Pressing the belly of a pregnant woman to speed up the expulsion of the baby is a gesture of the past, according to Professor Nisand. However, many testimonies indicate the opposite.
Angelism or refusal to accept reality? Reactions are mixed around the latest statements from the new president of the National College of French Gynecologists and Obstetricians (CNGOF). Prof. Israel Nisand is at the heart of a heated controversy over abdominal expression. In question, his interview with the magazine She on obstetric violence.
To believe the gynecologist, this gesture – which consists of pressing on the woman’s belly to accelerate the expulsion of the baby – is no longer practiced. “If you know a single gynecologist who has done abdominal exercises, I will call them personally to tell them not to do it anymore,” he explains. But you will be in check, Madam, because you will not find any. »Categorical words barely tempered by the rest of the interview.
A frequent gesture
The president of the CNGOF evokes the case of “a few black sheep who (…) feel that they know everything”. On reading these lines, the twittosphere was unleashed, denouncing the denial of Professor Nisand. An independent journalist decided to answer the professor, supporting figures. In a document shared online, she collects the testimonies of women victims of abdominal expression. In 24 hours, nearly 90 showed up.
In fact, Israel Nisand is wrong in asserting that abdominal expression is no longer practiced. Investigation of the Collective interassociative around the birth (Ciane) testifies well. Produced on the basis of 20,000 responses, it shows a real trend since 2010. In 2016 alone, 14% of women who testified declared having suffered an abdominal expression. Some even evoke a health professional kneeling on them to press on their stomachs.
Source : Ciane
At the request of the gynecologist
The act seems to be more common in women who give birth for the first time. They are 33% to declare an abdominal expression. More worrying: consent is rarely obtained before the gesture. Only 20% of women were asked. “In fact, there are hardly any complaints about the lack of consent,” laments Israel Nisand. They need to do more. “
An element could agree with the direction of the president of the CNGOF. The testimonies mainly implicate midwives. According to a thesis carried out by a student in maieutics, almost all practitioners know the official recommendations.
Despite this knowledge, 72% of midwives interviewed for this work reported practicing abdominal expression. 5 indications are taught during the training. One of them clearly dominates. 61% of midwives would practice abdominal expression at the request of the gynecologist.
Source : Thesis by Pauline Denni
A gesture to abandon
The official recommendations yet leave no doubt on the subject: nothing justifies the gesture. Since 2007, the Haute Autorité de santé has been clear. There is “no validated indication” of this practice which is “neither taught, nor codified, nor evaluated”. The institution admits all the same that the gesture is “in common use” and that it must be abandoned.
A message that should be recalled when a new recommendation is being developed. Scheduled for autumn 2017, it recalls good practices relating to “taking charge of normal childbirth”. And according to HAS, contacted by Why actor, the rules of abdominal expression will be the subject of a booster shot.
Prohibiting the practice is all the more justified as the physical and psychological consequences are heavy. Beyond the stress induced by this gesture, parturients suffer from prolonged abdominal pain and bruises. In rarer cases, they may present with fractures, perineal lesions and even, exceptionally, organ ruptures. A traumatic experience that we find in the testimonies collected by Ciane.
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