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En tant que sage femme ayant travaillé au sein de services hospitaliers aux objectifs différents en terme de prise en charge des patientes, j’ai été confrontée au problème majeur que constitue la toxicomanie chez la femme enceinte. Cette problématique, à la fois médicale et sociale, met à mal les services d’obstétrique. Les peurs mutuelles et violentes paralysent les relations et la prise en charge médicale s’apparente souvent à un malaise. Cette situation observée à plusieurs reprises dans mon quotidien de sage-femme m’a poussé à m’intéresser en profondeur aux raisons de ce problème et aux remèdes nécessaires pour le résoudre.
La consommation de drogues pendant la grossesse est un problème majeur de santé publique. Les risques tératogènes, de prématurité, et de faible développement intra-utérin pour l’enfant à naître amènent une morbidité et une mortalité bien éloignées des standards attendus. On peut donc parler de grossesse à haut risque quand on évoque la grossesse d’une femme consommant des substances psycho-actives telle que l’héroïne et cela nécessite naturellement un suivi obstétrical rapproché, une compréhension de la toxicomanie ainsi qu’un soutien psychosocial. La sage-femme exerce un rôle essentiel dans cette prise en charge puisqu’elle est amenée à rencontrer la future mère aux différentes étapes de sa grossesse, que ce soit pour lui prodiguer des soins ou simplement l’accompagner.
Dans ce travail, nous nous sommes donc intéressés non seulement aux normes attachées à la maternité mais aussi aux représentations sociales des soignants sur la toxicomanie chez une future mère usagère de drogue, deux notions souvent en opposition. En effet, dans ce contexte difficile et différent, tant la mère que la sage-femme perdent toute une série de repères. La future mère usagère de drogue, peu habituée à faire face à des échéances bien précises, rentre dans un cadre strict (celui de la grossesse) et se retrouve, du jour au lendemain, obligée de faire face aux normes du suivi hospitalier. De plus, elle pénètre au sein « d’une grande machine », la machine hospitalière, qui a tendance à broyer les déviants et à les isoler. Or, la prise de substances illicites est déjà souvent liée (ou dictée) à un certain isolement (social, familiale, relationnel). La grossesse les plonge donc dans une autre forme d’isolement. Quant à la sage-femme, son métier la confronte à un moment singulier que certains considèrent comme un des plus beaux moments d’une vie. Même si ce métier est loin de se limiter à des cas exemplaires, la sage-femme opte souvent pour ce métier pour le côté captivant de la naissance. L’irruption de la toxicomanie dans son cadre de travail met à mal tous ces repères.
La prise en charge de femmes enceintes toxicomanes confronte donc les équipes à au moins deux difficultés majeures : l’adaptation à une clientèle spécifique pour laquelle la plupart des sages-femmes n’ont pas reçu de formation adéquate, pouvant se traduire par des représentations négatives ou des attitudes de rejet, l’accompagnement de grossesses à risques débouchant sur des mères vulnérables et des nouveau-nés nécessitant une vigilance particulière. Dans cette situation, plus encore qu’ailleurs ; l’intérêt d’une coordination, d’un accueil, d’une revalorisation des futures mères est primordiales.
Parce qu’elles peuvent par leur statut et leur fonction imposer leurs propres normes, nous voudrions, à travers cette étude, porter un regard différent sur les professionnelles de la maternité que sont les sages-femmes. Que se passe-t-il quand une mère vulnérable vient frapper à leur porte et perturbe leurs représentation sur la naissance ? Comment vont-elles s’adapter à cette vulnérabilité ? Comment vont-elles poser les actes qu’elles pratiquent tous les jours, par habitudes ?
Pour répondre à ces questions, nous vous présenterons, dans un premier temps, une revue de littérature abordant la maternité et ses allégories, les représentations mentales des soignants sur l’usage de drogue pendant la grossesse et, pour conclure, un chapitre sur les spécificités de la maternité chez une mère consommatrice de produits illicites. Ensuite, nous vous exposerons la partie méthodologie. L’analyse qualitative a été choisie pour cette étude, car il s’agit de la méthode de recherche la plus pertinente pour étudier des représentations. Concernant l’outil de collecte de données, nous avons opté pour des interviews semi-dirigées réalisées à l’aire d’un guide d’entretien sur deux types de sages-femmes : des professionnelles travaillant dans un milieu hospitalier dit « classique » et les autres travaillant de manière plus spécifique avec des mères usagères de drogue. Nous voudrions dans la partie analyse, mettre en lumière les similitudes et les différences qui existent entre les représentations de ces deux catégories de professionnelles et mesurer l’impact que ces perceptions ont sur leur pratiques. Pour conclure, suite à la discussion, nous tenterons d’émettre des recommandations réalistes destinées au personnel soignant afin d’améliorer le prise en charge de ces futures mères et de leurs nouveau-nés
Midwifery --- Substance-Related Disorders --- Prenatal Exposure Delayed Effects --- Pregnancy --- Pregnancy
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nursing --- midwifery --- medicine --- health sciences --- nutrition --- dietetics --- Nursing --- Nursing. --- Clinical nursing --- Nurses and nursing --- Nursing process --- Care of the sick --- Medicine
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Esoteric sciences --- History of human medicine --- History of Europe --- anno 1400-1499 --- anno 1500-1599 --- Alchemy --- Midwifery --- Women in medicine --- Women in science --- Women --- History, Early Modern 1451-1600 --- Science --- History. --- history
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Essential Midwifery Practice: Intrapartum Care addresses a wide range of topics including the evolution of Intrapartum care, debates about knowledge and childbirth education. It looks at birth environments, labour rhythms, working with pain, normal birth, unusual labours and complementary therapies. Written by key experts, this unique and diverse text will bring readers right up-to-date with the latest research and reflection in their specialist fields, and provide guidance on best practice.
Kraamverpleegkunde --- Postnatale zorgen --- multidisciplinaire benadering --- postnatale zorgen --- postnatale zorg --- Geboorte --- Vroedkunde --- Bevalling --- bevalling --- obstetrie --- vroedkunde --- 610 --- arbeid --- evidence-based practice --- geboorte --- pijn --- 614.7 --- baby's --- ouderschap --- voeding --- Baby's --- Midwifery --- Postnatal care --- Postpartum care --- Puerperal care --- Maternal health services --- Puerperium --- Nursing specialties --- Midwives --- Postnatale zorg --- Opleiding
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*Mothers and meaning on the early modern English stage* is a study of the dramatised mother figure in English drama from the mid-sixteenth to the early seventeenth centuries. It explores a range of genres: moralities, histories, romantic comedies, city comedies, domestic tragedies, high tragedies, romances and melodrama and includes close readings of plays by such diverse dramatists as Udall, Bale, Phillip, Legge, Kyd, Marlowe, Peele, Shakespeare, Middleton, Dekker and Webster. The study is enriched by reference to religious, political and literary discourses of the period, from Reformation an
English drama --- Mothers in literature. --- Motherhood in literature. --- History and criticism. --- Drama --- English literature --- anno 1500-1599 --- Literature --- Literature and literary studies --- Literature: history and criticism / Literary studies: plays and playwrights --- PERFORMING ARTS --- Biography, Literature & Literary studies --- Theater --- History & Criticism. --- Literary studies: plays & playwrights. --- English drama. --- Mother's Legacies. --- comedies. --- early modern dramatists. --- history plays. --- melodrama. --- midwifery manuals. --- mother figure. --- romances. --- tragedies.
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For nearly two decades, anesthesiologists and obstetricians have turned to this handbook as the definitive reference for obstetric anesthesia. Authoritative yet concise, it has been designed as a practical guide to all aspects of anesthesia for childbirth and related obstetric procedures, including perinatal pharmacology, relief of labor pain, fetal monitoring, anesthesia for cesarean delivery, high risk pregnancy, and in vitro fertilization. The fifth edition of Obstetric Anesthesia Handbook has been reorganized and revised to both update the content and help expedite the retrieval of the most pertinent information. New chapters include "Pain of Labor and Delivery" and "Effects of Epidural Analgesia on Labor and the Infant." An appendix has been added that includes the most recent national guidelines for obstetric anesthesia. With numerous illustrations and tables, as well as updates regarding new medications and techniques, this esteemed handbook is more valuable than ever.
Anesthesia in obstetrics --Handbooks, manuals, etc. --- Anesthesiology. --- Medicine. --- Obstetrics. --- Anesthesia in obstetrics --- Anesthesia --- Anesthesia and Analgesia --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Anesthesia, Obstetrical --- Surgery & Anesthesiology --- Medicine --- Health & Biological Sciences --- Gynecology & Obstetrics --- Anesthesiology --- Pregnancy --- Labor (Obstetrics) --- Complications. --- Complicated labor (Obstetrics) --- Labor, Complicated --- Labor complications (Obstetrics) --- Complications of pregnancy --- High-risk pregnancy --- Pregnancy, Complications of --- Pregnant women --- Anesthetics in obstetrics --- Obstetric anesthesia --- Diseases --- Medicine & Public Health. --- Obstetrics/Perinatology. --- Obstetrical emergencies --- Obstetrics --- Obstetrics/Perinatology/Midwifery. --- Maternal-fetal medicine --- Anaesthesiology --- Surgery
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Effective communication skills are crucial in all aspects of nursing and midwifery practice - this book will enable readers to communicate effectively and with confidence in their professional practice. It focuses on the communication skills needed for the development of effective professional and therapeutic relationships. It is a 'how to do it' book that relates the theory of effective and ethical communication to the practice of nursing and midwifery and provides a framework for developing communication skills to meet a variety of situations.
Communication in nursing --- Communicatievaardigheden --- Nurse-Patient Relations --- Communication --- Midwifery --- Nursing Care --- Nurse Patient Relations --- Nurse Patient Relationship --- Nurse Patient Relationships --- Nurse-Patient Relation --- Patient Relations, Nurse --- Patient Relationship, Nurse --- Patient Relationships, Nurse --- Relations, Nurse Patient --- Relations, Nurse-Patient --- Relationship, Nurse Patient --- Relationships, Nurse Patient --- Nursing --- Communication Programs --- Communications Personnel --- Misinformation --- Personal Communication --- Communication Program --- Communication, Personal --- Personnel, Communications --- Program, Communication --- Programs, Communication --- methods --- Verpleegkunde --- Communicatie --- Patiënt-verpleegkundige relatie --- Agressiviteit --- Social Communication --- Communication, Social --- Communications, Social --- Social Communications --- Relatie verpleegkundige - patiënt
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Amenorrhea: A Case-Based Clinical Guide is a comprehensive review of the current knowledge regarding normal female reproductive physiology. Replete with interesting case vignettes and providing diagnostic algorithms and therapeutic strategies for amenorrhea, Amenorrhea: A Case-Based Clinical Guide is divided into three sections. The first section is composed of two chapters that provide a thorough review of basic science and clinical knowledge about the organ systems responsible for normal physiology of the menstrual cycle. The second section includes discussion about menstrual cycle disruption as it relates to hypothalamic-pituitary dysfunction, surgical and natural menopause, genetic defects, premature ovarian failure/insufficiency and the effects of caloric excess and restriction. The third section offers an update on the physiological effects of prolonged amenorrhea induced surgically or by hypothalamic dysfunction and also includes an original chapter that focuses solely on the impact of race and ethnicity on the prevalence and diagnosis of amenorrhea. Amenorrhea: A Case-Based Clinical Guide brings together chapters from renowned experts who offer state-of-the-art, clinically useful information in a case-based, reader-friendly fashion. This title will be a welcome addition to the bookshelves of all clinicians who practice in women’s health settings.
Amenorrhea. --- Menstruation disorders. --- Amenorrhea --- Menstruation Disturbances --- Pathologic Processes --- Pathological Conditions, Signs and Symptoms --- Diseases --- Medicine --- Clinical Endocrinology --- Gynecology & Obstetrics --- Health & Biological Sciences --- Etiology --- Etiology. --- Menstrual disorders --- Medicine. --- General practice (Medicine). --- Gynecology. --- Obstetrics. --- Internal medicine. --- Endocrinology. --- Primary care (Medicine). --- Medicine & Public Health. --- Obstetrics/Perinatology. --- Internal Medicine. --- Primary Care Medicine. --- General Practice / Family Medicine. --- Generative organs, Female --- Menstruation disorders --- Emergency medicine. --- Family medicine. --- Obstetrics/Perinatology/Midwifery. --- Internal medicine --- Hormones --- Family practice (Medicine) --- General practice (Medicine) --- Physicians (General practice) --- Medicine, Emergency --- Critical care medicine --- Disaster medicine --- Medical emergencies --- Medicine, Internal --- Maternal-fetal medicine --- Gynaecology --- Endocrinology . --- Gynecology . --- Primary medical care --- Medical care
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Since 1987, when the global community first recognized the high frequency of women in developing countries dying from pregnancy-related causes, little progress has been made to combat this problem. This study follows the global policies that have been implemented in Sololá, Guatemala in order to decrease high rates of maternal mortality among indigenous Mayan women. The author examines the diverse meanings and understandings of motherhood, pregnancy, birth and birth-related death among the biomedical personnel, village women, their families, and midwives. These incongruous perspectives, in
Mothers --- Pregnancy --- Maternal health services --- Childbirth at home --- Mortality --- Complications --- Home birth --- Home childbirth --- Home delivery (Obstetrics) --- Homebirth --- Home care services --- Natural childbirth --- Health services, Maternal --- Maternal and child health services --- Maternal and infant health services --- Maternal health care --- Maternity care --- Mother and child health services --- Perinatal care --- Safe motherhood programs --- Obstetrics --- Reproductive health services --- Women's health services --- Maternal and infant welfare --- Gestation --- Conception --- Physiology --- Reproduction --- Moms --- Parents --- Women --- Housewives --- Motherhood --- Pregnant women --- Medical care --- Guatemala. --- Maternal Mortality. --- Mayans. --- development. --- global health. --- latin america. --- maternal death. --- maternal health. --- medical anthropology. --- midwifery. --- midwives. --- motherhood. --- pregnancy. --- the Maya.
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