Anne-Sophie Pilarski's thesis defense

Ms Anne-Sophie PILARSKI publicly defended her thesis entitled " La profession maïeutique ou l'art du risque mesuré. Une sociologie du gouvernement des grossesses en France", directed by Mr Laurent Visier and Mr François Buton, on Friday December 13, 2024 at 9:00 am, at the Montpellier Faculty of Law and Political Science, Salle Justitia.

Composition of the proposed jury

Mr Laurent VISIER - University of Montpellier - Thesis supervisor

M. François BUTON - CNRS ENS de LYON - Thesis co-supervisor

Mr Philippe CHARRIER - Nantes University - Rapporteur

Mrs Priscille SAUVEGRAIN - Sorbonne University - Rapporteur

Mrs Laura MICHEL - University of Montpellier - Examiner

Ms Anastasia MEIDANI - University of Toulouse - Jean Jaurès - Examiner

Keywords: maieutic profession, prenatal monitoring, professionalization, empowerment, technicization, care/cure

Summary:

This sociological investigation of the work of midwives in the context of prenatal surveillance in France sheds light on the mechanisms of professional appropriation of this activity. The methodological approach, rooted in a multi-dimensional perspective, combines contributions from the sociology of work and professions and public action "from below", based on a multi-sited ethnographic approach. A socio-historical analysis of the profession since the 18th century reveals a non-linear trajectory, alternating between expansion and jurisdictional restrictions. After consolidation in the 19th century, the 20th saw an erosion of prerogatives in favor of emerging medical specialties. The beginning of the 21st century saw a reappropriation of competencies, against a backdrop of medical demographic tension and collective mobilization. The professional identity of midwives is characterized by an interstitial position between cure/care and medical/paramedical. Bureaucratization and the development of research in midwifery are seen as legitimizing strategies. The study of midwife-patient interactions, through the concept of agency, shows how professional evolution favors the empowerment of users. Proximity" emerges as a characteristic trait, attenuating expert-profane asymmetry. Analysis of practices reveals a cure/care articulation and a critical integration of probabilistic reasoning and technicization. The prudential nature of the activity is underlined, characterized by adaptation to singularities and fine-tuned risk management, positioning midwives as professionals of vulnerability rather than mere guarantors of physiology. The contributions of this research include analysis of the specific position of midwives in the professional ecology of the healthcare system, examination of the extension of their jurisdiction, and their nuanced approach to the technicization of care. This study contributes to shedding light on the dynamics of transformation in the healthcare professions, and highlights the relevance of apprehending the maieutic profession as an analytical prism for contemporary public health issues and the reconfiguration of the medical field.