[Prenatal vulnerabilities, ethical issues of prevention: French regional practice survey]

OBJECTIVE: Some prenatal situations may be characterized as concerning on the medico-psycho-social level, leaving a risk of danger to the unborn child, raising different issues between prevention and protection, legal and justified. The objectives were to evaluate the professionals’ perceptions with respect to the most worrying prenatal situations, to assess the practices of care, and to identify potential measures for improvement. METHOD: The research was based on a qualitative-quantitative methodology: Semi-directed interviews with experts who allowed the construction of a questionnaire, validated according to a Delphi-type methodology, and a regional survey based on the questionnaire, which was directed to the maternities and the departmental councils. RESULTS: The participation rate was 69%. The survey revealed a willingness to create regional perinatal partnerships, an awareness of ethical issues (information sharing, conflict of values, ethics of Care, vulnerability…), and a lack of knowledge of the regulatory framework (legal, ethical). Different possibilities of improvement have been proposed. CONCLUSION: Simultaneously, this study participates in the observatory missions of the ethical committee, as well as in public policies of perinatal prevention.