Contents
What is the fourth month interview?
The fourth month interview was introduced in the perinatal calendar in 2006. The purpose of this optional meeting with our doctor is to inform us about our pregnancy and childbirth. But also to listen to us and refer us to professionals in the event of medical or social concerns.
THE4th month maintenance was introduced by the 2005-2007 perinatal plan, whose objective was to increase “humanity, proximity, security and quality” in the support of pregnant women. Objectives underpinned by the desire to accelerate the prevention of psychoaffective developmental disorders in children, by involving women and couples from pregnancy on in a process of prevention, education and guidance. Established in 2006, this meeting, which is not a medical examination, but an informal discussion, is in addition to the seven compulsory prenatal visits. Systematically offered during the first prenatal visit, however, this interview remains optional.
When does the fourth month interview take place?
It normally takes place at the end of the first trimester of pregnancy, but can be performed later if, for reasons of personal organization, it could not be planned for the 4th month. Sometimes taken care of by a doctor, it is most often led by a midwife from the maternity ward, from the PMI, or by a liberal midwife of our choice. As part of a global support, this interview is part of the simple continuity of meetings, often longer, between the woman and the midwife. It concerns the future mother alone, or else accompanied by the future father. The maintenance of the 4th month is covered 100% by Social Security.
What does the 4th month maintenance consist of?
The purpose of the 4th month interview is to allow us to freely discuss all the questions we have about pregnancy monitoring, preparation for birth, childbirth, breastfeeding, reception and newborn care, after-births… It can also help us to establish a birth plan. The practitioner will also provide us with information on the social benefits to which we can claim (birth premium, allowance for single parents, family allowances, household help, etc.) or on labor legislation.
In accordance with its purpose of screening for psychological difficulties or dependency, this interview also allows the doctor or midwife to list our personal and family history, and to identify any psychological or social vulnerabilities. Indeed, some mothers, already fragile during pregnancy, may be victims of postnatal depression after the birth of their child. This phenomenon affects 10 to 20% of women. The objective of the 4th month interview is also to anticipate this type of problem.
Finally, from a more practical point of view, this consultation presents the network of professionals (general practitioners or specialists, liberal midwives or midwives, social workers, associations …), which can be used in case of concern. We can confidently confide in the practitioner who receives us: he is there to inform us and, if necessary, to help us. Of course, he is subject to medical confidentiality: what he is told will not come out of his office.
For whom is this interview particularly recommended?
Certain profiles of expectant mothers, considered to be more vulnerable, are targeted as a priority by this preventive interview.
- Moms-to-be with a badly experienced obstetrical history (previous pregnancy or complicated or painful birth);
- those living with relationship-type problems, in particular in their relationship; victims of domestic violence, especially domestic violence; women suffering from stress or intense anxiety about their pregnancy and childbirth …
- Women isolated or stricken by precariousness (employment, housing); those who have to deal with a sudden change in their family situation (rupture, death, illness, unemployment);
- Finally, pregnant women who are experiencing a high-risk pregnancy, in particular with the announcement of an illness, a malformation or a fetal disability. This list is not exhaustive.
Time to take stock
The major stake of this meeting was to help vulnerable mothers and to prevent postpartum depression. If this measure has been welcomed by all health professionals, it seems that its effectiveness is yet to be demonstrated. Only 28,5% of pregnant women would benefit for the moment from this interview according to a report evaluating the device.
4th month interview: what do moms think?
“For my first child in 1, I don’t remember having this interview. I started going to the hospital for monthly follow-up. And in the 2006th month, nothing more than the usual questions happened. Probably this consultation had not yet been set up. On the other hand, I was able to benefit from the 4th month maintenance for my second pregnancy in 2010. I found myself, I do not know how at the PMI, and it was there that I had the right to an appointment with a midwife. We talked about my fears, my fatigue from my first child. She completed the file received by Social Security but nothing more. Being followed in the hospital, I can’t say that this meeting brought me something. There are surely requesting mothers and hospitals who do this interview well. If it can help, so much the better. But we are not sufficiently informed. ”
titcoeurprtoi
“I am ending my 2nd pregnancy and I never had a 4th month maintenance. Yet in both cases it was a If you have an at-risk pregnancy. For the first, I was followed in the hospital from the 4th month by a midwife, but I never found any interest in these consultations. Suddenly, this time, I preferred that it be my gynecologist who follows me every month. But that doesn’t mean I had the famous interview. He didn’t even know I was smoking until I told him I had quit! ”
lunalupo
“For my part, nobody told me about this interview. It’s a shame because I think it can be useful. At the same time I find that it is a little early in the fourth month, this meeting could take place later, around the 7th month because that is when we really start to realize what is going to happen to us. In a general way, I regret that the doctors do not ask us more about our psychological well-beingSometimes we get depressed during pregnancy. It was just after giving birth that a midwife asked me without really listening to me: “And morale, are you okay?”. Otherwise nothing. “
lilili
* National perinatal survey 2016