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[Abstract]: Over the last century, Western countries have undergone a process of medicalisation and hospitalisation of childbirth. This process led to the subordination of midwives to doctors’ authority and made the hospital the main focus of childbirth care, which entailed a break with the traditional formula. This article analyses the case of Spain, a country of special interest due to the convergence of three elements: a belated passage of public health insurance, a shortage of beds for maternity care and the context of a dictatorship where a woman’s role was almost exclusively that of wife and mother. Under these circumstances, home childbirth continued well into the 1970s, despite the interests of health policymakers who defended hospital childbirth despite in a situation of insufficient infrastructures. Hence, when hospital delivery care finally became predominant in Spain, the debate about natural childbirth and a rejection of invasive techniques used in hospitals had already begun in other countries.

Background Public patient involvement (PPI) generates knowledge about the health-illness process through the incorporation of people's experiences and priorities. The Babies Born Better (BBB) survey is a pan-European online questionnaire that can be used as a PPI tool for preliminary and consultative forms of citizens' involvement. The purpose of this research was to identify which practices support positive birth experiences and which ones women want changed. Methods The BBB survey was distributed in virtual communities of practice and through social networks. The version launched in Spain was used to collect data in 2014 and 2015 from women who had given birth in the previous 5 years. A descriptive, quantitative analysis was applied to the sociodemographic data. Two open-ended questions were analyzed by qualitative content analysis using a deductive and inductive codification process. Results A total of 2841 women participated. 41.1% of the responses concerned the category “Care received and experienced,” followed by “Specific interventions and procedures” (26.6%), “Involved members of care team” (14.2%), and “Environmental conditions” (9%). Best practices were related to how care is provided and received, and the main areas for improvement referred to specific interventions and procedures. Conclusions This survey proved a useful tool to map the best and poorest practices reported. The results suggest a need for improvement in some areas of childbirth care. Women's reports on negative experiences included a wide range of routine clinical interventions, avoidable procedures, and the influence exerted by professionals on their decision-making.

Gender has historically played an important role in pregnancy, birthing and birth itself. Women were the ones in charge of assisting other women during childbirth. Not until the 18th century did men show interest in becoming involved in births, especially those concerning upper class society. They were first surgeons primarily interested in monopolizing pregnancy and birth care. So, in the 19th century there was widespread debate about who were most appropriate to attend deliveries, midwives or doctors. About this time, other “practitioners of medicine” also tried, though unsuccessfully, to access this professional field. Later on they were finally allowed practice in towns under ten thousand inhabitants after receiving proper training. But, who were the first male-midwives? This paper provides new information on men incorporation into professional midwifery practice in 20th-century Spain., Históricamente, embarazo, parto y nacimiento han sido cuestiones íntimamente relacionadas con los roles de género. Eran mujeres las encargadas de asistir a otras durante sus partos. Pero a partir del siglo xviii los hombres quisieron tener un papel más activo en los nacimientos, especialmente en los casos de mujeres que pertenecían a las clases altas de la sociedad. Inicialmente fueron los cirujanos los interesados en monopolizar la asistencia al embarazo y el parto. De esta forma, en el siglo xix se generalizó el debate sobre cuál de los dos profesionales, la matrona o el médico, era el más adecuado para atender partos. En este mismo siglo, los practicantes también quisieron acceder a este campo profesional, aunque inicialmente sin éxito. Con el paso del tiempo, los practicantes consiguieron sus objetivos, pero con la condición de tener una formación adecuada y desarrollar su labor en ciudades de menos de diez mil habitantes. Pero ¿quiénes fueron los primeros hombres que obtuvieron el título de matrona? Esta investigación proporciona nueva información relativa a la incorporación dificultosa y gradual de hombres a la profesión de matrona en España durante el siglo xx y hasta nuestros días.

El presente trabajo muestra el proceso de transformación de la formación de las matronas en España, desde finales del siglo xviii a mediados del siglo xix. Para ello se exponen cuáles fueron las circunstancias que propiciaron que las matronas comenzasen a formarse en los Colegios de Cirugía, y se analizan los datos sobre dicha formación: requisitos de acceso, profesorado, duración de los estudios, exámenes y obligaciones adquiridas al obtener el título. Se apunta, también, el número de alumnas que iniciaron en 1790 en el Real Colegio de Cirugía de San Carlos el primer curso y como Pablo Ferrándiz Bendicho llevó a cabo la inauguración de la Cátedra de Partos el 19 de abril de 1790. Los cambios que, por lo general, fueron endureciendo la admisión de las aspirantes a matronas durante la existencia del Colegio son puestos de manifiesto a continuación. También se recogen los nombres de esas primeras matronas tituladas, lo que puede servir de ayuda para futuras investigaciones sobre la profesión en distintas zonas geográficas.