Prenatal diagnosis and foetal medicine : From medical practice framework to the anticipation of disability. Comparison between France and Brazil ; Diagnostic prénatal et médecine fœtale : Du cadre des pratiques à l'anticipation du handicap. Comparaison France-Brésil ; Diagnóstico pré-natal e medicin...
In search of modes of anticipating disability, this thesis examines and compares prenatal diagnosis (PND) practices in France and Brazil. In Europe and North America, PND has developed directly in line with legislation on abortion and is rooted in the monitoring of pregnancy, as one of the ways of preventing disability at birth. Its expansion into countries where access to abortion is restricted, is led by the globalization of knowledge and techniques, and has to be adapted to suit local regulations. Regulatory frameworks govern professional work (networking, multidisciplinarity) and the recording of PND practices (omnipresent in France, non-Existent in Brazil). As can be seen from our analysis of semi-Directive questionnaires given to two groups of women at two different periods of time, in France such mechanisms modulate the experiences of women who have undergone an abortion due to a foetal pathology. In 1999 women wanted greater autonomy when deciding whether or not to terminate a pregnancy. In 2005 they were more readily in favour of sharing decision-Making with doctors, but felt that the decision was theirs to make when it was a question of late-Term pregnancies, of situations with a risk of mental retardation, of major prognostic uncertainty, and of situations subject to specific tests during the prenatal period (such as Down's Syndrome). These regulatory mechanisms also affect how technical tools are used and the information given to couples. In Brazil, in a context of restricted access to abortion and of very significant social inequality, an ultrasound in a situation of foetal normality glorifies the "anticipated social birth" of the child and its family. When a foetal anomaly is diagnosed, a radical rupture occurs. In public hospitals – used by the majority of women – obligatory continuation of pregnancy regulates doctors' attitudes: the ethnographic study carried out in Rio de Janeiro shows that obstetricians have opted for the education of women (in the hope of gradual access to autonomy, hopefully ...