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Présentation foetale en siège en fin de grossesse : effet des interventions et des attitudes professionnelles sur le vécu des femmes

Abstract : Context: Management of breech remains complex due to divergence of practices and recommendations reported in the literature. Objective: To highlight the effects of health professionals' interventions on women's experiences. Methods: Five research studies qualitative were conducted at the University Hospitals of Geneva, including a total of 311 participants. Two studies used a method with interviews and thematic analysis, two used a quantitative method with a statistical analysis, and one used a mixed methods' design. Results: Breech diagnosis often requires anticipating a disappointment of an idealized childbirth. Women demonstrate a strong motivation to try to turn their fetus. 69% of women use complementary and alternative medicine (CAM) for their treatment. 68% of participants qualified external cephalic version (ECV) as "strong to unbearable". An accompaniment by a hypnotist compared to a midwife did not decrease pain intensity (visual analogic scale: 6.0 vs 6.3/10, respectively; p=.25). For the choice of breech delivery mode, women reported strong decisional conflicts. Medical information is often perceived in favour of a planned caesarean. Feelings of control, emotions and the first moments with the newborn are perceived differently and, notably, negatively in the case of emergency ceasarean section. Conclusion: A difficult emotional and decision-making process is associated with term breech. Use of CAM should be considered by professionals. Developing tools to assist women, and relationship techniques for professionals could facilitate these processes. Reduction of pain during ECV is necessary
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Submitted on : Thursday, May 6, 2021 - 9:14:23 AM
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Marie-Julia Guittier. Présentation foetale en siège en fin de grossesse : effet des interventions et des attitudes professionnelles sur le vécu des femmes. Médecine humaine et pathologie. Université de Lorraine, 2013. Français. ⟨NNT : 2013LORR0193⟩. ⟨tel-01750447⟩



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