A country that hesitates over the care of those giving birth is a country without direction’.

The crisis hitting Obstetric services in Portugal drags on this summer with limited services and even straightforward closures of State (National Health Service) Maternity Units during the weekends, including hospitals of reference in the Greater Lisbon area.

Pregnant women either make do on their own or have to go to private hospitals, where more than half of the doctors specializing in obstetrics are working.

The country’s tabloid Correio da Manhã commented that ‘something is wrong in a country with a shrinking population, that cannot guarantee the minimum conditions for its babies to be born safely and obliges pregnant women with obstetric emergencies to travel irresponsibly long distances because the closest maternity bloc is closed due to lack of doctors.

The reason for the public consternation was the recent loss of a baby whose 41-year-old mother in labor was forced to travel 100 km before reaching a functioning maternity hospital.

The Nurses’ Order and the NGO Observatory for Obstetric Violence are urging the Health Minister Martha Temido to put in place the European directive to give specialist nurses – who have the skills required to oversee low-risk pregnancies in primary care centers – the autonomy they are calling for, at the same time reducing the total dependence on hospital care.

There are currently 3,182 specialist nurses whose potential is being wasted in this regard.

The lack of medical specialists and obstetric care is not only affecting perinatal care but also maternal mortality, which has reached its highest level since 1982. Last year – with 85,000 live births – 17 pregnant women died due to complications of pregnancy ( 8 during pregnancy, 1 during childbirth, and 8 within six weeks after delivery). Thirteen occurred in hospital, a mere 3 were 40 years or older.

Moreover, instrumental vaginal birth (with help of a vacuum extractor or forceps) is three times (31%) higher in Portugal than the European average (11%). Episiotomies (incisions made in the perineum to enlarge the birth canal) are also more frequent and amount to 41%, twice the European average (20%).

These are the main conclusions of a European study including more than 21.000 women from 12 countries and published in the February issue of The Lancet Regional Health – Europe.
‘We have an exacerbated use of the these unnecessary practices similar to countries with a poor quality of care’, declared Raquel Costa, one of the researchers at the Institute of Public Health at the University of Porto.

Enjoy the week                                             Boa semana                          (pic Público/Sapo)

Last month marked the 650th anniversary of the Treaty of Tagilde, which led to the formation of the Anglo-Portuguese Alliance – the oldest alliance in the world still in force. Only a small stone memorial in Tagilde (Vizela), reminds us that more than six centuries ago the northern village in the Braga district was the site of a historic pact, signed at its church of São Salvador on July 10, 1372.

Its importance was underscored when the Portuguese prime minister António Costa recently met Boris Johnson to sign an agreement on foreign policy, education, security, and trade.

They inspected the original version of the treaty – which had been moved to Downing Street for the occasion by the National Archives – and commemorated the alliance that has not only survived world wars, the rise and fall of empires, and decolonization but also promoted pleasures such as port and tea.

It all started with an English claim for the throne of Castile, Portugal’s old foe.
That is not absurd as it sounds as England had large possessions in the southwest of France that bordered Castile.

The treaty was signed by King Ferdinand I of Portugal and John of Gaunt, Duke of Lancaster and third son of the English King Edward III. The document is written in the original Castilian language to reflect John’s claim to the Castilian throne.
The Anglo-Portuguese Alliance agreed that both England and Portugal would wage war against Castile on two fronts; the English on the north and the Portuguese on the west. In 1385, the Portuguese army, with help from English archers, defeated Castilian forces in the Battle of Aljubarrota.

More than three centuries later, Catherine of Braganza, daughter of King John IV of Portugal married King Charles II of England in 1662 to become queen.
She helped to popularise tea in England and supported the Methuen treaty in 1703, which bolstered the port trade. She is also said to have made popular orange marmalade and the use of the fork.

To end with, the alliance played an important role in World War II when Britain was given facilities in the Azores to help in the Battle of the Atlantic against German submarines. But it also survived difficult times such as the 1890 British Ultimatum, which forced the retreat of Portuguese forces from areas in Africa that had been claimed by Portugal but occupied by Britain.

Enjoy the week            Boa semana                          (pic Público/Times)