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Open Access From Braxton Hicks to Preterm Labour: The Constitution of Risk in Pregnancy Des contractions de Braxton-Hicks à l'accouchement prématuré : la constitution du risque pendant la grossesse

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With the recent introduction of preterm birth prevention programs there has been a shift in our understanding of what the presence of contractions during pregnancy means and a reconstituting of risk in ways that position increasing numbers of women at risk for preterm birth. This paper highlights the findings of a study exploring the influences of risk discourses on women's experiences of preterm labour. The primary goals of this institutional ethnographic study were to describe the effects of societal discourses, institutional structures, and nursing work processes on the everyday lives of childbearing women experiencing preterm labour. The findings suggest that risk discourses exert social control over pregnant women and result in fear, guilt, feelings of being judged or punished, and an overwhelming sense of personal responsibility for preventing preterm birth. The study also exposes ways in which biomedical constructions of risk and preterm labour affect the organization of health services, including nursing practice.

French
L'introduction récente de programmes de prévention des accouchements prématurés a modifié notre perception du phénomène des contractions survenant pendant la grossesse. Elle a aussi donné lieu, en matière de reconstitution des risques, à une approche qui tend à faire augmenter le nombre de femmes considérées à risque d'accouchement prématuré. Cet article présente les résultats d'une ethnographie institutionnelle menée dans le but d'analyser l'influence des discours sur le risque sur l'expérience des femmes qui accouchent prématurément. L'étude visait notamment à décrire l'effet des discours sociaux, des structures institutionnelles et des interventions infirmières sur la vie quotidienne de ces femmes. Les discours sur le risque exercent un contrôle social sur les femmes enceintes, selon les auteures. En effet, ils alimentent la crainte et la culpabilité, l'impression d'être jugée ou punie et le sentiment d'être personnellement investie de la responsabilité de prévenir un accouchement prématuré. L'étude fait aussi ressortir l'influence des constructions biomédicales du risque et de l'accouchement prématuré sur l'organisation des services de santé, dont la prestation des soins infirmiers.

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Keywords: DISCIPLINING EFFECTS; DISCOURSE; INSTITUTIONAL ETHNOGRAPHY; PRETERM LABOUR; RISK

Document Type: Research Article

Publication date: 2006-06-01

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