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Master Thesis

Quels peuvent être les facteurs impactant le vécu des sages-femmes en salle de naissance dans l’accompagnement des couples dont l’enfant est atteint d’une pathologie létale et n’ayant pas souhaité l’interruption médicale de grossesse ?

Abstract : Background: in France, in 2017, 1480 women have chosen to continue their pregnancy, knowing their child was carrying a lethal pathology, even if they could have done a termination of pregnancy. This means that nowadays, midwives are taking more frequent care of these patients, especially during childbirth. During this unusual medical care, these professionals can feel intense and various emotions. Objective: this study investigates the existence of various factors having an impact on midwives’ feelings while taking care of these patients. Population and method: as part of a retrospective regional multi-center descriptive study midwives working in hospitals in Ile-de-France answered an online survey. It was circulated between July 10 and October 28, 2019. Results: 134 responses have been collected. 47% of midwives said they were satisfied with the support provided, 38.8% were sad by identification with the person suffering, 9% were anxious in anticipation of the tragic event and 5.2% were angry because of their impotence in this situation. The individual characteristic influencing the midwives' experiences, positively, was self-confidence (p = 0.031), and negatively, was stress (p = 0.019). This study shows that the presence of a prenatal diagnosis team (p = 0.014), file transmissions between the prenatal diagnosis teams and those in the birthing room (p = 0.02), the presence of a pediatrician to welcome the child (p=0,01) leads to a better satisfaction of the provided support. Four other influencing factors on midwives’ feelings were also pointed out: uncompromising support for the patient (p <0.001), well-appropriated responses to her needs (p <0.001), spending necessary amount of time with her (p = 0.001) and a greatest confidence-inspiring relationship build up (p = 0.013). Satisfied midwives got an overall sense of belonging (p <0.001) and felt less lonely (p <0.001) than those who were sad, anxious or angry in supporting these patients. They thought they had more knowledge (p = 0.01), skills (p = 0.015) and experience (p <0.001) than the others. Support, help, empathy, listening as well as benevolence brought to the couple were essential concepts for the midwives during the accompaniment. Conclusion : This study shows that the environment plays an important role into midwives’ satisfaction, no matter their own personal experience. All these environment’s aspects are keys to their satisfaction: the time spent with the couple, the sense of belonging, the collaboration with a prenatal diagnosis team and the presence of a pediatrician to welcome the newborn.
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https://dumas.ccsd.cnrs.fr/dumas-03064662
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Submitted on : Wednesday, February 17, 2021 - 3:30:05 PM
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Ségolène Grangé. Quels peuvent être les facteurs impactant le vécu des sages-femmes en salle de naissance dans l’accompagnement des couples dont l’enfant est atteint d’une pathologie létale et n’ayant pas souhaité l’interruption médicale de grossesse ?. Gynécologie et obstétrique. 2020. ⟨dumas-03064662⟩

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