[Support for the mother-child relationship during total denial of pregnancy: Midwives' point of view].

Abstract

Objectives: Total pregnancy denial is a phenomenon where the woman does not recognize her pregnancy until a late stage, sometimes just before childbirth. These complex situations raise many questions about the support of the mother-child dyad. This qualitative study aims to describe the experiences and strategies of midwives when dealing with cases of total pregnancy denial, as well as the relational dynamics within these particular dyads, in order to identify avenues for appropriate care.

Methodology: Eight semi-structured interviews were conducted with midwives practicing in Île-de-France (hospital, private practice, home hospitalization, and maternal and child protection services). The data were analyzed using grounded theory with the help of the Quirkos software.

Results: The midwives' experiences show that the mother-child relationship evolves favorably in most cases, even in anonymous childbirth situations. The results are organized into several themes: the description of the mother-child relationship, the proposed care approaches, and the midwives' experiences. For the first theme, five sub-themes emerged: maternal investment, psychological ambivalence, childbirth circumstances, the influence of the social environment, and maternal guilt. The second theme highlights the importance of multidisciplinary and personalized support, respecting the pace of the dyad.

Conclusion: This study emphasizes the importance of not stigmatizing women in total pregnancy denial when establishing the mother-child bond. A personalized and gradual care approach, based on empathetic, non-judgmental, and multidisciplinary support, fosters the mother-child bond.