentieth century, the health care of women and children was inadequate in the post-war Yugoslavia, including the city of Novi Sad, due to the severe post-war reality: poverty in the devastated country, shortage of all commodities and services and especially of medical supplies, equipment and educated staff. OUT-OF-HOSPITAL MATERNITY UNIT: One of the serious problems was parturition at home and morbidity and mortality of the newborns and women. Soon after the World War II the action programme of improving the women's health was realized on the state level by establishing out-of-hospital maternity units but under the expert supervision. The Maternity unit at 30 Ljudevita Gaja Street in Novi Sad played a great role in providing skilled birth attendance at mainly normal deliveries. With a minimal number of medical staff and modest medical equipment, about 2000 healthy babies were born in this house. MOTHERHOOD HOME: After 5 years of functioning in that way, this unit was transformed into the Motherhood Home and became a social and medical institution for pregnant women and new mothers. Regardless of the redefined organization concept the curative and preventive health care as well as women and children social protection programmes were provided successfully for the next 12 years. Although the Motherhood Home was moved into the Women Health Centre of Novi Sad and later into the former Maternity Hospital in Sremski Karlovci, its great importance for women and children's health care remained unchanged. In 1979 the overall social situation and mostly economic issues led to its closing. EPILOGUE: The house in Gajeva Street is now used as the municipality office. However, this house with its story recommends itself to become a house for a special social function, such as a museum of medical history of Novi Sad. A small investment could make it possible to collect, preserve and display the valuable records of our past, which is something we do owe to the generations to come.

The Inuulitsivik Maternities: culturally appropriate midwifery and epistemological accommodation.

This is a literature-based historical analysis that uses Michel Foucault's technique of tracing epistemological change over time to understand the epistemological changes and their outcomes that have occurred in Nunavik, the Inuit region of Northern Quebec, with the introduction of modern techniques and technology of childbirth in the period after the Second World War. Beginning in 1986, in the village of Puvurnituq, a series of community birthing centres known as the Inuulitsivik Maternities have been created. They incorporate biomedical techniques and technology, but are incorporated into the Inuit epistemology of health, in which the community is the final arbitrator of medical authority. This epistemological accommodation between modern biomedicine and the distinctly premodern Inuit epistemology of health has led to the creation of a new and profoundly non-modern approach to childbirth in Nunavik.

Childbirth among the Canadian Inuit: a review of the clinical and cultural literature.

BACKGROUND: This study reviews the historical, anthropological and biomedical literature on childbirth among Canadian Inuit resident in the Canadian Arctic. The modern period is characterised by increased tension as southern intervention replaced traditional birthing with a biomedical model and evacuation to metropolitan hospitals for birth. Inuit concern over the erosion of traditional culture has confronted biomedical concern over perinatal outcomes. Recently, community birthing centres have been established in Nunavik and Nunavut in order to integrate traditional birthing techniques with biomedical support. OBJECTIVES: To review the literature on Inuit childbirth in order to suggest avenues for future research. STUDY DESIGN: Material for this review was gathered through combining library searches, database searches in ANTHROPOLOGYPlus, MEDLINE, CINAHL and Science-Direct, and a bibliographic search through the results. RESULTS: Epidemiological studies of Inuit childbirth are outdated, inconclusive, or inseparable from non-Inuit data. Anthropological studies indicate that evacuation for childbirth has deleterious social and cultural effects and that there is considerable support for traditional communal birthing in combination with biomedical techniques and technology. CONCLUSIONS: Investigation of alternative solutions to maintaining acceptable perinatal outcomes among the Inuit seems desirable. Epidemiological and comparative qualitative studies of perinatal outcomes across the Arctic are needed to reconcile the cultural desirability of communal birthing with claims of its medical feasibility.

Cartografia de luta das enfermeiras obstetras na Maternidade Leila Diniz (1996¬1998): do soldado ao batom... (A)

Estudo que se utiliza da abordagem qualitativa, tendo por objetivo identificar as representações acerca da luta de operacionalização do Projeto de Assistência ao Parto e Nascimento por Enfermeiras Obstetras, na Maternidade Leila Diniz (MLD), e analisar o significado das mesmas sobre a luta, no período de 1996-1998, registrando sua memória no processo de construção do conhecimento. Utilizou-se como estratégia para colher as representações das enfermeiras a Dinâmica de Sensibilidade e Criatividade, através de um mapa estilizado da MLD onde os sujeitos do estudo dispuseram alguns objetos que lhes foram oferecidos, num total de 114, escolhidos aleatoriamente, e que variavam em forma de soldado a batom. Os resultados apontaram para duas categorias analíticas: A Cartografia do Espaço de Luta e A Cartografia das Lutadoras: Guerreiras Feridas -A Morte Simbólica Durante a Luta, tendo como palco, o espaço físico da MLD, agindo como campo de lutas. As considerações finais foram realizadas em duas cartas: uma destinada à Sociedade Brasileira, solicitando providências sociais e a outra para a Instituição em apreço, relatando a relação de instituinte e instituído.

[History of gynecology and perinatology in Croatia. Clinics and hospitals in Zagreb. Primary health care. Specialty societies of the Croatian Medical Association]. / Povijest ginekologije i perinatologije u Hrvatskoj. Klinike i bolnice izvan Zagreba. Primarna zastita. Strucna drustva Hrvatskoga lijecnickog zbora.

The formation and development of University clinics in Rijeka, Split and Osijek, and thereafter the formation and development of maternity departments in all Croatian hospitals are presented. Shortly the formation of out-patients clinics for women and maternity health-care is described, then the formation and development of Croatian Society of Gynecology and Obstetrics and of Croatian Society of Perinatal Medicine, as scientific societies (formerly "Sections") of Croatian Medical Association.

From home to hospital: Parallels in birthing and dying in twentieth-century Canada.

This article highlights the striking parallels in the history of birthing and dying as they moved from home to hospital in Canada in the twentieth century. It shows that deaths, like birth, has been hidden in hospitals only since mid-century. It demonstrates that the availability of paid and unpaid female caregivers was a key factor affecting the shifts in location of death, much as it was for birth. Thus, women have been the major consumers and caregivers of health services at both ends of the life cycle.

[Birthing institutions and births in Norwegian counties in the early 1990s]. / Fødeinstitusjoner og fødsler i norske fylker i begynnelsen av (1990-)årene.

Between 1972 and 1993 the number of hospitals and maternity homes providing obstetric help in Norway fell from 158 to 67. Most of the decline is explained by the closing down of maternity homes and obstetrical units in small hospitals, partly due to a reduction in number of births and partly to a deliberate drive towards giving birth in larger units. 16 of the 19 counties of Norway contained four or fewer obstetric institutions in 1993. Nevertheless, most of the 60,000 births took place in institutions with between 500 and 2,999 births annually. Births at home accounted for 0.3%, and births during transport for 0.2% of the total in 1990 and 1993.

Birth centers. Economy, safety, and empowerment.

UNLABELLED: The first three-quarters of this century saw births in the United States shift dramatically from the home toward hospital-based, physician-oriented care. More recently, the establishment and proliferation of modern birth centers and the increased numbers of certified nurse-midwives in this country have expanded birth alternatives for women but not without controversy. The objectives of this article are as follows: 1) to review literature comparing modern birth centers with hospital and physician-attended births in terms of safety, rates of complications, number of invasive procedures, cost-effectiveness, and patient satisfaction, and then 2) to explicate models of empowerment as applied to birth centers and consider how they may manifest in individuals and in the community. FINDINGS: comprehensive data have clearly demonstrated that birth centers are as safe as hospitals for low-risk births, do fewer invasive procedures and cesarean sections, are less expensive, and have high rates of patient satisfaction. Furthermore, birth centers effectively shift the locus of control of the pregnancy from physician to mother, and conform closely to ideal models of empowerment structures described in the literature. CONCLUSIONS: For low risk pregnancies, birth centers confer many advantages over conventional hospital-based births without compromising the safety of the mother or infant and in the process can empower women to transform their lives and their community.

[Learning at the bedside of pregnant patients. On the typology of the birthing center in Germany (1728-1840)]. / Lernen am Bett der Schwangeren. Zur Typologie des Entbindungshauses in Deutschland (1728-1840).

The process of institutionalization of obstetrics in the German universities is investigated on the basis of contemporary accounts and archival documents. The inauguration of the "school for midwives" by Johann Jakob Fried at Strasbourg (1728) was followed after 1750 by the foundation of numerous other obstetric departments and lying-in hospitals, in which midwives and medical students could attend a regular and systematic bedside-teaching for the first time. As to the architectural types, four basic structures have to be distinguished: Whereas in big cities the teaching centres were integrated in pre-existing hospitals (type A), the setting up of lying-in hospitals in regional universities took place in decaying old buildings (type B). The organizing of an obstetric ward in the former "clinicum" together with the medical and surgical department (type C) was rather seldom. Before 1850 the construction of expensive new buildings for lying-in hospitals (type D) was only realized at few places. In conclusion the emphasis is put on the political intentions and tendencies of the enlightenment philosophy which influenced considerably the creation and the development of the first teaching centres for obstetrics.