Maternal care

This study set out to determine to what extent three recalled parental rearing styles (care, discouragement of behavioural freedom, denial of psychological autonomy), self-esteem, and self-criticism predicted self-rated happiness in a normal, non-clinical, population of young people in their late teens and early 20s. Three hundred and sixty-five participants completed four questionnaires: Parental Bonding

Purpose -The purpose of this paper is to develop a psychometric scale -the birth satisfaction scale (BSS) -for assessing women's birth perceptions. Design/methodology/approach -Literature review and transcribed research-based perceived birth satisfaction and dissatisfaction expression statements were converted into a scored questionnaire.

AbstractÐHaiti has one of the highest rates of maternal mortality in the Caribbean. The``Three Delays'' model proposes that pregnancy-related mortality is overwhelmingly due to delays in: (1) deciding to seek appropriate medical help for an obstetric emergency; (2) reaching an appropriate obstetric facility; and (3) receiving adequate care when a facility is reached. This framework was used to analyze a sample of 12 maternal deaths that occurred in a longitudinal cohort of pregnant Haitian women. Because of political upheavals in Haiti during the survey, these deaths are an underestimate of all deaths that occurred in the cohort. Family and friend interviews were used to obtain details about the medical and social circumstances surrounding each death. A delayed decision to see medical care was noted in eight of the 12 cases, whereas delays in transportation only appeared to be signi®cant in two. Inadequate care at a medical facility was a factor in seven cases. Multiple delays were relevant in the deaths of three women. Family and friend interviews suggest that a lack of con®dence in available medical options was a crucial factor in delayed or never made decisions to seek care. Expanding the coverage of existing referral networks, improving community recognition of obstetric emergencies, and improving the ability of existing medical institutions to deliver quality obstetric care, are all necessary. However, services will continue to be under-utilized if they are perceived negatively by pregnant women and their families. The current data thus suggest that improvements to Haiti's maternity care system which focus on reducing the third delayÐthat is, improving the quality and scope of care available at existing medical facilitiesÐwill have the greatest impact in reducing needless maternal deaths. #

This study set out to determine to what extent three recalled parental (care, discouragement of behavioural freedom, denial of psychological autonomy), self-esteem, and self-criticism predicted self-rated happiness in a normal, non-clinical, population of young people in their late teens and early 20s. Three hundred and sixty-five participants completed four questionnaires: Parental Bonding Instrument (Parker, Tupling and Brown: 1979, British Journal of Medical Psychology 55, pp. 1–10), Rosenberg Self-Esteem Scale (Rosenberg: 1965, Society and the Adolescent Self-Image (Princeton University Press, Princeton, NJ)), Self-Criticism Questionnaire (Brewin, Firth-Cozens, Furnham and McManus: 1992, Journal of Abnormal Psychology 101, pp. 561–566), and the Oxford Happiness Inventory (Argyle, Martin and Crossland: 1989, Recent Advances in Social Psychology: An International Perspective (Elsevier, North Holland)). Regressions showed self-esteem (the positive five items) to be the most dominant and powerful correlate of happiness. Maternal care was a significant correlate of both self-esteem and self-criticism. Maternal care was the only direct correlate of happiness when paternal and maternal rearing styles were examined together suggesting that the warmth showed by mothers towards their children was particularly beneficial in increasing the offsprings' scores on self-reported happiness.

To describe antenatal care attendance by mothers of Pacific infants recently delivered at Middlemore Hospital, South Auckland and to examine the demographic and psychosocial factors associated with late initiation of care and inadequate attendance. The data were gathered as part of the Pacific Islands Families: First Two Years of Life (PIF) Study in which 1365 birth mothers in the cohort (n=1376) were interviewed when their infants were six weeks old about their antenatal care attendance. Almost all (99.1%) mothers attended antenatal care at least once. Over a quarter (26.6%) initiated their antenatal care late, and 10.7% attended fewer than the recommended number of times. Maternal factors significantly associated with late initiation of antenatal care were high parity, first pregnancy, not being employed prior to pregnancy and Cook Island Maori ethnicity. Factors associated with inadequate attendance were reaction to the pregnancy and being employed prior to pregnancy. A significa...

Women and children bear the greatest burden in the midst of war and long-term disasters. Complex humanitarian emergencies are characterized by social disruption, armed conflict, population displacement, collapse of public health infrastructure, and food shortages. Humanitarian assistance for refugees and internally displaced populations requires particular attention to the common issues affecting morbidity and mortality in women and infants. Gender-based violence and reproductive health concerns are discussed within the context of populations affected by conflict and forced migration. Recommendations for midwives and women's health care providers engaging in care for women and children in complex humanitarian emergencies are discussed.

Whereas mammalian mothers and young may retain long-term social affiliations in nature, the management of animals in captivity typically dictates that offspring are abruptly and permanently separated from their mothers at a relatively early age, often prior to the time of natural weaning. For animal breeders, this strategy can enhance the yield of offspring from a breeding population. Morbidity and

This article draws on findings from a recent Cochrane systematic review of midwife-led care and discusses its contribution to the safety and quality of women's care in the domains of safety, effectiveness, womancenteredness, and efficiency. According to the Cochrane review, women who received models of midwifeled care were nearly eight times more likely to be attended at birth by a known midwife, were 21% less likely to experience fetal loss before 24 weeks' gestation, 19% less likely to have regional analgesia, 14% less likely to have instrumental birth, 18% less likely to have an episiotomy, and significantly more likely to have a spontaneous vaginal birth, initiate breastfeeding, and feel in control. In addition to normalizing and humanizing birth, the contribution of midwife-led care to the quality and safety of health care is substantial. The implications are that policymakers who wish to improve the quality and safety of maternal and infant care, particularly around normalizing and humanizing birth, should consider midwife-led models of care and how financing of midwife-led services can support this. Suggestions for future research include exploring why fetal loss is reduced under 24 weeks' gestation in midwife-led models of care, and ensuring that the effectiveness of midwife-led models of care on mothers' and infants' health and well-being are assessed in the longer postpartum period.

Background: there is limited knowledge about the pregnancy, childbirth and motherhood experiences of women living with a disability. Traditionally, such women have been viewed unsympathetically by society and professionals have challenged their fitness for motherhood. The situation is compounded by a lack of robust evidence regarding the life experience of pregnant women with a disability and their perspective on childbirth. Method: seventeen pregnant women from the island of Ireland who had a physical, sensory and/or intellectual disability were interviewed at home, pre and post birth, using a qualitative approach derived from descriptive phenomenology. Interpretative phenomenological analysis (IPA), was chosen for data analysis. Findings: the women in this study welcomed pregnancy as affirming their identity and worth as women and as mothers. They encountered mixed reactions from partners and families, while professionals tended to view them as liabilities, regarding most as 'high risk'. These reactions intensified mothers' fears. They felt their ability to make choices and maintain control over their childbirth experiences was removed as the usual services were geared to provide for 'normal', able bodied women and were not adapted to their individual needs. Moreover, a proportion were offered a termination and, although all refused, they subsequently went on to indicate feeling pressurised to place their newborn babies into social services care. Conclusion: pregnant women with disabilities, in particular those labelled 'high risk', should expect equal ease of access to appropriate maternity care and consultation as that enjoyed by their mainstream, 'low risk' or 'normal' counterparts. Maternity services should foster these vulnerable women's independence and autonomy as far as practicable and uphold their identity and worth as women and as mothers. Three strategies are proposed for doing this.

This article draws on findings from a recent Cochrane systematic review of midwife-led care and discusses its contribution to the safety and quality of women's care in the domains of safety, effectiveness, womancenteredness, and efficiency. According to the Cochrane review, women who received models of midwifeled care were nearly eight times more likely to be attended at birth by a known midwife, were 21% less likely to experience fetal loss before 24 weeks' gestation, 19% less likely to have regional analgesia, 14% less likely to have instrumental birth, 18% less likely to have an episiotomy, and significantly more likely to have a spontaneous vaginal birth, initiate breastfeeding, and feel in control. In addition to normalizing and humanizing birth, the contribution of midwife-led care to the quality and safety of health care is substantial. The implications are that policymakers who wish to improve the quality and safety of maternal and infant care, particularly around normalizing and humanizing birth, should consider midwife-led models of care and how financing of midwife-led services can support this. Suggestions for future research include exploring why fetal loss is reduced under 24 weeks' gestation in midwife-led models of care, and ensuring that the effectiveness of midwife-led models of care on mothers' and infants' health and well-being are assessed in the longer postpartum period.

In a population-based cohort of approximately 6000 Brazilian children, the associations between maternal education and a number of child health outcomes were studied while controlling for potentially confounding variables such as family income and education of the husband.

to explore the relationship between a one-to-one model of maternity care and the creation of calm in order to: (1) illuminate one of the mechanisms, i.e. calm, through which the provision of relational continuity may be associated with positive care outcomes; and (2) highlight a model of care, i.e. relational continuity, that is well placed to create calm (a desirable outcome in its own right).a qualitative study, using non-participant observation and semi-structured in-depth interviews.a community midwifery practice delivering one-to-one care in London.10 women, 21–40 years of age, six of whom had experienced a different type of care during a previous birth; seven of their birth partners; and four midwives.calm is aspired to by women and birth partners, and experiencing calm is associated with greater satisfaction. Relational continuity is perfectly placed to create calm, as it tends to foster a sense of familiarity and enables all parties to get to know what to expect from one another. It also facilitates calm because conflicting advice is minimised and midwives are able to build their confidence and wisdom by learning from the repercussions of their own actions.since calm has been found to be a key expectation for childbirth, and since a fulfilment of expectations has been found to be linked to greater satisfaction and an enhanced mother–child relationship, creating calm should be one of the aims of maternity care.the well-known benefits of calm, and the association between relational continuity and the creation of calm found in this study suggest that relational continuity may be considered a priority within current national and international plans to expand the delivery of continuity.

This article draws on findings from a recent Cochrane systematic review of midwife-led care and discusses its contribution to the safety and quality of women's care in the domains of safety, effectiveness, woman-centeredness, and efficiency. According to the Cochrane review, women who received models of midwife-led care were nearly eight times more likely to be attended at birth by a known midwife, were 21% less likely to experience fetal loss before 24 weeks' gestation, 19% less likely to have regional analgesia, 14% less likely to have instrumental birth, 18% less likely to have an episiotomy, and significantly more likely to have a spontaneous vaginal birth, initiate breastfeeding, and feel in control. In addition to normalizing and humanizing birth, the contribution of midwife-led care to the quality and safety of health care is substantial. The implications are that policymakers who wish to improve the quality and safety of maternal and infant care, particularly around normalizing and humanizing birth, should consider midwife-led models of care and how financing of midwife-led services can support this. Suggestions for future research include exploring why fetal loss is reduced under 24 weeks' gestation in midwife-led models of care, and ensuring that the effectiveness of midwife-led models of care on mothers' and infants' health and well-being are assessed in the longer postpartum period.

To describe antenatal care attendance by mothers of Pacific infants recently delivered at Middlemore Hospital, South Auckland and to examine the demographic and psychosocial factors associated with late initiation of care and inadequate attendance. The data were gathered as part of the Pacific Islands Families: First Two Years of Life (PIF) Study in which 1365 birth mothers in the cohort (n=1376) were interviewed when their infants were six weeks old about their antenatal care attendance. Almost all (99.1%) mothers attended antenatal care at least once. Over a quarter (26.6%) initiated their antenatal care late, and 10.7% attended fewer than the recommended number of times. Maternal factors significantly associated with late initiation of antenatal care were high parity, first pregnancy, not being employed prior to pregnancy and Cook Island Maori ethnicity. Factors associated with inadequate attendance were reaction to the pregnancy and being employed prior to pregnancy. A significa...

Effective collaboration between professional groups is increasingly seen as an essential element in good quality and safe health care. This is especially important in the context of maternity care, where most women have straightforward labour and birth experiences, but some require rapid transfer between care providers and settings. This article presents current accounts of collaboration-or lack of it-in maternity care in the United Kingdom, United States, and Australia. It then examines tools designed to measure collaboration and teamwork within general health care contexts. Finally, a set of characteristics are proposed for effective collaboration in maternity care, as a basis for further empirical work in this area.

In terms of reproductive success the quality and duration of maternal care exhibited by any particular species is of paramount importance, and yet compared with the amount of research studying the control of reproductive cycles, sexual behaviour, and fertility, it has historically received considerably less attention. However, we are now beginning to understand how the brain is organised to mediate this complex behaviour and how its expression is orchestrated by different hormonal and neurochemical factors. This review summarises a series of neuroanatomical, electrophysiological, in vivo sampling and behavioural neuropharmacological experiments carried out in sheep. These have attempted to define the neural circuitry and hormonal neurotransmitter systems involved both in the control of maternal behavoiur per se and in the selective olfactory recognition of lambs, which is the basis of an exclusive emotional bond between mother and offspring. © 1997 Elsevier Science Inc.

The neonate's development and survival is dependent upon being vigorous at birth and receiving appropriate maternal care. However, difficulty at delivery can result in less vigorous offspring and maternal care can be altered, probably as a consequence of exhaustion, pain and human intervention. The first 3h after expulsion of the calf were observed continuously from videos following twelve natural calvings and sixteen calvings assisted by farm staff (including four malpresentations) from Holstein cows. Calvings were balanced within groups for parity of the dam, genetic group, sex and birth weight of the calf, calving pen and calving season. Assisted calves were less vigorous with higher latencies to attempt to stand, achieve standing, walk and reach the udder than unassisted calves (P<0.05). Furthermore, assisted calves also tended to be less likely to stand and walk within the first 3h after birth (P<0.1), spent more time lying on their flank (P=0.019) and had more freque...

Enclosure design and the use of enclosure space influence the activity budget of captive leopards. The study laid out in grids all enclosures on the base map and segregated these grids into 4 zones. Every 5 min, the study recorded the proportion of time spent in these zones with the leopards' behavior. Captive leopards most frequently used the "edge" zone. Almost all leopards used the edge zone for stereotypic pacing, the "back" zone for resting, and the "other" zone for activity. The study positively correlated the proportion of time spent in the "enriched" zone with activity levels exhibited by leopards housed in some enclosures and with resting in others. Thus, the study segregated structural objects in the enriched zone into activity-related features (e.g., logs) and rest-related features (e.g., trees and sleeping platforms). Compared with individuals housed in barren enclosures, leopards housed in structurally enriched on-exhibit enclosures exhibited higher levels of activity. Enclosure design was found to be an important factor influencing the welfare of leopards in captivity.

There is considerable interest in exploring the potential of health insurance to increase the access to, and the affordability of, health care in Africa. We focus on the recent experience of Ghana, where a National Health Insurance Scheme (NHIS) became law in 2003 and fully implemented from late 2005. Even though there is some evidence of large coverage levels, the effect of the NHIS on health care demand and out-of-pocket expenditures has still not been fully examined. This paper is an attempt to close this gap. Using nationally-representative household data from the Ghana Demographic and Health Survey, we find that the introduction of the NHIS has a positive and significant effect on the utilisation of health care services, although it does have only a weak effect on out-of-pocket expenditure.

Background: Coupled with the largest number of maternal deaths, adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed.

There are profound maternal effects on individual differences in defensive responses and reproductive strategies in species ranging literally from plants to insects to birds. Maternal effects commonly reflect the quality of the environment and are most likely mediated by the quality of the maternal provision (egg, propagule, etc.), which in turn determines growth rates and adult phenotype. In this paper, we review data from the rat that suggest comparable forms of maternal effects on both defensive responses to threat and reproductive behavior and which are mediated by variations in maternal behavior.

This study explored pretreatment patient characteristics associated with the level and growth of working alliance in therapies lasting up to 120 therapy sessions. The quality of working alliance was rated by both patients (N0201) and therapists (N0 61) at Sessions 3, 12, and 20 and then at every 20th successive session. Patients reported that experience with good maternal care up to adolescence and better current interpersonal relationships were associated with positive ratings of working alliance throughout therapy. Higher global functioning was associated with growth of alliance over time. Higher levels of interpersonal problems of the cold/detached kind were associated with poorer early working alliance. On the other hand, this type of interpersonal problems was also associated with improvement of working alliance over time. Therapists' ratings of alliance were associated with patients' intrapsychic functioning. Implications for treatment and research are discussed.

Males and females are often defined by differences in their energetic investment in gametes. In most sexual species, females produce few large ova, whereas males produce many tiny sperm. This difference in initial parental investment is presumed to exert a fundamental influence on sex differences in mating and parental behavior, resulting in a taxonomic bias toward parental care in females and away from parental care in males. In this article, we reexamine the logic of this argument as well as the evolutionarily stable strategy (ESS) theory often used to substantiate it. We show that the classic ESS model, which contrasts parental care with offspring desertion, violates the necessary relationship between mean male and female fitness. When the constraint of equal male and female mean fitness is correctly incorporated into the ESS model, its results are congruent with those of evolutionary genetic theory for the evolution of genes with direct and indirect effects. Male parental care evolves whenever half the magnitude of the indirect effect of paternal care on offspring viability exceeds the direct effect of additional mating success gained by desertion. When the converse is true, desertion invades and spreads. In the absence of a genetic correlation between the sexes, the evolution of paternal care is independent of maternal care. Theories based on sex differences in gametic investment make no such specific predictions. We discuss whether inferences about the evolution of sex differences in parental care can hold if the ESS theory on which they are based contains internal contradictions.

Orangutans have the longest immature period and inter-birth interval of all ape species. This may be explained by a slow life history, the need to develop skills or by their relatively solitary lifestyle, which prevents a mother from associating with two offspring. This study of wild immature orangutans at the Ketambe Research Station, Indonesia, describes, with partly cross-sectional, partly longitudinal data, their development to independence. The study subjects ranged from 1 to 11 years of age. Data on their activity budget, diet, mother-offspring proximity and maintenance of proximity, association with conspecifics and play behavior were collected. The results indicate that immature orangutans can provide for their own food and transport, and therefore were independent of direct maternal care, at an age of possibly 3 but more clearly 6 years. This is similar to chimpanzees, and refutes the slow life history hypothesis. Immature orangutans remain within their mother's vicinity until the age of 8 years, indicating a dependence on indirect maternal care, and this coincides with the period during which the mother does not produce another offspring. A female orangutan seems unable to associate with an older immature while caring for a new infant. This is consistent with the solitarylifestyle hypothesis and corroborates the results obtained with the Sumatran orangutan population at Suaq Balimbing. However, why an immature depends indi-rectly on its mother for such a long period remains unclear. It is possible that it needs to develop ecological or social skills or needs the protection of its mother. Unfortunately, no data were available to distinguish between these possibilities.

It is widely acknowledged that the nature of the maternal care a child receives can have long-term repercussions, and that children raised in deprived environments can have severe cognitive and behavioural difficulties that last into adulthood. The mechanisms underlying these effects are not understood, but recent data from rodents provide insight into a potential molecular mechanism. Like humans, rodent maternal behaviour towards offspring can effect long-term changes in responses of the offspring to stress throughout the rest of their lives. Remarkably, these changes reflect permanently altered gene expression, so-called 'environmental programming', and its downstream effects on the hypothalamic-pituitary-adrenal axis. This review discusses the nature of this environmental programming -the mechanism by which it occurs in rats, its long-term implications, and opportunities for its reversal in rodents and ultimately in humans.

Neonatal maternal separation (MS) in rats has widely been used as a neurodevelopmental model to mimic mood-related disorders. MS produces a wide array of behavioral deficits that persist throughout adulthood. In this study we investigate the effect of MS and substitute maternal handling (human handling) on the dendritic morphology of neurons in the prefrontal cortex (PFC), the CA1 ventral hippocampus, and the nucleus accumbens (NAcc), brain regions in male rats that have been associated with affective disorders at pre-pubertal (postnatal day 35 (PND35)) and post-pubertal (PND60) ages. The morphological characteristics of dendrites were studied by using the Golgi-Cox staining method. MS induced decreases in total dendritic length and dendritic spine density in the neurons of the PFC, the CA1 ventral hippocampus, and the NAcc at a post-pubertal age. Conversely, human handling produced an increase in dendritic spine density in the pyramidal neurons of the PFC and the hippocampus at a prepubertal age, and a decrease in the dendritic length of the NAcc neurons at a post-pubertal age. These results suggest that the maternal care condition affects the dendritic morphology of neurons in the PFC, the CA1 ventral hippocampus, and the NAcc at different ages. These anatomical modifications may be relevant to altered behaviors observed in maternally separated animals. ß

Objective: this study describes the views of midwives and educators regarding interprofessional working and learning within midwifery care. Design: qualitative methods using semi-structured interviews and focus groups. Participants: 39 participants, drawn from three participant groups -midwifery educators, newly qualified midwives and Heads of Midwifery -from four university sites throughout the UK took part in the research. Findings: midwives are called upon to work collaboratively with other professionals during the daily provision of maternity care. Midwives are aware of the competencies required for effective collaboration and are supportive of the inclusion of interprofessional education in the training of student midwives. However, the relevance of this education was questioned by some participants because it is not apparent whether its inclusion will result in midwives who are better able to collaborate. Key conclusions: midwives are supportive of interprofessional learning for students but are uncertain whether it will result in changes in practice. Implications for practice: interprofessional education may support collaboration in practice, but future educational research aimed at understanding how learning is applied to practice is needed.

Theories of professions and healthcare organisation have difficulty in explaining variation in the organisation of maternity services across developed welfare states. Four countries -the United Kingdom, Finland, the Netherlands and Canada -serve as our case examples. While sharing several features, including political and economic systems, publicly-funded universal healthcare and favourable health outcomes, these countries nevertheless have distinct maternity care systems. We use the profession of midwifery, found in all four countries, as a 'touchstone' for exploring the sources of this diversity. Our analysis focuses on three key dimensions:

Objectives: First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC) compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births.

This study investigated the effects of maternal separation in C57BL/6 male and female mice during infancy on later adult fear and anxiety behaviors. Additionally, we observed the maternal behavior of the dams to examine aspects of maternal care that may be modulated by daily bouts of separation. In males, mice that experienced maternal separation during the neonatal period displayed significantly higher levels of anxiety and fear behavior, as measured by the open field test and elevated plus maze, compared to control, standard facility reared males. In females, however, maternal separation reduced anxiety and fear behavior in the open field test, but only when the females were in the diestrous phase of their estrous cycle. The 30-min daily observation of the dams revealed that the separation did not significantly alter the frequency of the maternal care provided by the dam at the time point measured. These results indicate that the emotionality of adult male and female mice can be modulated by maternal separation. However, this effect is dependent on the sex of the offspring and the phase of the estrous cycle of the female.

An estimated 190 million people are now living outside their countries of birth or citizenship, and the rate of this migration is expected to remain high. The resulting growing cultural and ethnic diversity in societies adds specific challenges to the requirement of delivering public services such as health care to consumers. Globally, about half of the migrant population are women. Migrants' outcomes of pregnancy are known to be poor, showing significant disparities when compared with those of native populations. Although these disparities have been noted, knowledge is limited regarding the availability and accessibility of healthcare services, as well as the acceptability of maternity care for women with experiences of free and forced migration. Healthcare research in general, and maternity care research specifically, have often neglected this population. This paper examines the existing international guidelines intended to address inequities in health outcomes, policies which have been introduced at national levels, and the widely used concepts of 'patient-centred' and 'woman-centred' health services. The ideals implicit in those guidelines and concepts are contrasted with the available evidence of many overseas nationals' experiences with healthcare provisions in general, and maternity care in particular. This is followed by reflections on deficiencies in current studies and on those methodological problems which make research on maternity care for migrant women particularly challenging. The conclusion considers the appropriateness and relevance of guidelines currently promoting equity in maternity care and suggests a future agenda for priority research.

RESUMEN
Nuestro objetivo ha sido localizar, documentar y analizar las sepulturas en las que se asociaba la presencia de una mujer con restos de fetos o perinatales. Son doce los casos recogidos, nueve mujeres fallecidas en diferentes etapas de la gestación, dos en íntima relación con restos perinatales y otra con datos menos precisos debido a alteraciones post mortem. Todas las mujeres eran adultas con tallas entre los 147 y 158’5 cm. La edad
fetal entre las 22 y 42 semanas. En un caso la causa de muerte fue intraparto. Varios fetos muestran alteraciones óseas posiblemente relacionadas con infecciones o déficits nutricionales. Todos los casos pertenecen a época medieval y moderna (s. VI-XV).
Palabras clave: muerte gestacional; distocia de parto; paleopatología; Edad Media; Navarra (España).
LABURPENA
Gure helburua izan da aurkitzea, dokumentatzea eta aztertzea emakumeen gorpuak eta ondoan fetu edo perinatalen gorpuzkinak dituzten hilobiak. 12 dira jaso jaso diren kasuak: bederatzi emakume haurdun hil zirenak, haurdunaldiko hainbat etapatan, bi gorpuzkin perinatalekin eta beste bat ez dituena horren datu zehatzak, hil ondoren eraldaketak izan zirelako. Guztiak ere emakume helduak, 147 eta 158,5 cm bitartekoak.
Fetuen adina 22 astetik 42 astera bitartekoa. Kasuetako batean, heriotza erditzean gertatu zen. Zenbait fetuk hezurretan asaldurak dituzte, ziurrenik infekzioen edo
elikadura urriaren ondorioz. Kasu guztiak dira Erdi Arokoak edo Aro modernokoak (VI-XV. mendeak).
Gako hitzak: heriotza gestazionala; erditzeko distozia; paleopatologia; Erdi Aroa; Nafarroa (Espainia).
ABSTRACT
Our objective has been to locate, document and analyze those burials where woman presence was associated with the remains of fetuses or perinatals. Eleven cases have been collected, 9 women that died in different stages of gestation, two more in close relation with perinatal remains, and another with less precise data due to post mortem alterations. The fetuses were aged from 22 to 42 weeks. One case has been documented to be delivery dystocia. Several fetuses exhibit bone alterations, probably related to infections or nutritional deficits. All cases belong to medieval or modern times (6th-15th
centuries).
Keywords: Gestational death; childbirth dystocia; paleopathology; Middle Age; Navarre (Spain).

Lactation exerts heavy energetic and physiological costs to mothers, whilst determining early growth and survival of offspring. To mountain ungu-lates, access to high-quality forage during nursing and weaning is crucial for reproductive success. We have evaluated the effects of pasture quality on suckling behaviour and winter survival of Apennine chamois Rupicapra pyrenaica ornata kids, across three areas. Areas A-B ('poor' areas) were characterised by a reduced availability of nutritious forage, thus a lower diet quality for female chamois and kids; Area C (a 'rich' area) included a much greater availability of nutritious forage. In poor areas, pasture quality has been reduced by climatic and plant composition changes, as well as the presence of a herbivore competitor (red deer Cervus elaphus). In poor areas, we recorded a significantly (1) lower suckling success of chamois kids (number of suckling bouts/number of suck attempts); (2) lower frequency of suckling bouts (n. suckling bouts/kid/h); and (3) lower suckling intensity (suck duration/kid/h) in respect to the rich area. Conversely, frequencies of suckling rejections and those of suckling attempts (n. events/ kid/h) were the lowest in the rich area. Winter survival of chamois kids was c. 2 times greater in the rich area (45%) than in poor areas (20–26%). In the poor areas, resource scarcity induced adult female chamois to decrease maternal cares and favour their own maintenance, ultimately affecting population dynamics through kid winter mortality.

Postnatal depression (PND) is recognised as a common maternal health problem, but little evidence examines PND among refugee, asylum seeker and immigrant women in developed country settings. This review aimed to identify the rates of PND and highlight common risk factors among this group of women. An iterative and dynamic literature search was conducted across ten databases to identify published articles on PND among immigrant, asylum-seeking and refugee women in developed country settings. Medical Subject Headings (MeSH) and 'free text' search terms, as well as thesaurus terms, acronyms and truncation were used where appropriate. Findings suggest that PND may affect up to 42% of migrant women, compared to around 10-15% of native-born women. Common risk factors for PND among migrant women include history of stressful life events, lack of social support and cultural factors. With a growing number of babies born to immigrant mothers, greater awareness of PND among this group is needed in order to respond to their particular maternal mental health needs. Maternity care providers should regard all recent immigrants as at high risk of PND and give closer observation and support as necessary.