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Gaceta Sanitaria
Print version ISSN 0213-9111
Abstract
BENET, Marta et al. The extent of the implementation of reproductive health strategies in Catalonia (Spain) (2008-2017). Gac Sanit [online]. 2019, vol.33, n.5, pp.472-479. Epub Dec 23, 2019. ISSN 0213-9111. https://dx.doi.org/10.1016/j.gaceta.2018.02.004.
Objective
We analyse how reproductive health strategies have been incorporated into the everyday activities of the services and the resulting transformation of professional and user practices.
Method
Cartographic research taking a multi-sited ethnographic approach that seeks to reveal the processes of transformation. Data generation techniques featuring participant observation and situated interviews. Discourse analysis of the text corpus using three analytical axes based on three main lines of action promoted by the strategies.
Results
We identified transformations in: 1) demedicalisation: an increase in midwives’ know-how and autonomy, changes in episiotomy practice and the facilitation of bonding practices; 2) warmth of care: incorporation of women's needs and expectations and improvements in the comfortableness of birth settings, especially in assistance at physiological birth; and 3) participation: actions that foster shared decision-making and the involvement of the persons accompanying women in labour.
Conclusions
Above all, transformation is visible in the incorporation of new attitudes, sensibilities and practices that have developed around the old structures, especially during physiological childbirth. The more technological areas have been less permeable to change. Risk management in decision-making and addressing diversity are identified as areas where transformation is less evident.
Keywords : Public policy; Reproductive health services; Humanizing delivery; Patient participation; Health services research; Qualitative research; Ethnography.