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  • Title: [Maternity and extreme poverty: the relationship between mothers and midwives].
    Author: Deschamps G, Baumann M, Deschamps JP.
    Journal: Contracept Fertil Sex (Paris); 1987 Nov; 15(11):1105-10. PubMed ID: 12341567.
    Abstract:
    A research team consisting of a female physician and a female sociologist studied the "interface" between the needs and perceptions of impoverished pregnant women who gave birth at a regional maternity hospital in France and the perceptions of the midwives who attended them. The ultimate goal of the study was to shed light on reasons for the extreme vulnerability of very poor women and their infants during pregnancy and delivery. 30 new mothers meeting the criteria of extreme poverty were interviewed at their bedsides and 57 of 97 midwives returned questionnaires. 29 of the 30 pregnant women received regular prenatal care and 26 had their pregnancies diagnosed in the first trimester. 27 of the women received all or part of their prenatal care at the maternity hospital. The 3 women receiving all their prenatal care from private physicians averaged 5 consultations each, while the 16 receiving all their care from the hospital averaged 8.3 visits each. The number of health professionals seeing each woman varied from 2-9, not counting hospitalizations. 20 of the 30 women were hospitalized a total of 43 times. 2 other women refused hospitalization. 3 of the mothers stated that prenatal visits were useless and 8 stated that they had derived no benefit from the visits. 16 stated they were disturbed by seeing so many different health workers. 16 said they had some good experiences during the visits. 10 reported they had had "bad moments" resulting from the unpleasant general ambience, the dry and unfriendly attitude of the health workers, long waits, and the succession of workers. Lack of communication, the absence of moral support, and the feeling of being negatively judged were other complaints. 63% of the midwives believed the very poor women were indifferent to their pregnancies, and only 26% believed they were happy to be expecting babies. Only 21% believed they sought regular prenatal care, and 75% believed their care was haphazard. 30% of the midwives believed the women found the visits boring or useless. 44% of the midwives believed the very poor women saw more health workers than other women, but 60% felt they did not object to seeing so many workers. The feelings and attitudes attributed to poor women by the midwives did not correspond to the perceptions of the poor women themselves. Health improvements for newborns in situations of poverty may require a better fit between the needs of the mothers and what the health care system offers.
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