{"id":893,"date":"2022-05-25T09:45:12","date_gmt":"2022-05-25T07:45:12","guid":{"rendered":"https:\/\/afman.fr\/?p=893"},"modified":"2022-12-08T11:54:36","modified_gmt":"2022-12-08T10:54:36","slug":"toucher-vaginal-pas-obligatoire","status":"publish","type":"post","link":"https:\/\/afman.fr\/index.php\/2022\/05\/25\/toucher-vaginal-pas-obligatoire\/","title":{"rendered":"Le saviez-vous ? Le toucher vaginal pendant l&#8217;accouchement n&#8217;est pas obligatoire&#8230;"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"893\" class=\"elementor elementor-893\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-cedf9f7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"cedf9f7\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-99e6fcc\" data-id=\"99e6fcc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d56df35 elementor-widget elementor-widget-text-editor\" data-id=\"d56df35\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.11.1 - 15-02-2023 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#818a91;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#818a91;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<article class=\"magic-content prose md:prose-md dark:prose-invert max-w-none my-6\"><h3>Le saviez-vous ? Le toucher vaginal pendant l&#8217;accouchement n&#8217;est pas obligatoire&#8230;<\/h3><p>Le toucher vaginal est un examen m\u00e9dical visant d\u2019abord \u00e0 v\u00e9rifier, avant le terme, la tonicite\u0301, la longueur et l\u2019ouverture du col, ainsi que la pr\u00e9sentation foetale. Puis, pendant l\u2019accouchement, il est r\u00e9alis\u00e9 pour \u00e9valuer l\u2019avanc\u00e9e du travail.<\/p><p>Dans notre soci\u00e9t\u00e9, cet acte est la norme, un rituel qui fait partie int\u00e9grante de l\u2019accouchement, \u00e0 intervalles r\u00e9guliers. Bien qu\u2019il reste important dans certains cas, comme en cas de saignements anormaux pour en d\u00e9terminer la provenance, le toucher vaginal ne doit pas \u00eatre syst\u00e9matique.<br \/>Il doit toujours \u00eatre soumis au consentement, et peut \u00eatre refus\u00e9 (loi Kouchner 2002) ou diff\u00e9r\u00e9. D\u2019ailleurs, cet examen ne se pratique m\u00eame pas dans certains autres pays.<\/p><p>Gardons \u00e0 l\u2019esprit que le toucher vaginal n\u2019est pas un acte anodin. Il s\u2019agit d\u2019un geste intrusif, qui sort la femme de sa bulle, qui peut s\u2019av\u00e9rer anxiog\u00e8ne, d\u00e9sagr\u00e9able, voire douloureux, et qui comporte certains risques, comme la rupture pr\u00e9matur\u00e9e des membranes\u00a0<em>(1)<\/em>\u00a0ou un risque infectieux\u00a0<em>(2)<\/em>.<\/p><p>De plus, l\u2019examen vaginal n\u2019est pas tr\u00e8s fiable : l\u2019estimation est correcte dans 48 \u00e0 56% des cas, et cette pr\u00e9cision diminue au fur et \u00e0 mesure que le travail progresse\u00a0<em>(3)<\/em>. En d\u2019autres termes, le toucher vaginal estime la dilatation du col \u00e0 l\u2019instant T mais ne permet absolument pas de pr\u00e9voir le d\u00e9roul\u00e9 du travail.<\/p><p>En effet, le col peut \u00eatre totalement ferm\u00e9 la veille de l\u2019accouchement, et le travail \u00eatre finalement rapide.<br \/>Le col peut \u00eatre dilat\u00e9 \u00e0 2 cm apr\u00e8s 12 heures de travail, puis passer \u00e0 dilatation compl\u00e8te en 1 heure.<\/p><p>Si l&#8217;examen vaginal par un professionnel vous rassure sur le bon d\u00e9roul\u00e9 des \u00e9v\u00e9nements, c&#8217;est ok. Mais si cela vous rend inconfortable et vous d\u00e9connecte de vos instincts, vous \u00eates toujours en droit de refuser.<\/p><p><em>Sources<br \/>(1) Lenihan, J. P. 1984. \u00ab Relationship of Antepartum Pelvic Examinations to Premature Rupture of the Membranes \u00bb. Obstetrics and Gynecology 63 (1): 33\u201137.<br \/>(2) Marowitz, Amy, et Heather Hunter. 2004. \u00ab Management of Ruptured Membranes at Term \u00bb. Journal of Midwifery &amp; Women\u2019s Health 49 (6): 539\u201141<br \/>(3) Phelps, J. Y., K. Higby, M. H. Smyth, J. A. Ward, F. Arredondo, et A. R. Mayer. 1995. \u00ab Accuracy and Intraobserver Variability of Simulated Cervical Dilatation Measurements \u00bb. American Journal of Obstetrics and Gynecology 173 (3 Pt 1): 942\u201145.<\/em><\/p><p><strong><em>Cindy Jbt<br \/>En Co-Naissance<\/em><\/strong><\/p><\/article><div class=\"flex-none flex-centered w-full p-6 mx-auto\">\u00a0<\/div>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Le saviez-vous ? Le toucher vaginal pendant l&#8217;accouchement n&#8217;est pas obligatoire&#8230; Le toucher vaginal est un examen m\u00e9dical visant d\u2019abord \u00e0 v\u00e9rifier, avant le terme, la tonicite\u0301, la longueur et l\u2019ouverture du col, ainsi que la pr\u00e9sentation foetale. Puis, pendant l\u2019accouchement, il est r\u00e9alis\u00e9 pour \u00e9valuer l\u2019avanc\u00e9e du travail. Dans notre soci\u00e9t\u00e9, cet acte est &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/afman.fr\/index.php\/2022\/05\/25\/toucher-vaginal-pas-obligatoire\/\"> <span class=\"screen-reader-text\">Le saviez-vous ? Le toucher vaginal pendant l&#8217;accouchement n&#8217;est pas obligatoire&#8230;<\/span> Lire la suite\u00a0\u00bb<\/a><\/p>\n","protected":false},"author":1,"featured_media":1029,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"categories":[24],"tags":[12,39,38],"class_list":["post-893","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-accouchement","tag-accouchement","tag-examen-medical","tag-toucher-vaginal"],"featured_media_urls":{"thumbnail":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre-150x150.jpg",150,150,true],"medium":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre-300x149.jpg",300,149,true],"medium_large":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"large":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"1536x1536":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"2048x2048":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"portfolio_item-thumbnail":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"portfolio_item-masonry":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"portfolio_item-thumbnail_cinema":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"portfolio_item-thumbnail_portrait":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false],"portfolio_item-thumbnail_square":["https:\/\/afman.fr\/wp-content\/uploads\/2022\/05\/ventre.jpg",450,223,false]},"_links":{"self":[{"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/posts\/893","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/comments?post=893"}],"version-history":[{"count":8,"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/posts\/893\/revisions"}],"predecessor-version":[{"id":1032,"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/posts\/893\/revisions\/1032"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/media\/1029"}],"wp:attachment":[{"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/media?parent=893"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/categories?post=893"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/afman.fr\/index.php\/wp-json\/wp\/v2\/tags?post=893"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}