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Master Thesis

Le toucher vaginal en salle de naissance : évaluation des pratiques professionnelles et freins à l’arrêt de son recours horaire systématique

Abstract : Vaginal examination in France is systematically practiced by caregivers to assess the state of progress of labor. Currently, there is no recommendation for a TV schedule in case of low-risk pregnancy and labor. Although WHO recommends a vaginal examination every 4 hours during labor, most midwives resort it hourly during labor. It seems that this schedule is a specifically French since health professionals of our European neighbors resort to it much less frequently. The purpose of this study was to assess this practice and the restraints to stop its systematic use among women working in low obstetric risk. This quantitative and descriptive study was realized by establishing a questionnaire with clinical vignettes from actual obstetric cases with hospital midwives in Ile-de-France. Our study covers the period from October 2015 to January 2016 and relies on 82 respondents. According to the results, the majority of professionals practice vaginal exam on the basis of a systematic schedule in labor and delivery ward even when the patient is presenting low-risk pregnancy and labor. Epidural analgesia, more than any other obstetric feature, displays strong correlation with this practice. Even if midwives are in favor of changing their practice, they argue being limited by the lack of time, the workload, the uncertainty on the legal responsibilities and service protocols. The challenge of an evolution of practices towards the English model involves a reorganization of the workload in the delivery room and better collaboration between care teams.
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https://dumas.ccsd.cnrs.fr/dumas-01417280
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Submitted on : Thursday, December 15, 2016 - 2:57:26 PM
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  • HAL Id : dumas-01417280, version 1

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Marine Guidez. Le toucher vaginal en salle de naissance : évaluation des pratiques professionnelles et freins à l’arrêt de son recours horaire systématique . Gynécologie et obstétrique. 2016. ⟨dumas-01417280⟩

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