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Biomedical subjects

M Garel

Publications and source records attributed to M Garel.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Psychological effects of embryonal reduction. From the decision making to 4 months after delivery].

The psychological effect of reducing the number of embryons was studied prospectively in two Paris hospitals. All women who had multifetal pregnancy reduction (n = 18) were contacted for interviews just after the operation, during pregnancy, and four months after delivery. The decision to reduce the number of embryons was painful and led to a guilty feeling. After operation, nearly one-half of the women suffered psychologically. To justify their decision, and contain their emotions, the women spoke of the problems related to having triplets and, most importantly, the medical arguements explained by the physician. Medical counselling is thus essential to help this couples at the time of the operation. The pregnancy period is almost always a period of calm for these women. Nevertheless, four months after delivery, 5 women expressed a psychological malaise related to the reduction, and 2 women refused to continue the study because they did not want to revive their suffering. This study shows that psychological problems are of major importance after multifetal pregnancy reduction and can occur several months after delivery. These negative conclusions should however be examined in light of the consequences if reduction had not been performed.

Adult↗
PubMed1994

[Two-year follow-up cohort studies on triplets: development of children and mother-child relationship].

BACKGROUND: The number of triplets births has increased during the last 15 years. The psychomotor development of triplets, problems concerning long-term relationships between the mother and her children and between the children themselves are still incompletely studied. PATIENTS AND METHODS: Eleven families with triplets, consecutively born at the Clinique Baudelocque, were assessed at home for 2 years by the same psychologist. IQ was measured in each child at the age of 2 years using the Brunet-Lezine test. At this age, all mothers completed the Symptom-Check List allowing to assess eventual relationship difficulties between the mother and their children. RESULTS: The psychomotor development of the children (IQ = 100) was similar to the mean score in the general population. The mother reported great physical fatigue during the first year after birth and psychological difficulties during the second year. They mentioned behavioral problems and difficult relationships among the triplets. They complained of not being able to fulfill the children's demands. In four families, more severe difficulties, potentially damaging the psychological well-being of the children, required an intervention during the survey. CONCLUSIONS: Improved and prolonged help to families with triplets is necessary, requiring the participation of pediatricians, nurses, psychologists, social workers and specialized people.

Child Development↗
PubMed1994

[Follow-up of mothers of triplets 2 years after delivery. Results of a longitudinal study].

The aim of the study was to assess the health of mothers of triplets, two years after delivery. As part of a longitudinal study, 11 mothers having delivered consecutively in clinique Baudelocque were interviewed at home. They reported considerable fatigue and stress. Four women suffered with anxiety and depressive symptoms and three of them used psychotropic medication. Considering the possible consequences of maternal depression upon the child development, one third of the children in the study are particularly at risk. These results showed that the difficulties experienced by mothers of triplets persisted and remained important even under favourable medical and social circumstances.

Child Development↗
PubMed1992

Assessment at 1 year of the psychological consequences of having triplets.

The purpose of this study was to assess the psychological difficulties encountered by mothers 1 year after the birth of triplets. Twelve mothers entered the study having delivered triplets in a public hospital in Paris. Nine pregnancies had been initiated after in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT), two after ovarian stimulation and one was spontaneous. The method consisted of tape-recorded semi-structured interviews at the mothers' homes. At 1 year, a majority of mothers reported considerable fatigue and stress. In most cases, home help was no longer provided by social services or by relatives. A majority suffered from social isolation and had difficulties in going out because of a lack of help, and inquisitive looks and questions from other people. Most mothers said that having triplets placed a strain on the marital relationship. The relationship with the children was often disturbed. Mothers reported that it was difficult to give adequate attention to the three children at the same time. Most of them tended to become emotionally detached. Eight mothers expressed psychological difficulties and three of them were treated for depression. Families with triplets should be provided with increased help, special attention, counselling and support, either at home, in clubs or in special clinics.

Emotions↗
PubMed1990

Psychosocial consequences of caesarean childbirth: a four-year follow-up study.

This paper describes the last part of a study on the long-term psychosocial consequences of caesarean delivery. One group of 103 primiparous caesarean delivered women and one control group of 103 women delivered vaginally were followed from delivery to the children's fourth birthday. Previous assessments were made at birth, two months and one year later (Garel, M., Lelong, N. and Kaminski, M. (1987) J. Psychosom. Obstet. Gynecol., 6, 197-209 and (1988) Early Hum. Dev., 16, 271-282). Four years after delivery, 58 mothers of the caesarean group and 50 mothers of the control group returned a completed questionnaire. The questionnaire included questions about subsequent pregnancies and mother's and child's general state of health. The comparisons between respondents and non-respondents showed no significant difference with regard to social and medical factors. As far as possible, factors which might have interfered with the mothers' and children's conditions were controlled in the analysis. There was no association between the method of delivery and the mother's overall state of health. However, after a caesarean section, mothers tended to have fewer children and more difficulty in conceiving. Four years after delivery, mothers in the caesarean group reported fatigue more frequently than control mothers. Five mothers (9%) consulted a psychiatrist, none in the control group (P less than 0.09). Between one and four years, caesarean born children had more hospital admissions but their overall behaviour and development, as reported by the mothers, was not different from those of children in the control group.

Cesarean Section↗
PubMed1990

[Maternal consequences of cesarean delivery. Results of a 4-year follow-up].

This study is of a 4-year follow-up of two groups of mothers, the first having had caesarean operations and the second vaginal deliveries. We have already published studies of the results after delivery, after two months and after one year. The purpose of this 4-year follow-up after delivery is to determine the effects of caesarean operation on the numbers of future pregnancies and their results and to look at the long-term consequences for the physical and psychological health of the mothers. Fifty-eight mothers who had had caesarean operations and fifty mothers as controls replied to a postal questionnaire. The response level was 52%. From the social and the medical point of view there was no significant difference between those who replied and those who did not. The results indicate that mothers who had had a caesarean operation were less likely to have another baby or did so in lower numbers. They further had more difficulty in conceiving another pregnancy than did the control mothers (the differences were not statistically significant). After four years they were often more tired than the others, apart from objective medical and social differences. The use of health services was not linked to the method of delivery, but 9% of women who had had a caesarean consulted a psychiatrist in the last three years but none of the controls did. The replies show that caesarean section contributed to or re-awoke a labile psychological state. The data do not make it possible for us to say that women who had had a caesarean operation had particular psychological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean Section↗
PubMed1988

Follow-up study of psychological consequences of caesarean childbirth.

This study was the follow-up part of a survey of psychosocial consequences of caesarean delivery (J. Psychosom. Obstet. Gynecol., 6 (1987) 197-209). Two groups of primiparous mothers were compared, one group of 103 mothers delivered by caesarean section and one control group of 103 mothers delivered by vaginal delivery. Semi-structured questionnaires were mailed at 2 months and 1 year after birth to explore the mothers' physiological and psychological condition and mother-infant adaptation. At 2 months, 92 mothers in the caesarean section group and 84 mothers in the control group returned a completed questionnaire. At one year there were, respectively, 79 and 71 in each group. The data indicated that the most obvious long-term psychological ill-effects of caesarean delivery appeared to be on mothers. They more often reported psychosomatic symptoms during first year than controls. At 2 months the concerns of caesarean mothers seemed more self-oriented than in the control group. They also felt less confident about their abilities to care for their babies. At 1 year these differences disappeared. Signs of disturbance in mother-infant interaction were not linked to the mode of delivery either at 2 months or at 1 year. The influence of the mode of anaesthesia for surgical delivery was also examined. The positive consequences of epidural analgesia which were observed are discussed taking into account the role of confounding variables.

Adaptation, Psychological↗
PubMed1987

[Consequences of peridural analgesia for the Cesarean experience and initial mother-child relations].

Semi-directed interviews were conducted with 103 primiparous women between the 3rd and the 6th day after delivery to compare the effects of the two methods of anaesthesia on the way they experienced caesarean operation. Analysis of the contents of the interviews show that the mothers who had caesarean operation under general anaesthesia were more often depressed than those who had an epidural. Overall, the experience of delivery was more satisfying when the caesarean took place under an epidural because it enabled the mother to take part in the delivery. The mothers who were unconscious because they had a general anaesthetic felt sorrow that they deprived of the experience of the delivery. All the same, it must be said that one-third of the women felt ill-at-ease owing to delivery under epidural, both physically and psychologically. The first contacts with the infant are earlier and less disagreeable after epidural analgesia, but in the days following the delivery the interactions between mother and baby and the comments the mothers make about their child do not differ markedly whichever form of anaesthesia has been used.

Anesthesia, Epidural↗
PubMed1983

[Early discharge of women after delivery. Results of an opinion survey among patients and unit personnel].

Women's and maternity staff's opinion about early discharge and home care after hospital delivery was studied in 1981 in an university clinic; 100 pregnant women and 100 newly delivered mothers filled in a questionnaire, the former during an antenatal visit, the latter during their stay in hospital after delivery; and so did all the staff of the maternity unit. We found that 28% of pregnant women, 22% of newly delivered mothers and 25% of maternity staff were in favour of a short stay in hospital after delivery followed by home care. The main reasons for disapproving a short postnatal stay were medical safety, need for rest and fear of being alone with the baby. For the women approving of early discharge the best duration of hospital stay was 2 or 3 days. Rather more doctors, head nurses and midwives than nurses, auxillary nurses and ancillary staff approved a short stay in hospital after delivery. It seems that the opinion of the maternity staff was not linked to changes in working conditions that this new organization would introduce. We consider that the women's preference should be given priority in deciding early discharge after delivery, when there is no medical contra-indication. Home care could be a useful transition between hospitalization and being alone at home; for instance health visitors could give advice about breastfeeding, infant care and birth control. But before generalizing this type of care it would be important to evaluate the medical, economic and psycho-social consequences.

Female↗
PubMed1982

[Epidural analgesia. Women's viewpoint].

To study women's views on epidural analgesia, three groups of primiparous women were compared. In the first group (41 women), they were given epidural analgesia, after having asked for it during pregnancy. In the second group (79 women), epidural analgesia was given during labour although it had not been planned during pregnancy. The third group included 60 women who underwent labour and delivery using the preparation for childbirth technique alone. The data showed differences between the three groups from medical and social points of views. Women in the first group were of a higher social status than the others; they had been more often admitted to hospital during their pregnancy. Women of the second group more frequently explained that they had psychosocial problems during pregnancy. Furthermore, women who had planned an epidural explained that their choice was mainly due to anxiety. On the other hand the majority of women were rather hostile to this technique. Even though women pointed out the physical and psychological relief due to epidural analgesia, there was no obvious difference in maternal satisfaction between the three groups. Maternal satisfaction with the birth experience was related rather to the moment when the epidural analgesia had been decided on, before or during labour, to the attitude of the medical staff and to the hospital standards for labour and delivery. Advance planning of an epidural analgesia also appeared to be insufficient to keep control of the whole process of childbirth and particularly of its psychological meanings. The study showed that even with a perfect technique, epidural analgesia is not the only possible answer to women's anxiety.

Analgesics↗
PubMed1982

[Forms of care, health evaluation at 10 months, and maternal behavior].

The purpose of this survey was the comparison of 4 forms of day care: day care center, baby minder, care at home by the mother herself or care at home by someone else. A sample of 1,010 children, born to French mothers in a public hospital in Paris, was examined at a check-up clinic organized by National Social Security for 10 months old children. Home care by the mother herself was more frequent for mothers with primary level education or for families with 2 children or more; care at home by someone else was often chosen by families with high social level. The health and psychosocial and motor development of the children were not very different according to the type of day care. There was a higher frequency of acute respiratory tract infections and a lower weight gain for children in day care centers. Mothers whose children went to a day care center were more anxious about medical symptoms and more often called for a doctor.

Body Weight↗