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Les pratiques médicales lors de l’accouchement: comparaison France-Canada

Medical practice during delivery: a comparison between France and Canada

Revue de médecine périnatale

Résumé

L’objectif de cet article est de comparer les pratiques obstétricales entre la France et le Canada et d’évaluer l’éventuel impact de ces différences sur la santé maternelle et périnatale. Nous avons plus particulièrement comparé les pratiques lors du deuxième stade du travail non compliqué. Les recommandations françaises proposent de limiter la durée totale du deuxième stade à deux heures et de limiter la durée des efforts expulsifs à trente minutes, alors que cette limite n’est pas proposée au Canada. En France, on recommande le monitorage fœtal continu pendant le travail, alors que l’auscultation intermittente est conseillée, sous certaines conditions, au Canada. La pratique d’une épisiotomie est encore beaucoup plus fréquente en France qu’au Canada, bien que les deux pays recommandent une utilisation restrictive de cette intervention. Enfin, le nombre et le rôle des sages-femmes sont très différents entre les deux pays, avec une intégration beaucoup plus importante des médecins et des sages-femmes en France et une autonomie complète des sages-femmes au Canada.

Abstract

The purpose of this article is to compare the obstetric practices current in France and Canada and evaluate the possible impact of these differences on maternal and perinatal health. We compared more particularly the practices during the second stage of uncomplicated labor. French recommendations advise limiting the total duration of the second stage to two hours and the duration of active pushing to 30 minutes, whereas no limit is recommended in Canada. In France, continuous fetal monitoring during labor is recommended, whereas intermittent auscultation is advised, in certain cases only, in Canada. Episiotomies are still performed much more frequently in France than in Canada, although the two countries recommend a restricted use of this intervention. Finally, the number and role of midwives are very different in the two countries, physicians and midwives working together much more in France, whereas midwives enjoy total autonomy in Canada.

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Correspondence to F. Audibert.

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Le Ray, C., Audibert, F. Les pratiques médicales lors de l’accouchement: comparaison France-Canada. Rev. med. perinat. 1, 61–65 (2009). https://doi.org/10.1007/s12611-009-0014-7

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  • DOI: https://doi.org/10.1007/s12611-009-0014-7

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