[Brazelton observation of newborns, promoting the parent-baby-caregiver relationship]. / L'observation Brazelton en post-partum, une rencontre parents-bébé-soignant.

The Brazelton observation tool, centred on the discovery of the baby during the first two months, helps parents to build confidence in themselves as competent parents and reinforce the bond with their baby. For some, it is also an opportunity to evoke their personal, sometimes painful, journey. The baby is thereby freed of a previous complex generational history.

[The art of being when there is nothing you can do: caring for perinatal bereavement]. / Etre là quand on ne peut rien faire: accompagnement du deuil périnatal.

The period of mourning after perinatal loss is not synonym for depression. The article illustrates a way of caring for bereaved parents, which takes into account the temporality and individual nature of the bereavement process. The use of rituals and symbolic gestures allows for calling into existence the loss of a human being, who is gone without leaving many reminders. Psychotherapeutic care by the liaison-psychiatric service is part of the multidisciplinary care program proposed by the maternity of the University Hospitals of Geneva. These encounters offer parents the possibility to continue to include the dead in the membership of our lives.

Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction.

BACKGROUND: According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period. AIM: The goal of this study was to evaluate the satisfaction and outcomes of the obstetric and neonatal care of women who received comprehensive support during pregnancy, childbirth and the postpartum period, and compare them to women who received shared care. METHODS: This was a prospective comparative study between two models of care in low risk pregnant women. The satisfaction and outcomes of care were evaluated using the French version of the Women's Experiences Maternity Care Scale, two months after giving birth. FINDINGS: In total, 186 women in the comprehensive support group and 164 in the control group returned the questionnaire. After adjustment, the responses of those in the comprehensive support programme were strongly associated with optimal satisfaction, and they had a significantly lower epidural rate. No differences were observed between the two groups in the mode of delivery. The satisfaction relative to this support programme was associated with a birth plan for intrapartum and postnatal care. CONCLUSIONS: Team midwifery had a positive impact on satisfaction, with no adverse effects on the obstetric and neonatal outcomes, when compared to shared care.

Breech presentation and choice of mode of childbirth: a qualitative study of women's experiences.

OBJECTIVE: To explore women's perceptions of their experience of the diagnosis of breech presentation and decision-making processes regarding the choice of mode of childbirth. DESIGN: A qualitative study was conducted using semi-structured interviews. Data were analysed thematically. SETTING: Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland. PARTICIPANTS: seven primiparous and five multiparous women experiencing a singleton breech presentation for childbirth were interviewed. FINDINGS: Two concomitant and interdependent processes were identified. First, an emotional response ranging from the hope that the fetus would return to a normal vertex position to the acceptance of breech presentation and its consequences. Second, a decision-making process related to childbirth mode for breech presentation with the complex management of intra- and extra-personal factor influences. Women perceive information about the risks of vaginal childbirth of paramount importance compared with those associated with caesarean childbirth. When women choose vaginal childbirth, influences related to their personality and life history appear to predominate. Women often have the feeling of being alone to assume the choice of childbirth mode and possible complications. KEY CONCLUSIONS: The diagnosis of breech presentation should not be treated as a commonplace event. The role of caregivers needs to go beyond information on the risks and benefits of both modes of childbirth. Emphasis should be placed on listening to the expectations of pregnant women for childbirth, creating spaces for dialogue, and allowing additional time for reflection. Useful information material should be provided to give the women a feeling of shared decision-making.