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Genest Louise

PhD student in Sociology, Paris Descartes University

PhD school, Human and Social Science: Cultures, Individuals, Societies (ED 180)

Contact: louise.genest(at)gmail.com

Thesis defended on 23 November 2015: Early pregnancies and vulnerabilities: Sociological analysis of their significance and of the perinatal policies in effect

Under the supervision of Laurence Simmat-Durand and Alain Ehrenberg

The vulnerabilities of mothers during pregnancy and certain risk factors are described in the international literature as having an impact on the health of the child and future adult. The social and family environment, as well as the parents’ behavior, has consequences on health in adulthood, the development of chronic diseases, and health. The concept of vulnerability was developed by the WHO in 1998, then was set up as a major area of prevention actions in France, like in particular the 2005-2007 perinatal care plan or the preparation for birth and parenthood (préparation à la naissance et à la parentalité – PNP) plan. This latter action uses a new tool called “early antenatal interview” conducted during the fourth month of pregnancy and intended to evaluate the mother’s situation with regard to the various types of vulnerability. Implementation of perinatal policies in France is however geographically diversified and the actions set up are different from one perinatal network to another. Currently and since 2005, an examination (individual and/or as a couple) is proposed to all pregnant women and future parents during the fourth month of pregnancy in order to prepare with them the best possible conditions for the birth of their child. This examination is intended to benefit all women, in particular the most vulnerable or the most isolated. These are notably underage women who are a population affected by social exclusion, precariousness, and a whole series of discriminations, extrinsic (education, place of residence, etc.) or intrinsic (youth, gender, ethnic origin, marital status, etc.).

Our particular focus on very young pregnant women is based on many studies showing that these women make up a population cumulating several vulnerability factors. A survey conducted in 2005 in the Île de la Réunion tends to show that teenage pregnancies are primarily characterized by a major risk of premature birth. In addition, certain recurring social and demographic factors – such as dropping out early from school, absence of occupation, absence of resources, and youth – seem to have a strong influence on the quality of obstetrical follow-up.

This research project will observe vulnerabilities, and more particularly those related to early pregnancy, among pregnant women through the privileged observation tool of the early antenatal interview. It will also analyze how women feel about this early antenatal interview, evaluate whether the care supply meets their expectations, and whether it enables combatting certain forms of discrimination specific to this population.