Health professionals are concerned about this trend which can put women at risk.
“I would like to give birth squatting. Is this possible in the hospital? “” The maternity hospital next to me is a real baby factory. I don’t want this for my childbirth. What is the alternative? The forums are full of questions like this. The demedicalization of pregnancy is a movement which does not date from today but which is becoming more and more important. The doulas (1), in other words these birth attendants, are riding this wave and arrived in France in 2003. Their mission: to inform, provide moral support and accompany couples before, during and after birth. For example, they can help them choose their mode of delivery, massage them during labor or even help them breastfeed.
Professor Roger Henrion, obstetrician-gynecologist, was interested in this “emerging profession” since he submitted a report on the subject to the Academy of Medicine at the beginning of the summer. And overall, he “warns society against any official recognition” of doulas. Their “knowledge is essentially empirical, their theoretical training expensive and their practical training very limited”, denounces Professor Henrion. However, the danger is limited since they would only be fifty to exercise and a hundred in training. Are birth centers promised a better future? Not so sure. Certainly, the experimentation of these places for monitoring pregnancy and taking charge of non-pathological deliveries managed by midwives was one of the priorities of the 2005-2007 perinatal plan. But these birth centers remain in the pipeline for the moment. And several voices were raised against the experimental project. The National College of French Gynecologists and Obstetricians took a stand last March. According to him, it is “not coherent in terms of public health to close for safety reasons establishments carrying out less than 300 deliveries to open others which will make much less deliveries and will be moreover not medicalized”.
The limits of the technique However, not all doctors are deaf to the sirens of demedicalization. A certain number even concede that the excessive technique has perverse effects. Professor Claude Sureau, member of the Academy of Medicine, recognizes for example “the excess of monitoring”, a technique that he nevertheless helped to put in place. “If you record a change in rhythm, you don’t know how to interpret it well. But midwives immediately tend to apply the precautionary principle and perform caesarean sections. The massive recourse to episiotomy – 68% in first-time mothers – is also considered excessive. The CNGOF estimates that it should be less than 30%. A few rare professionals have gone further than the simple observation. For example, Prof. Israel Nisand recently opened a birthing center, but within the confines of his department at Strasbourg University Hospital, a level 3 maternity unit. Women who want it and whose pregnancy is not at risk, can give birth in a bathtub, with suspension cords, without an epidural, “with an intimacy appropriate to the beginnings of life”, specifies Professor Nisand. A means of reconciling security and humanity.
(1) Doula is the feminine of “doulo” which means slave in ancient Greek.
Questions to Prof. Claude Sureau, member of the Academy of Medicine
Childbirth is not a natural act
What do you think of doulas? Prof. Claude Sureau. Doulas are untrained, unqualified personnel who can interfere with the workflow. In this, they constitute a bad response to the anxiety of future mothers concerning childbirth. Especially since the right answers already exist. This is simply called childbirth preparation classes.
Is the emergence of doulas due to the desire of women to demedicalize pregnancy? Pr CS Not really. They benefit above all from the budgetary restrictions that hospitals are forced to take. Indeed, over the years, I have seen the staff shrink and the quality of support for pregnant women unraveling. These elements are the first to drink. Suddenly, we try to replace them with the doulas. This revolts me because this lower quality service is expensive, and therefore reserved for the wealthiest women.
Despite everything, should we promote more natural childbirth? Pr CS Women should be reminded that childbirth is not a natural act. It requires a lot of attention. Failure to supervise in the name of excessive naturalism can have dire consequences. This is why I sincerely believe that birth centers outside the hospital walls would constitute a real regression.
