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Master Thesis

Retentissements sur la vie professionnelle des sages-femmes d’une procédure mettant en cause leur pratique médicale

Abstract : Introduction: obstetrics is one of the specialties most exposed to litigation. Midwives are subject to several liabilities in their profession leading to potential criminal, civil or administrative and disciplinary procedures. They can also be exposed indirectly to a procedure questioning their medical practice (through mediations or conciliations). The experience of a procedure, contentious or not, by a caregiver is a potentially painful event that can have multiple implications. The goal of our study was to determine the impact of such a procedure on midwives’ professional life. Methods: we interviewed, between September and December 2018, fourteen French midwives, working in hospital or in a private practice and having experienced one or more out-of-court, legal or disciplinary procedures. Eight procedures involved midwifes practicing home delivery. Results: our results revealed some consequences for midwives' career development, with a temporary or definitive cessation of work for many of them. A few have reduced their professional activities because of stress or doubts about their desire to continue their practice. Some of them have felt the impulse to do their jobs differently through new personal engagements. In addition, a procedure has an impact on individual medical practice, with different changes depending on midwives. There is mainly an increased vigilance in writing and updating patient medical records and, for hospital midwives only, they have a tendency to consult and call doctors more frequently. Regarding midwife-patient relationships, there is distrust or a desire to optimize communication, including for complaints from somebody else than patient. On the other hand, the impact of procedures on inter professional relationships is not so obvious. Conclusion: several components of professional life are affected by a procedure. Midwives must be aware of the forensic risk to protect themselves.
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Clémence Nielly. Retentissements sur la vie professionnelle des sages-femmes d’une procédure mettant en cause leur pratique médicale. Gynécologie et obstétrique. 2019. ⟨dumas-02322759⟩

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