La grossesse et l'accouchement à l'ère de la biotechnologie: l'expérience de femmes au Québec

The processes of pregnancy and childbirth even though they are biological, are nonetheless shaped by culture and society. The technology associated with these events has increased alongside the social movements for the demedicalisation of birth and reappropriation of maternity by women, thus transforming their expectations and the way in which they experience them. In an era where biotechnology is more and more present, women's experiences are undergoing profound change. They approach pregnancy with representations that they have formed over time from their family and social environments. It could be expected that over the months, their experience is shaped and it affects childbirth. In a context where biomedical technology occupies a predominant place, we tried to understand how women experience their pregnancy and childbirth. To this end, we wanted to identify the representations women have regarding pregnancy and childbirth, what they know in concrete terms, their experience, practices surrounding childbirth, and how their experience itself sheds light on the comparison between sense and action.  This questioning gave rise to qualitative and inductive research. Emanating from narrative-type discussions, answers were gathered from 25 future mothers at three different times during their experience: during their pregnancy (twice) and after childbirth (once). These answers were supplemented by a logbook of their account of childbirth. Women from Quebec, living in both urban and rural environments were invited to express their views. Both their pregnancy care (ensured either by physicians or midwives) and place of childbirth (hospital, birthing centre, home) were varied. The analysis is based on a contextualized phenomenological reference framework from an interdisciplinary viewpoint, in keeping with anthropological, sociological and philosophical studies regarding pregnancy and childbirth care. It sheds detailed contemporary light on women’s experiences by placing them within the context of interactions in which they occur.  Generally, women begin their quest for motherhood in their early thirties. As soon as they know they are pregnant, women choose the professional who will follow them in accordance with where they want to give birth: the hospital, birthing centre or home. The need for reassurance is very strong. To meet this need, they turn to technology. Screening tests and examinations are available to and used by all women during their pregnancy, no matter what type of follow-up they choose. The family, and more specifically the mother, as well as family and friends and the media play an important role in the building of representations strongly influenced by medicalisation. However, women’s rhetoric polarizes and their practices differ regarding childbirth. Spontaneously, they consider three possible ways of giving birth: natural, with epidural or by Caesarean section. Their expectations and the amount of control they believe they have, their self-confidence and relationships with the various intervenors shape their experience. The medical environment and technology modify the childbirth process and contribute to creating experiences that are sometimes disturbing for women, leaving permanent marks.  This thesis helps us to better understand the experiences of pregnant women and new mothers and to identify social and cultural representations pertaining to these experiences. It covers the preparation of motherhood, documents subjectivities and turning points in the development of representations, expectations and hopes nurtured by women, their knowledge, practices, view of technology as well as their pregnancy and childbirth experience in various care contexts, as well as the meaning women give to this experience.

Keyphrases: Culture, Socio-anthropologie, Sage-femme, Pregnancy, Childbirth, Birth, Experience, Phenomenology, Culture, Social representation, Social anthropology, Anthropology, Sociology, Feminism, Psychology, Biotechnology, Technology, Medicalisation, Perinatal, Obstetrics, Midwifery, Woman, Quebec