50 years of childbirth without pain

Created initially for the Steelworkers, the maternity ward of the Bluets in Paris has become the reference for painless childbirth. But since the 1950s, the preparation at birth has deeply changed. For Dr. Evelyne Petroff and Danielle Sfoggia today the accompaniment should be customized and fostering dialogue. They respond to issues of Doctissimo.

Doctissimo: Bluets surrogacy was pioneer in childbirth without pain. What developments experienced by this method?

Dr. Petroff and Sfoggia: Childbirth without pain has been developed by Dr. Fernand Lamaze and his team, after attending a birth in the former USSR. This method is based on two pillars. The first is pedagogical: it comes to learn the mother-to-be how birth, just as it would teach him to swim. Be given particular notions of anatomy. In the 1950s, pedagogy through lectures, and metallurgical workers ‘returning on the benches of the school”. The other pillar of the program is a physical component. It was based on the work of Pavlov at the time: it was of “deconditioning” women to suffer during childbirth. This happening by associate contraction with breathing to oxygenate baby, rather than associate it with pain.

childbirth without pain

This method was very controversial. In the 1970s, M. Leboyer added the concept of softness of the baby home. Light, gestures… the Leboyer method advocates a birth without violence. Then there was the arrival of the epidural in the 1980s, heavily dosed at the time. Women felt more nothing. They were passive, while Lamaze approach was intended to make them active. Need to find a balance between pain reduction and the involvement in its delivery.

Doctissimo: Precisely, how do you manage to find this balance?
Dr. Petroff and Sfoggia: Our goal is not to control the pain at all costs but to accompany women in what they wish to: singing, breathing, epidural dosed mini… We have women who opt for a method, and then change their mind along the way. Our support for the mother-to-be is refined. We are not aiming a kind “of ideal childbirth”, but what is best for each. But we keep the two pillars of the Lamaze, teaching method and physical approach. We give ourselves the means to propose more human accompaniments, favouring dialogue and Exchange. Thus, the educational part is done by classes diversified, with not more than 10 persons, from the 4e month of pregnancy. Because every woman is unique, and each baby is unique.

Doctissimo: But how do you manage to propose a personalised welcome, while most maternity wards are experiencing a real crisis?

Dr. Petroff and Sfoggia: First, it is true that we do not problem pregnancies. This allows us to concentrate on coaching. In addition, we work in network. Many doctors general practitioners and gynaecologists are related to our maternity to extend the monitoring. We regularly offer training.

Doctissimo: What is the profile of women who give birth at you and what methods of painless childbirth are preferred?
Dr. Petroff and Sfoggia: We give birth to 1,750 babies each year. But we do not have detailed data on the most methods. Because as I told you, many women change along the way. But in General, 70 to 80% of women are opting for a preparation for childbirth. Those who do not follow have often already practiced a technique they know. Or there may be other cultures, which will have specific approaches. With regard to the profile of expectant mothers, we welcome women of all backgrounds, of all socio-professional categories.

Doctissimo: Within your maternity, the father there a privileged position?
Dr. Petroff and Sfoggia: The father was always present during childbirth. But it is true that in the mid-1970s, there was a very militant movement so he attended the birth, cut the cord… Today, there is a return to more reason. Father occurs depending on what it is willing to do, there is no obligation. But there is a genuine work of the team, to make fathers feel welcomed as part of the adventure. They are welcome everywhere: in consultation, ultrasound, in preparation (“words of men” interview them is devoted), childbirth (even during caesarean sections) and in puerperium throughout the day.

Doctissimo: Under your auspices, a birth House will soon see the light of day?
Dr. Petroff and Sfoggia: This House of birth is expected in 2006. Attention, it is not an extension of motherhood the Bluets, but an autonomous structure, which will occur the liberal midwives. It will be attached to our maternity. The goal is to offer women a yet more custom tracking, and delivery “at home”. Because it is now almost impossible to give birth at home.

Who will give birth me?

It is with a tinted relief to apprehension that you see closer to the date of the birth. After having made acquaintance with doctors, midwives and even the anaesthetist, finally it is the encounter with your child. But in fact, who will be present the day?

Everything depends on the type of institution you have chosen, hospital or private clinic, and the nature of your pregnancy. Maternity wards are classified by levels. Pregnancies without complications are oriented towards a level 1. Then there are 2 levels that include a neonatal unit to which address example twin pregnancies. Finally, level 3 have a Neonatal ICU. Anyway, from 1,500 births a year, regulation requires 24 hours of a full medical team (pediatrician, gynecologist-obstetrician, anaesthetist, midwives, etc).

Who will give birth me

In the structures of first, or even second-level operation of the team differs. The midwife and obstetrician doctor are custody, i.e. present on the spot, while anaesthetist or pediatrician doctors are on call, in other words physically absent, but can be “Mexican”. Finally in the private structures, you’ll case the midwife, physician accoucheur not moving during the last phase of the work, for the release of the baby. Continue reading “Who will give birth me?”

Facilitate access by minors to contraception

While 18,000 young girls became pregnant in 2010, only 4,500 have gone at the end of their pregnancy. To avoid unintended pregnancies, a report is to be delivered to the Secretary of State for youth stressing the need for anonymous and free contraception for all teenage minor.

Being pregnant at 13 or 14 years, this is not normal. If certain songs, movies and TV shows sometimes evoke teenage pregnancies with idealism, the reality is often difficult for very young mothers suffered some insecurity. The subject of teenage pregnancies and abortion, behind is before all a lack of information and access to adequate contraception.

minors-to-contraception

The paradox of contraception
In their report on the contraception and abortion of girls, Professor Israel Nisand, Dr. Brigitte Letombe (gynecologists) and Sophie Marinopoulos (psychologist), highlight a paradox that is specific to the France. Abortion and emergency contraception are free, anonymous, while contraception is paid or refundable by the social security of parents, thus requiring their authorization. “In France, we prefer to pay abortion rather than contraception” exclaims the Israel Nisand gynecologist.

Today, the contraceptive pill is given free of charge in family planning, which respect the anonymity and confidentiality of patients. However, they are rare in rural areas and the family planning association deplored the lack of means and calls to sign a petition for “Defend the right to information and education in sexuality”.

Package contraception for minors
The 18 proposals in the report, include provision of anonymously and free of contraception all and up to age 18 (and condoms under conditions of resources of 18 to 25 years). This proposal could emerge in the form of a “contraception for minor package” proposed by the State voluntary pharmaceutical laboratories. “Annual cost by minor would be around 80 euros in addition to the price of an annual consultation of renewal”, assess the authors. A cost to “put next to the cost of an abortion (on the order of 350 euros) which takes into account costs occasioned by suspicion of pregnancy, or emergency contraception, nor psychological consequences of Abortions to minors, if difficult to measure”, continuing the specialists.

The idea is also to provide suitable contraceptives minor. “We always speak of the pill, but most of the time, it is not suitable for the girls; It is better to provide the patch, the ring , or the implant, who avoid accidents. Unfortunately, these new methods of contraception are not reimbursed to date”adds Jeannette Bougrab, Secretary of State for youth.

Inform… from kindergarten!
Avoid unwanted pregnancies, it also passes by informing adolescents about sexuality and its consequences. According to the Nissan Professor, “pornography educates our children. Near three boys on four and more than a girl on two began to consume pornography before the age of 14 years”. In addition to maintaining the law of 2001 on school-based sexuality information, the report suggests to provide information on “la vie affective, emotional, sentimental” and respect for oneself in a sexed body report from kindergarten for the dialogue to become fluid and constant on these subjects, from the earliest age. How to apply to adolescents, specialists exclaim in echo ‘stop at the pure information only. “Young people need information but also especially to feel listened, to speak freely”.

But facing the sexuality of adolescents are also parents need help. They may indeed find it difficult to interact with their children. The report suggested the creation of places of parent-child home offering a listen for anonymous and free.

Cancer: how to limit the risks?

Cancer is the disease that makes the most fear, because nobody can feel safe. The most common cancers in women are breast (30%), uterus (12%) and ovaries (4%). More than anything, these cancers can be prevented through regular screening and lifestyle tips.

In an Ifop survey published in November 2000, the cancer appeared as the disease that fear most. It is cited in head in 63% of cases, far before AIDS (39%), cardiovascular diseases (26%), (28%) Alzheimer’s disease Creutzfeld-Jakob (23%) and meningitis (11%). The fear of cancer appears homogeneous, regardless of the age group or sex. Everyone feels potentially concerned. Thus, it appears today useful to recall some prevention tips.

the risk of breast cancer

The importance of screening
For most cancers of women, the importance of screening is crucial. More cancer is detected early, more the chances of cure are high. Through screening by mammography, 50% of breast cancers are detected in the early stages of evolution while the tumor is less than 2 cm. In addition to an increase in the chances of recovery, this early diagnosis allows a use less aggressive treatments. For this cancer, we recommend regular monitoring by your doctor or your gynecologist, every six months or annually over 30 years, and a mammogram every two years over 50 years. Every month, you will need to perform a self-examination of your breasts. Continue reading “Cancer: how to limit the risks?”

Trigger childbirth

Be able to decide the date of the birth of a child is an ideal for some parents and obstetricians and one aberration for others. Between these two extremes, there is certainly no established truth but a multitude of situations ranging from wait where is the “nature” which will decide the spontaneous starting of the mother until the trigger for “personal reasons”.

In what circumstances trigger a delivery?
Basically, there are two types of situations where one may cause a birth: those that are carried out in a therapeutic or medical indications and those which fall within organizational reasons. Of course a trip may sometimes meet several aspects and be thus classified in two categories.

Trigger childbirth

Medical indications
Many situations can lead a doctor to offer parents a treatment aimed at hastening the birth of a child. One of the most common is the excessive prolongation of pregnancy beyond the theoretical term fixed. Even if the duration of a normal pregnancy is still under discussion (280 days + or – 12 days for many authors) it is common in France consider that 9 months or 39 weeks of pregnancy, is the normal duration of pregnancy and beyond, either after 41 weeks of amenorrhea (must be added to the duration of the pregnancy the two theoretical weeks separating the latest rules from the date of ovulation for at the beginning of the pregnancy)It is necessary to increase the monitoring of the mother and the fetus. Indeed, at the end of pregnancy, the placenta has aged and can no longer perform all of its roles of trade. Then, there is the risk to the fetus (cessation of growth, lack of oxygenation.) and the consequences can be very serious. In these circumstances, it is important to monitor very carefully these days of gestation that extends through a review of the pass as well as recordings of the heart baby, ultrasound and other tests, possibly. Continue reading “Trigger childbirth”

The Senate examines the draft law

The centrist Senator for the Rhone Muguette Dini presented February, 2013, his bill authorizing experimentation of the birth houses. The text was discussed in the Senate, but due to time constraints, could not be voted on. The vote will take place in the coming weeks.

Birth houses: consideration of the Bill in the Senate
The idea of the birth houses is not new. This will now make 15 years that several politicians have expressed their desire to create. Bernard Kouchner, in 1998, while he was Secretary of State for health, then Jean-François Mattei, in 2003, while he was Minister of health, there were favourable. But others, conversely, opposed to this project, especially the College of Obstetricians of France (CNGOF) gynecologists. In December 2012, it has changed its tune and has expressed its support at the opening of the birth houses. Since then, it seems that things will settle.

the Senate examines the draft law

Standardized in maternity support

During the presentation of its proposal for a law, Muguette Dini emphasized that women did feel not respected as their project’s birth choices. Based on a survey of the Union Nationale des Associations Familiales (UNAF) conducted in 2010 952 women or, more recently, the CIANE 5 640 women investigated, the Senator for the Rhône insisted on the fact that a third of women who had specific requests concerning childbirth (freedom of movement, support custom pain and episiotomy notably) believed that everything had not been done to ensure that these are met. Continue reading “The Senate examines the draft law”

The heart, this extraordinary pump

The heart is a pear-shaped hollow muscular organ located between the lungs, in the middle of the chest. It ensures the circulation of blood throughout the body, cells receive oxygen and nutrients. It is attached to the sternum by specific connective tissue called ligaments. The size of an adult heart is comparable to that of the fist. An average person, it measures approx 13 cm long and 8 cm wide, and weighs less than 500 grams.

The heart, this extraordinary pump

The heart, located between your lungs in the middle of the thorax is the engine of the cardiovascular system, whose role is to pump the blood that circulates in all tissues of the body. Continue reading “The heart, this extraordinary pump”

What aid bring to hit something by a Cerebral vascular Accident?

The aid that you can make to a subject who has suffered a stroke depend on the seriousness of the situation. On the basis of disability and the speed of the recovery, you in turn support and both functional and psychological.

The stroke may have important consequences on the patient but also on his entourage. Relatives will have a vital role to play in the recovery after the accident.

Cerebral vascular Accident

The Guide to more autonomy
Don’t be not stingy with incentives against the efforts made by the patient. Do not forget that these efforts are for him considerable, even if you consider them very inadequate. In addition, violations are too often considered by the patient as a very degrading. He has struggled to express themselves, to do what he wants which places him in a situation of dependence difficult to live. The support is necessary, but you do so without being offensive. Continue reading “What aid bring to hit something by a Cerebral vascular Accident?”

Why men don’t listen to half?

It might be a scientific justification for the scant attention which men are capable. Researchers at Indiana University (United States) found the explanation to this ancestral problem: men seek only half of their brains when they listen while women use the two cerebral hemispheres.This is a study that could well feed conversations and revive a war of the sexes.

Rather than a lobe or an ear…
Equipped with headphones, twenty men and twenty women took attention to the reading of a passage from a novel by John Grisham. During this period, and under the eye a MRI (magnetic resonance imaging) scanner happening their brains examined, the majority of the men showed brain activity of one temporal lobe of the left hemisphere, generally associated with the functions of listening and language. Conversely, the brain of the majority of the women testified to an activity in the temporal lobe of the two hemispheres, both the left than the right, commonly used for musical activities and the situation in the area.

Why men don't listen to half

The areas of brain activity in red highlight that men use a lobe to listen to two women.
The study presented at the annual meeting of the society of Radiology in North America in Chicago does not, however, if men have a capacity of less than women listen. “Our research suggests that the way to listen differs between the sexes, but this does not necessarily imply that the capacity and performance go hand in hand,” says Professor Joseph Lurito, responsible for the study. Continue reading “Why men don’t listen to half?”

The summer of all dangers

Summer is here and the holidays are approaching. Moment of joy and family reunion but also dangers for the younger period. An American study comes to the demonstration. The period of the year from May to August is that exposes the most children in accidents.

American researchers have surveyed between 1991 and 1996 under the direction of Angela Mickalide, child accidents. The conclusions of this work are clear: with 3 million of declared emergencies and 2,550 deaths, or 42% of annual deaths, the months ranging from May to August are the most perilous of the year for the 14 years of age. And, during the summer, 10-14 years are particularly prone to this problem.

children's health

Multiple reasons for this phenomenon
For Angela Mickalide, leading from Washington the national campaign on the safety of the children, there is nothing very surprising in that the latter are more likely during the summer season. The children then leave the universe protected from the classroom to the dangers of the street or the track. Continue reading “The summer of all dangers”