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Background: Nowadays, burnout syndrome (BS) symptoms appear to have increased in healthcare workers, specifically midwives, but there are no studies on burnout among midwives in Catalonia. The present study aimed to assess and describe the prevalence of BS in midwives working in labour rooms. Methods: A cross-sectional descriptive study was conducted on 122 midwives working in 24 maternity hospitals in the Barcelona (region) which were selected using purposive sampling from January to March 2017. Data were collected using two questionnaires (demographic information, job burnout using Spanish Burnout Inventory with 20 items and four subscales). Data analysis was performed using SPSS software version 21 and Chi-Square, U Mann-Whitney, and Kruskall-Wallis. P

[Background] Early microbial colonization is a relevant aspect in human health. Altered microbial colonization patterns have been linked to an increased risk of non-communicable diseases (NCDs). Advances in understanding host-microbe interactions highlight the pivotal role of maternal microbiota on infant health programming. This birth cohort is aimed to characterize the maternal microbes transferred to neonates during the first 1000 days of life, as well as to identify the potential host and environmental factors, such as gestational age, mode of delivery, maternal/infant diet, and exposure to antibiotics, which affect early microbial colonization., [Methods] MAMI is a prospective mother-infant birth cohort in the Spanish-Mediterranean area. Mothers were enrolled at the end of pregnancy and families were follow-up during the first years of life. Maternal-infant biological samples were collected at several time points from birth to 24 months of life. Clinical and anthropometric characteristics and dietary information is available. Specific qPCR and 16S rRNA gene sequencing as well as short chain fatty acid (SCFAs) profile would be obtained. Multivariable models will be used to identy associations between microbiota and clinical and anthropometric data controlling for confounders. MAMI would contribute to a better understanding of the interaction between diet, microbiota and host response in early life health programming, enabling new applications in the field of personalized nutrition and medicine., MAMI team would like to acknowledge the support from H2020-ERC Starting Grant 639226., We acknowledge support of the publication fee by the CSIC Open Access Support Initiative through its Unit of Information Resources for Research (URICI)

Background: This paper critically reviews published tools and indicators currently used to measure maternity care performance within Europe, focusing particularly on whether and how current approaches enable systematic appraisal of processes of minimal (or non-) intervention in support of physiological or "normal birth". The work formed part of COST Actions IS0907: "Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care" (2011-2014) and IS1405: Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH) (2014-). The Actions included the sharing of country experiences with the aim of promoting salutogenic approaches to maternity care. Methods: A structured literature search was conducted of material published between 2005 and 2013, incorporating research databases, published documents in english in peer-reviewed international journals and indicator databases which measured aspects of health care at a national and pan-national level. Given its emergence from two COST Actions the work, inevitably, focused on Europe, but findings may be relevant to other countries and regions. Results: A total of 388 indicators were identified, as well as seven tools specifically designed for capturing aspects of maternity care. Intrapartum care was the most frequently measured feature, through the application of process and outcome indicators. Postnatal and neonatal care of mother and baby were the least appraised areas. An over-riding focus on the quantification of technical intervention and adverse or undesirable outcomes was identified. Vaginal birth (no instruments) was occasionally cited as an indicator; besides this measurement few of the 388 indicators were found to be assessing non-intervention or "good" or positive outcomes more generally. Conclusions: The tools and indicators identified largely enable measurement of technical interventions and undesirable health (or pathological medical) outcomes. A physiological birth generally necessitates few, or no, interventions, yet most of the indicators presently applied fail to capture (a) this phenomenon, and (b) the relationship between different forms and processes of care, mode of birth and good or positive outcomes. A need was identified for indicators which capture non-intervention, reflecting the reality that most births are low-risk, requiring few, if any, technical medical procedures. COST Action IS0907, ‘Childbirth Cultures, Concerns and Consequences: Creating a dynamic EU framework for optimal maternity care’ COST Action IS1405, ‘Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH)

Durante la segunda mitad del siglo XX se produjo un proceso de medicalización de la vida y los partos que se asistían en el domicilio hasta la segunda mitad del siglo XX se institucionalizaron. Actualmente, la atención al parto dentro de centros sanitarios y la cada vez más alta dotación tecnológica ha facilitado que se legitime la medicalización para todos los procesos asistenciales, incluso para aquellos fisiológicos como puede ser un parto normal. Son numerosos los autores que han puesto en evidencia como el proceso de medicalización de la vida ha concebido el cuerpo femenino, durante embarazo y parto, como anárquico y necesitado de control; asumiendo que el uso de las modernas técnicas obstétricas se ha extendido de forma inseparable a un proceso de alienación impuesto a las mujeres reclamándose una atención humanizada, respetuosa con la fisiología y sin medicalización. Desde una línea de argumentación post-estructuralista se critica el discurso basado en que la atención no tecnificada, y respetuosa con la fisiología del parto, significará, sin más, un empoderamiento de la mujer, puesto que, al igual que la posición medicalizadora de la asistencia, implica también una visión esencialista que no tiene en cuenta los componentes éticos y sociales [...]

Des de fa anys l'atenció al part està perseguint la fita d'aconseguir donar una assistència més humana i fisiològica a tot el procés, s'han creat guies de pràctica clínica, grups de treball, estratègies nacionals, etc., amb l'objectiu d'estandarditzar un tipus d'assistència menys intervencionista a un procés que no deixa de ser fisiològic en la majoria d'ocasions. L’objectiu d’aquesta tesi és explorar el tipus d’atenció al part en el nostre entorn, la medicalització del procés de part en referència a l’administració d’oxitocina i les possibles conseqüències per la mare i el nadó. Aquest estudi conclou en tres principals resultats: a) el tipus d’assistència que donem a les dones durant l’atenció al part al nostre entorn, no compleixen amb les recomanacions de la guia de pràctica clínica d’atenció al part normal; b) l’administració d’oxitocina durant el part s’associa amb pitjors resultats materns; c) l’administració d’oxitocina s’associa amb pitjors resultats neonatals al postpart immediat. In recent years, intrapartum care has been focused on providing more physiological assistance throughout the entire pregnancy process. Clinical Practice Guidelines, working groups, and national strategies have standardized a type of careless interventionist for a physiological process. The aim of this thesis is to explore the type of intrapartum care in our environment, the medicalization of the birth process in reference to the administration of oxytocin, as well as to describe the maternal and neonatal outcomes. This study concludes with three main results: a) intrapartum care that we give to women in our environment, does not meet the recommendations of the clinical practice guideline for normal birth care; b) oxytocin administration during intrapartum care is associated with worse maternal outcomes; c) oxytocin administration during intrapartum care is associated with worse neonatal outcomes in immediate postpartum.

El "Questionnaire for Assessing the Childbirth Experience (QACE)" busca identificar mujeres con una experiencia negativa del parto y evitar que tenga repercusiones en siguientes embarazos o en su relación de pareja. El objetivo de la tesis es adaptar y validar el QACE desde el inglés al castellano de España, así como describir los resultados obstétricos y el nivel de satisfacción en el parto de los dos hospitales participantes. Este estudio concluye en tres principales resultados: a) el CEEP ha sido adaptado y traducido de forma metodológicamente correcta, tiene una buena consistencia interna (ω=0,818) y es estable en el tiempo (CCI 0,94, p ,00); b) el anàlisis factorial confirmatorio mostró un ajuste adecuado/bueno con 20 ítems clasificados en cuatro factores que explicaban el 52,63% del total de la varianza; c) la satisfacción con el parto es similar en ambos hospitales, aunque el hospital de menor complejidad tiene mejores resultados obstétricos. The "Questionnaire for Assessing the Childbirth Experience (QACE)" seeks to detect those women who have had a negative experience in childbirth and avoid having repercussions in subsequent pregnancies or in their relationship. The objective of the thesis is to obtain, adapt and validate the QACE from English to the Spanish version of Spain, as well as to describe the obstetrical results and the birth satisfaction level between the participant hospitals. This study concludes in three main results: a) CEEP has been adapted and translated in a methodologically correct manner, internal consistency was assured (ω=0,818) and is stable over time (ICC 0.94, p