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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Keywords ➡  iatrogeny 

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Following Lokumage’s original usage of the term, this paper explores ’obstetric iatrogenesis’ along a spectrum ranging from unintentional harm (UH) to overt disrespect, violence, and abuse (DVA), employing the acronym ’UHDVA’ for this spectrum.

Kylea L. Liese, Robbie Davis-Floyd, Karie Stewart Melissa Cheyney (2021)

Obstetric iatrogenesis in the United States: the spectrum of unintentional harm, disrespect, violence, and abuse. Anthropology and Medicine 28(4):1-17  Display this record
➡ survey ; guidelines ; iatrogeny ; obstetric and gynecologic violence obstetric violence, obstetrical violence




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The main risk factors are obstetric, such as emergency cesarean section and perceived pain during labor, and women’s dissatisfaction with social support.
The main protective factors are: obstetric, including perceived sense of control during labor or satisfaction with partner support.

Chabbert, M., Panagiotou, D., & Wendland, J. (2021)

Predictive factors of women’s subjective perception of childbirth experience: a systematic review of the literature. Journal of Reproductive and Infant Psychology, 39(1), 43-66.  Display this record
➡ c-section/caesarean ; depression, anxiety ; father ; psychology ; public health ; iatrogeny ; obstetric and gynecologic violence obstetric violence, obstetrical violence ; social support ; interventions during childbirth ; interventions before childbirth ; pain ; post-traumatic stress ; midwife




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This audit of obstetrical practices shows that the medical errors committed by the gynecologist-obstetrician or the midwife are repeated from one year to the next: delays in carrying out a caesarean section or a forceps, misinterpretation of the fetal heart rhythm, failure of the midwife calling the obstetrician-gynecologist, and abuse of use of Syntocinon to stimulate uterine contractions.

Me Dimitri PHILOPOULOS (2020)

Avocat de victimes d’erreur médicale lors de l’accouchement et la naissance : les fautes commises dans les maternités par le gynécologue obstétricien et la sage-femme. Blog des avocats, Conseil national des barreaux, Paris.  Display this record
➡ law ; public health ; iatrogeny



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the experience of fathers exposed to their partner’s traumatic childbirth remains unknown. Qualitative study using a questionnaire with 61 fathers from the United Kingdom

Daniels, E., Arden-Close, E., & Mayers, A. (2019)

Be Quiet and Man Up: A Qualitative Study into Men Who Experienced Birth Trauma. BMC Pregnancy and Childbirth  Display this record
➡ depression, anxiety ; father ; psychology ; traumatism ; post-traumatic stress ; iatrogeny ; obstetric and gynecologic violence obstetric violence, obstetrical violence ; social support




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Assisted conceptions are at increased risk of developing maternal and fetal complications – many of which may be underappreciated or indeed overappreciated by those who go on to look after pregnant women.

Alison Richardson Myles Taylor Joo P. Teoh Tulay Karasu (2019)

Antenatal management of singleton pregnancies conceived using assisted reproductive technology. Obstetrics & Gynecology.  Display this record
➡ premature baby ; public health ; iatrogeny ; maternal health ; baby’s health ; IVF in vitro fertilisation




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In association with diagnosis codes indicating obstetric haemorrhage, hysterectomy and RBC transfusion appear to be good candidates for surveillance of maternal morbidity in Europe

Chantry A.A., Berrut S., Donati S., Gissler M., Goldacre R., Knight M., Maraschini A., Monteath K., Morris A., Teixeira C., Wood R., Zeitlin J., Deneux-Tharaux C. (2019)

Monitoring severe acute maternal morbidity across Europe: A feasibility study. Paediatr Perinat Epidemiol.  Display this record
➡ guidelines ; iatrogeny ; postpartum hemorrhage ; hysterectomy ; blood transfusion ; informed consent




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This study provides new and important information on the effects of resuscitation with an intact umbilical cord. The findings of improved SpO2 and higher Apgar score, and the absence of negative consequences encourages further studies with longer follow-up.

Ola Andersson, Nisha Rana, Uwe Ewald, Mats Målqvist, Gunilla Stripple, Omkar Basnet, Kalpana Subedi & Ashish KC (2019)

Intact cord resuscitation versus early cord clamping in the treatment of depressed newborn infants during the first 10 minutes of birth (Nepcord III) – a randomized clinical trial. Maternal Health, Neonatology and Perinatologyvolume 5, Article number: 15  Display this record
➡ iatrogeny ; baby’s health ; fetal distress ; morbidity



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Qualitative study on the obstetric prognosis of women with primary vaginismus. Significant comorbidity of cesarean section and extraction.

Elise Tourrilhes, Marie Veluire, David Hervé, et Erdogan Nohuz (2019)

Pronostic obstétrical des femmes atteintes de vaginisme primaire. Pan Afr Med J. 2019. 32: 160  Display this record
➡ attendance ; c-section/caesarean ; psychology ; iatrogeny ; sexuality ; birth planning birth preparation, birth education ; induction of labor ; post-term pregnancy ; episiotomy ; exams during labor ; instrumental delivery ; epidural ; vaginal examination ; forceps delivery


Malgré la relative insuffisance de consultations sexologiques sur le résultat obstétrical, il s’agit  more…



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Obstetric violence appears to intersect with systems of power and oppression linked to structural gender, social, linguistic and cultural inequities in Sri Lanka.

Perera, D., Lund, R., Swahnberg, K., Schei, B., & Infanti, J.J. (2018)

“When helpers hurt”: women’s and midwives’ stories of obstetric violence in state health institutions, Colombo district, Sri Lanka. BMC Pregnancy and Childbirth, 18(1).  Display this record
➡ history, sociology ; traumatism ; iatrogeny ; obstetric and gynecologic violence obstetric violence, obstetrical violence ; informed consent




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Results confirm said phenomenon to be more wide ranging than it appears through official channels.

Malvasi A., Zaami S., Tinelli A., Trojano G., Montanari Vergallo G., Marinelli E. (2018)

Kristeller maneuvers or fundal pressure and maternal/neonatal morbidity: obstetric and judicial literature review. J Matern Fetal Neonatal Med. 2018  Display this record
➡ ethics ; iatrogeny ; deontology ; risk of litigation ; informed consent ; fundal pressure




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Our judicial review, which includes many American and British court cases, shows that even in an unscarred uterus the use of fundal pressure exposes practitioners to a significant risk of conviction.

Zaami S., Malvasi A., Marinelli E. (2018)

Fundal pressure: risk factors in uterine rupture. The issue of liability: complication or malpractice? J Perinat Med. 2018  Display this record
➡ iatrogeny ; fundal pressure ; risk of litigation




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link established between ani leviator lesion and abdominal expression

Youssef A, Salsi G, Cataneo I, Pacella G, Azzarone C, Paganotto MC, Krsmanovic J, Montaguti E, Cariello L, Bellussi F, Rizzo N, Pilu G (2018)

Fundal pressure in second stage of labor (Kristeller maneuver) is associated with higher risk of levator ani muscle avulsion. Ultrasound Obstet Gynecol. 2018  Display this record
➡ iatrogeny ; fundal pressure ; incontinence/prolapsus




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An article in the online journal Insider that points to the still-too-common “husband’s point“ practice in the United States, a practice that is not approved by ACOG.

Alex Archambault (2018)

A woman says her vagina was sewn tighter after child birth without her knowledge - and it’s more common than you’d think. Insider.  Display this record
➡ iatrogeny ; sexuality ; obstetric and gynecologic violence obstetric violence, obstetrical violence ; pain ; dyspareunia ; scars ; episiotomy ; deontology ; informed consent



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We argue that providing a secure, supportive environment for laboring mothers can reduce the rate of ‘unnecessary’ surgical deliveries.

Rosenberg, K.R. & Trevathan, W.R. (2018)

Evolutionary perspectives on cesarean section. Evolution, Medicine, and Public Health, Volume 2018, Issue 1, 1 January 2018, Pages 67–81.  Display this record
➡ attendance ; c-section/caesarean ; ethics ; history, sociology ; iatrogeny ; evidence-based medicine/midwifery ; physiology ; position during labor ; psychology ; public health ; social support


Few articles argue that a secure, supportive environment would reduce the cesarean rate as it is difficult  more………


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High-quality evidence about low-risk pregnancies indicates that place of birth had no statistically significant impact on infant mortality. The lower odds of maternal morbidity and obstetric intervention support the expansion of birth centre and home birth options for women with low-risk pregnancies.

Vanessa Scarf, Vanessa Scarf, Vanessa Scarf, Chris Rossiter, Chris Rossiter, Saraswathi Vedam, Saraswathi Vedam, Hannah G Dahlen, David Ellwood, David Ellwood, Della Forster, Della Forster, Maralyn J Foureur, Maralyn J Foureur, Helen McLachlan, Helen McLachlan, Jeremy Oats, Jeremy Oats, David Sibbritt, David Sibbritt, Charlene Thornton, Charlene Thornton, Caroline S E Homer (2018)

Maternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: A systematic review and meta-analysis  Display this record
➡ attendance ; iatrogeny ; place of birth ; homebirth ; planned homebirth ; birthing center birthing centers ; evidence-based medicine/midwifery ; physiology ; public health ; obstetric and gynecologic violence obstetric violence, obstetrical violence ; guidelines ; deontology ; informed consent


28 etudes seulement. // Aucune etude, ni la méta-analysee avaient la puissance des statistiques pour  more…



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Children born by spontaneous vaginal birth had fewer short‐ and longer‐term health problems, compared with those born after birth interventions.

Peters, Lilian L., Charlene Thornton, Ank de Jonge, Ali Khashan, Mark Tracy, Soo Downe, Esther I. Feijen‐de Jong, and Hannah G. Dahlen. (2018)

The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population‐based cohort study. Birth.  Display this record
➡ c-section/caesarean ; ethics ; evidence-based medicine/midwifery ; iatrogeny ; newborn care ; public health ; vaginal birth after caesarean ; induction of labor ; instrumental delivery ; vacuum extraction (ventouse)




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Obstetrics is deeply misogynistic. It considers women to be weak, sick, dangerous, with bodies unsuitable for giving birth to children. Therefore, childbirth remains one of the last bastions of male domination.

Marie-Hélène Lahaye (2018)

Accouchement - Les femmes méritent mieux. Ed. Michalon. ISBN : 978-2-84186-876-6  Display this record
➡ history, sociology ; guidelines ; psychology ; public health ; iatrogeny ; obstetric and gynecologic violence obstetric violence, obstetrical violence ; birth plan ; deontology ; informed consent ; post-traumatic stress


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