The Art of Childbirth of the Midwives of Al-Andalus: Social Assessment and Legal Implication of Health Assistance in the Cultural Diversity of the 10th-14th Centuries

(1) Background: The role of Al-Andalus's women were the result of Arabization and Islamization in Spain. The 10th to the 14th centuries were a time of significant cultural diversity in the region. Female physicians and midwives were important for providing care to women. Despite existing studies, there is still a lack of focused research on the professionalization of these trades, including their requirements, intervention areas, and treatments. (2) Methods: To address this gap, we conducted a scoping review using the dialectical structural model of care (DSMC). Primary medical and legislative sources were used. (3) Results: two kinds of midwife, or qābila, were discovered, along with a woman physician, or ṭabība, who also acted as a midwife. These professions underwent diverse training and fulfilled duties as obstetricians and pediatricians. Midwives were esteemed members of society and were the sole female professionals who needed qualified training. Their performance in the courts was exemplary. Tools for facilitating childbirth and interventions related to female health were discovered in the study. (4) Conclusions: The patriarchal societies suffer from significant inequality in terms of academic training, knowledge transmission, and healthcare provision. Midwives functioned in segregated domestic and legal spaces and were responsible for providing public care to communities from the 10th to 14th centuries.

Women health providers: materials on cures, remedies and sexuality in inquisitorial processes (15th-18th century)

Background

The first inquisitorial trials were against Muslims and Jews. Later, they focused on women, especially caregivers. Progressively, they were linked to witchcraft and sorcery because of their great care, generational and empirical knowledge. The historiography of health in the 15th-18th centuries still has important bibliographical and interpretative gaps in the care provided by women.

Objective

To analyse the care provided by healers as health providers, accused by the Inquisition, justifying the importance of nursing in the diversity of community care in the 15th-18th centuries.

Method

A scoping review was conducted following the Dialectical Structural Model of Care (DSMC). A database search was conducted for the period 2013-2022. Bibliographic and legislative resources were used. Cases and convictions from Castilla la Nueva were found in the National Historical Archive and the Diocesan Archive of Cuenca.

Results

The concepts of healer, witch and sorceress envolved during the study period. They reflect and reveal the collective imaginary of the social structure. They had healing laboratories, practised psychological and sexual care. They used to accompany their therapeutic action with prayers and amulets. They shared their professional activity with their main denouncers, doctors, apothecaries and priests. They were usually women in socially vulnerable situations, who did not conform to social stereotypes.

Conclusions

They were predecessors of today's nursing, they overcame socio-cultural difficulties, although they were condemned for it. Healers did not manage to regulate their profession, but they acted as agents of health in a society that demanded them while participating in the "witch-hunt".

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.

Lactancia materna y feminismo: recorrido social y cultural en España

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.

Regulación de la Enfermería Española: incorporación a la profesión sanitaria (1850-1950)

RESUMEN OBJETIVO Conocer la evolución de la formación académica de la enfermería española (1850-1950), describiendo los cambios que la transformaron en profesión sanitaria. MÉTODO Investigación histórica en la modalidad exploratoria-descriptiva, con análisis e interpretación de información obtenida en bases de datos electrónicas, archivos nacionales, provinciales y municipales, Boletines Oficiales y Bibliotecas. RESULTADOS En 1850 coexistían diferentes categorías sanitarias, sin embargo, el título de enfermera no surgió hasta 1915. Con el auge que alcanzó la Salud Comunitaria durante esa época, en 1924, se funda la Escuela Nacional de Sanidad, creándose en 1932 las especialidades de Enfermero Psiquiátrico, Enfermeras Pediátricas y Enfermeras Visitadoras. CONCLUSIONES E IMPLICACIÓN PARA LA PRÁCTICA Entre 1915 y 1950 los profesionales de enfermería poseían formación universitaria, por tanto, a través del conocimiento científico estos sanitarios adquirieron una identidad propia dentro de las profesiones de la salud. Se logró proporcionar una asistencia especializada para el cuidado de personas.

An exaggerated increase in blood pressure with exercise does not predict mortality or severe cardiovascular events in women referred for exercise echocardiography for clinical reasons

BACKGROUND AND OBJECTIVES

The association between an exaggerated systolic blood pressure increase with exercise (EBPIE) and the probability of cardiovascular events is controversial and poorly studied in the female population. Our aim was to determine the possible association between EBPIE on one hand and mortality and cardiovascular events on the other in women referred for exercise echocardiography due to known or suspected coronary artery disease.

PATIENTS AND METHODS

A total of 3942 women with known or suspected coronary artery disease underwent exercise echocardiography. We defined EBPIE as a ≥70mm Hg increase in systolic blood pressure with exercise. The study endpoints were overall and cardiac mortality, acute myocardial infarction (MI), stroke and coronary revascularisation procedures.

RESULTS

A total of 332 women developed EBPIE during the test. During the follow-up, 458 deaths (162 of cardiac origin), 212 MIs, 89 strokes and 345 coronary revascularisation procedures were recorded. The annual rates of overall and cardiac mortality were lower in the patient subgroup with EBPIE (0.15% vs. 2.3%, P=.02 and 0.01% vs. 0.2%, P=.015, respectively). There were no significant differences in the rates of MI, stroke and the need for coronary revascularisation procedures, which occurred in 1.1%, 0.43% and 2.24% of the patients with EBPIE, respectively, and occurred in 0.09%, 0.05% and 0.13% of the women without EBPIE (P=.66; P=.57; P=.19, respectively). After a multivariate adjustment, EBPIE was not a predictor of mortality or cardiovascular events.

CONCLUSIONS

EBPIE is not associated with mortality or severe cardiovascular events in women with known or suspected coronary artery disease.