[A father's perspective for today's young families?]

Today, the distribution of parental roles is organised around an equity that is more than justified, but has the consequence of creating a territorial watershed where the negotiation of values, opinions, wishes and deep-seated needs is constantly activated. Where societal definitions used to provide a framework and contentment for transactions within the couple, the new generation finds itself obliged to cooperate and redefine the spaces and roles of each, with intergenerational issues multiplied tenfold and marital crisis often heightened.

[Examinations of cattle births with a special focus on Coxiella burnetii]

INTRODUCTION

Cattle births can carry the risk of transmissible and zoonotic diseases. The focus of the present study was the excretion of Coxiella (C.) burnetii during cattle births. Small ruminants are considered as the main reservoir of C. burnetii. Cattle are often subclinical carriers and their role as potential reservoir has not been fully elucidated until now, although the excretion of Coxiella has been demonstrated during cattle birth. The study recorded all births, caesarean sections and one abortion in 40 cattle at the ruminant clinic of the Vetsuisse Faculty in Bern in the study period from March 2019 to March 2020. A placenta -, milk - and fecal sample was examined for antigen diagnostics using polymerase chain reaction (PCR). In addition, a serum sample was analyzed to detect C. burnetii-specific antibodies. Antigen and/or antibodies (placenta, n=8/9; milk, n=2/9; faeces, n=1/9; serology n= 3/9) were detected in 22,5 % of the cows (n=9/40) without the presence of specific clinical symptoms. It is essential to sensitize contact persons to this zoonosis, since Coxiella can trigger Q-fever in humans.

The autonomous choice of delivery mode: A survey of Tunisian women

BACKGROUND

The recent overmedication of childbirth process ignores mothers wishes.  In Tunisia, women are not involved in decision-making during childbirth.

AIM

To analyze the opinion of a sample of Tunisian women regarding the possibility of making their own informed choices during childbirth and to determine the factors that may influence the requested mode of delivery.

METHODS

This was a 5-month descriptive cross-sectional survey. Were included: Tunisian women who were consultants or practitioners at a university obstetrics and gynaecology department in Tunis; female medicine students or members of women dedicated social network groups. The questionnaire was applied during direct interviews or posted online. The main judgment criteria was: participants' opinion regarding access to autonomous choice of delivery mode. Participants were initially enrolled into 2 groups: •    group of women requesting access to autonomous choice. •    group of women who do not request access to autonomous choice.  The participants were then divided into 2 other groups according to the requested mode of delivery: •    Group : Cesarean section •    Group: Vaginal delivery. A multivariate logistic regression was used to identify risk factors that may have influenced the responses.

RESULTS

The total number of participants was 197. Access to autonomous choice was requested by 63.45% of the participants. These were mainly: consultants: OR=7.76 95% CI [0.56-106.16] or practitioners: OR=3.93 95% CI [0.01-829.03], with a high level of education OR=1.22 95% CI [0-1174.40], with a past positive birth experience: OR=1.24 95% CI [0.27-5.74]. The women who did not claim access to autonomous choices were mainly: doctors OR=-0.31 95% CI [0-32.58], midwives: OR=-0.08, 95% CI [0-18.12] or even housewives OR=-0.42 95% CI [0-68.88]. The women who preferred to give birth by Caesarean section were mainly: practitioners: OR=2.03 95% CI [0.53-7.81], nulliparous OR=2.51 95% CI [0.243-25.98], pregnant OR= 4.44 95% CI [1.03-19.13], with a history of cesarean delivery: OR=5.68 95% CI [0.64- 50.43] or even a history of negative childbirth experience: OR=1.87 95% CI [0.22-15.85].

CONCLUSION

The request for an Autonomous choice during childbirth most often expresses a certain number of beliefs and fears. Obstetricians should take time to listen and explain, in order to understand the mother's anxieties and enable her to resolve them. Based on the principles of justice, the access to autonomous choices during childbirth process should be universally recognized by legislations and thus fairly respected for all.

[The support of the paediatric nurse in the paediatric emergency rapid response unit]

When a newborn baby is in need of rapid care outside the hospital where the mother has given birth, the nursery nurses work specifically to support the baby during the separation from its parents. They intervene before, during and after the separation of mother and child, particularly during the transfer of the baby to the mobile paediatric emergency and resuscitation unit.

[The caregiver faced with perinatal bereavement]

Being a caregiver in perinatal care means working with others' intimate feelings as well as one's own. Issues surrounding life and death coexist in delivery rooms, causing all those involved to consider the meaning of life and origins. When perinatal bereavement becomes part of the idealised picture of birth, the caregiver becomes the buoy to whom the parents hold on in order not to founder.

[The specificities of perinatal bereavement]

Parents can be faced with a situation of bereavement during pregnancy or birth. It is often during a later pregnancy, an ultrasound scan or a subsequent birth, that some will talk about the loss of a child. These situations resulting in bereavement during pregnancy or perinatal bereavement are specific and all perinatal caregivers must be aware of them.

[The evolution of places of birth]

Since the beginning of the 19th century, medical advances have drastically cut the number of deaths at birth, ensuring a maximum level of safety of childbirth today. However, there is increasing demand for alternative forms of childbirth which take into account more the expectations of the future parents as well as the psychological and relational dimensions. The current experimentation involving birth centres could lead the way for the development of such possibilities from 2018.

[The challenges of preparing for birth and parenthood]

Pregnancy and the birth of a child represents, for the new parents, a radical change in their lives. Access to parenthood involves a physical and psychological reorganisation which requires support. Preparation for birth and parenthood aims to help young parents along this pathway, in order to let them discover their own potential.

[Homebirth, a choice to support]

There are relatively few homebirths in France. They represent around 1% of births. However, more and more women and couples are demanding this choice. Jacqueline Lavillonnière, a midwife for 40 years, practises homebirths. Here, she describes her career and her particular practice in tune with the physiology of birth.

[Newborn care in the delivery room]

The arrival of a newborn in the delivery room is a precious and unique moment which caregivers support by seeing to the comfort and wellbeing of the baby and his or her parents. Developmental care is introduced early, skin-to-skin contact is favoured and invasive treatment is only performed if strictly necessary. At the same time, the teams are ready to intervene in the event of a complication.

[Mother-baby follow-up at home and the welcome of the baby in the family]

Upon discharge from the maternity hospital, the newborn is welcomed not only in a home but also within a family. The postnatal follow-up over the first few weeks can take several forms: a programme to support the return home, hospital at home service or follow-up by a private practice midwife or professionals from the mother and infant welfare protection service. The aim is to meet the needs of the baby, favour the establishment of the parent-baby bond and to support the construction of parenthood.

[Rituals of birth in Senegal]

In a Senegalese society undergoing profound change, holding on to certain beliefs and social and cultural practices can sometimes prove difficult. Prevention and care systems must take into account social and cultural representations in order to support these families as best as possible.

[Promoting developmental care in maternity and neonatal units]

Many professionals are involved in providing holistic care for infants and their family. To this effect, the teams of Tenon maternity hospital in Paris are promoting developmental care. This approach favours the support of the parents and the wellbeing of the baby. This article reflects on the conditions of its implementation.

[Supporting teenage fathers in parenthood centres]

Motherhood centres can cater for teenage couples with their baby. They support their parenthood project and oversee the establishment of solid bonds with their child. This support of the family cell is essential. It comprises specific help for the young man on his first steps towards parenthood.

[From one passing to another, analogies between birth and death]

There are disturbing analogies between the beginning and the end of the life of a child. The hypothesis of a similarity between the birth and the dying process of the child gives rise to discussion around the support provided in the context of paediatric palliative care.

"The Luxurious Daughters of Artificial Life": Female "Delicacy" and Pain in Late-Victorian Advice Literature

The second half of the 19th century marked the rise of obstetrics as a legitimate physician-dominated medical specialty. In this period of transition, distanced from traditional cultures of social childbirth but not yet embracing hospital deliveries, many middle-class North American women turned to prescriptive literature to fill a crucial gap. In the medical advice they directed at young wives and expectant mothers, physicians consistently emphasized the middle-class woman's heightened sensitivity to the pain of giving birth, relying on arguments that resonated with the class, gender, and racial tensions of the late-Victorian period while consistently reaffirming physicians' expanding authority.