Detection of gender-based violence in primary care in Central Catalonia: a descriptive cross-sectional study.

BACKGROUND: Violence against women is a serious public health problem. Primary care could be one of the ideal places for the detection of gender-based violence (GBV), since women come into contact with PC at some point in their lives to look after their sexual and reproductive health. The increase in initiatives promoted by the health authorities regarding GBV offers the possibility of observing its evolution over the last few years. METHODS: A descriptive cross-sectional study of reported cases of GBV in the region of Central Catalonia, during the period from 2017 to 2021, was carried out. All women of legal age, belonging to the specified health region and suffering episodes of GBV, were included. The variables analysed were age, area of residence, health diagnoses related to GBV, whether or not they were pregnant at the time of the attack, and mental health history. RESULTS: Of the total number of women studied, 1,467 presented some type of diagnosis of GBV, with a total of 3,452 episodes reported. We found an increase in the detection of cases, although it must be noted that there is an underreporting of cases in PC. The prevalence according to the total number of women assigned per year over the period studied was 0.42% in 2017 and 0.48% in 2021. It has also been observed that the average number of episodes per woman increased from 1.03 in 2017 to 1.15 in 2021. During the 5 years analysed, the minimum number of episodes per woman was 1 and the maximum was 10. In reference to the duration of the episodes, the minimum was 1 day, and the maximum was 32 years. The mean age of the women was 42.10 years, the most frequent nationality was Spanish (46.60%), and 54.15% of them lived in rural areas. CONCLUSIONS: Despite the established protocols and procedures, it seems that primary health care is not the most frequent place for its detection. It is necessary to continue working to raise awareness and train professionals, and to ensure coordination among all the parties involved in accompanying women in these processes. TRIAL REGISTRATION: CEIm: 21/278-P.

Las vivencias de las matronas en la atención online a grupos de mujeres durante el preparto, posparto y apoyo a la lactancia / The experiences of midwives in online care for groups of women during prepartum, postpartum and breastfeeding support

Objetivos: Conocer las experiencias y vivencias de las matronas al rea- lizar las clases preparto, posparto y grupos de apoyo a la lactancia onli- ne, así como describir los cambios que se llevaron a cabo para adaptarse a este modelo educativo. Método: Estudio cualitativo fenomenológico. Las participantes eran matronas del centro de atención a la salud sexual y reproductiva (ASSIR) de Osona. La recogida de la información se realizó mediante un grupo fo- cal online. Se llevó a cabo un análisis temático del contenido según los criterios propuestos por Taylor y Bogdan. Resultados: Participaron 8 matronas. Se obtuvo un total de 20 códigos clasificados en 6 categorías (objetivos formativos, vivencias, recursos, or- ganización, adaptación y ventajas). La formación online fue un reto para las matronas. Adaptaron sus recursos a las necesidades de la situación para que las mujeres sintieran su proximidad y «crearan tribu» entre ellas. Conclusiones: A pesar de la escasa formación de las matronas res- pecto a la conducción grupal a través de las nuevas tecnologías, el equi- po se actualizó para dar la mejor atención posible y soporte a las muje- res, poniendo sus necesidades en el centro de todo el proceso. Se ha podido observar que, aunque ambas partes prefieren sesiones presencia- les, las visitas online han sido una buena alternativa en un momento en que debían evitarse al máximo los contactos directos. (AU)

Objectives: To know the experiences and feelings of midwives, who were organizing and carrying out maternal, postpartum and breastfeed- ing education by online support groups, and describe the chances of ad- aptation to the new teaching model. Methodology: Phenomenological descriptive study. The study subjects were midwives who are working in ASSIR Osona. To analyze the qualitative comments, content analysis was carried out according to methods sug- gested by Taylor and Bogdan. Results: Participants were 8 midwives. It is present a list of 20 codes into 6 categories (training objectives, experiences, resources, organization, ad- aptation and advantages). Online training was a challenge for midwives. They adapted their resources to the needs of the situation so that the women could feel their closeness and create a tribe among themselves. Conclusions: Despite the limited training of midwives regarding group leadership through new technologies, the team has developed new skills to do the best prenatal care as possible, give support to women and put- ting their needs at the center of the process. Although both parties pref- ered face-to-face sessions, online reunions have been a good alternative when direct contact should have been avoided as much as possible. (AU)

Use of alternative and complementary therapies in labor and delivery care: a cross-sectional study of midwives' training in Catalan hospitals accredited as centers for normal birth.

BACKGROUND: The use of complementary and alternative medicine (CAM) and complementary and alternative therapies (CAT) during pregnancy is increasing. Scientific evidence for CAM and CAT in the field of obstetrics mainly covers pain relief in labor. Midwives are responsible for labor and delivery care: hence, their knowledge of CAM and CAT is important. The aims of this study are to describe the professional profile of midwives who provide care for natural childbirth in Catalan hospitals accredited as centers for normal birth, to assess midwives' level of training in CAT and their use of these therapies, and to identify specific resources for CAT in labor wards. METHODS: A descriptive, cross-sectional, quantitative method was used to assess the level of training and use of CAT by midwives working at 28 hospitals in Catalonia, Spain, accredited as public normal birth centers. RESULTS: Just under a third of midwives (30.4%) trained in CAT after completion of basic training. They trained in an average of 5.97 therapies (SD 3.56). The number of CAT in which the midwives were trained correlated negatively with age (r = - 0.284; p < 0.001) and with their time working at the hospital in years (r = - 0.136; p = 0.036). Midwives trained in CAT considered that the following therapies were useful or very useful for pain relief during labor and delivery: relaxation techniques (64.3%), hydrotherapy (84.8%) and the application of compresses to the perineum (75.9%). The availability of resources for providing CAT during normal birth care varied widely from center to center. CONCLUSIONS: Age may influence attitudes towards training. It is important to increase the number of midwives trained in CAM for pain relief during childbirth, in order to promote the use of CAT and ensure efficiency and safety. CAT resources at accredited hospitals providing normal childbirth care should also be standardized.

Oferta formativa en terapias alternativas y complementarias para la asistencia al parto / Training programmes in complementary and alternative therapies for midwifery

Las terapias complementarias y alternativas (TCA) son las intervenciones y prácticas que no forman parte del sistema sanitario convencional. En la obstetricia, su uso es cada día más frecuente. Para asesorar a las gestantes es necesario tener unos conocimientos adecuados al respecto. El objetivo de este estudio es conocer la oferta formativa de las matronas en TCA para la atención al parto mediante una revisión bibliográfica y la consulta de fuentes documentales. El actual programa de formación no las contempla y su aprendizaje depende de motivaciones personales. Existe poca información al respecto. Para recomendarlas y utilizarlas con eficacia y seguridad, es necesario dedicar más recursos a la investigación e incorporarlas en los planes convencionales de estudio (AU)

Complementary and alternative therapies (CAM) are interventions and practices not used in the conventional healthcare system. The application of these therapies is becoming increasingly common in Obstetrics. An adequate knowledge of CAM is required to advise pregnant women. The aim of this study was to determine the training of midwives in TCA for delivery care through a literature review and consultation of documentary sources. The current training programme does not include such therapies and learning depends on personal motivation. There is little information. To recommend these therapies and use them effectively and safely, it is necessary to devote more resources to research and incorporate CAM in conventional plans of study (AU)

Moxibustión en la malposición fetal / Moxibustion in fetal malposition

Introducción: La incidencia de la presentación fetal podálica en España es del 3,8%. La moxibustión es parte integral de la milenaria medicina tradicional china. La técnica consiste en la colocación de un palillo incandescente de Artemisia vulgaris a unos pocos centímetros del punto de acupuntura Zhiyin (punto 67 del meridiano de vejiga, ubicado en la base externa de la uña del quinto dedo del pie). Los objetivos son: 1. Conocer el porcentaje de fetos que han rotado a cefálica mediante la moxibustión en gestantes que presenten una malposición fetal a partir de las 32 semanas de embarazo; 2. Identificar las complicaciones materno-fetales en la aplicación de la técnica. Sujetos: Se estudiaron 18 gestantes de más de 32 semanas de embarazo. Material y métodos: Mediante un estudio descriptivo de intervención, analizamos el porcentaje de fetos que rotaron a presentación cefálica. Resultados: Quince gestantes (83,9%) realizaron el tratamiento adecuadamente y las 3 restantes (16,7%) lo realizaron de manera ocasional y terminaron con una cesárea electiva por nalgas. Conclusiones: Parece razonable concluir que el cumplimiento del tratamiento influye en el tipo de parto (χ2= 12,600; gl= 1; p= 0,000), aunque no modifica el Apgar del recién nacido. Esta técnica se presenta como una alternativa económica, segura, sencilla y práctica para la versión fetal de la presentación podálica (AU)

Introduction: The incidence of fetal breech presentation in Spain is of 3.8%. Moxibustion is an integral part of the ancient traditional Chinese medicine. The technique involves placing an incandescent stick of Artemisia vulgaris a few inches of the acupuncture point Zhiyin (point 67 of the bladder meridian, located at the outer base of the nail of the fifth toe). The objectives are: 1. To find out what percentage of fetuses have turned around to a cephalic presentation due to moxibustion in pregnant women displaying fetal malposition after the 32nd week of pregnancy; 2. To identify any materno-fetal complications associated with the use of the technique. Subjects: A total of eighteen pregnant women were studied with more than 32 weeks of gestation. Material and methods: Through a descriptive study with one group intervention, we analyzed the percentage of cephalic fetus that rotated with this therapy. Results: Fifteen pregnant women (83.9%) did the treatment properly; three pregnant women (16.7%) carried out the treatment on an occasional basis and ended with a caesarean section due to buttocks. Conclusions: It seems reasonable to say that compliance with the treatment influences the type of delivery (2= 12.600; gl= 1; p= 0.000), but does not modify the Apgar of the newborn. This technique is presented as an economic, safe, simple and practical alternative, for the fetal version of breech presentation (AU)

El plan de parto a debate. ¿Qué sabemos de él? / The birth plan. What do we know about it?

El objetivo de este artículo es buscar el nivel de evidencia actual del plan de parto mediante una revisión bibliográfica. Los planes de parto los presentan mujeres que demandan una atención de calidad. Sirven para exponer sus opiniones y deseos, y mejorar la comunicación con los profesionales. No siempre mejoran su satisfacción, pueden irritar a los profesionales y no siempre se basan en la mejor evidencia existente. El plan de parto es un documento útil para fomentar la participación de los padres en el nacimiento de sus hijos. Las matronas que atienden a las madres durante la gestación deben orientar a las parejas en la elaboración de los planes para que puedan construir expectativas realistas y flexibles, con el fin de alejar los miedos y favorecerla confianza en ellas mismas y su entorno (AU)

The aim of this paper is to seek current level of evidence birth planthrough a literature review. Delivery plans are presented by women who demand quality care. They serve to present their views and wishes and improve communication with professionals. Not always improve your satisfaction, can irritate the professionals and not always based on the best evidence available. The birth plan is a useful document to promote parental involvement in the birth of their children. Midwives provide care during the pregnancy, should guide their development so they can build expectations realistic and flexible in order to ward off fears by promoting confidence in themselves and their environment (AU)