Friends of Sézane

Friends of Sézane

Interview

Malika Benkenane

Helping expecting mothers in trouble
01.21.18

A former nurse trained in psychology, Malika has been working for ten years with the team of midwives at Aubervilliers maternity clinic. The organization's purpose is to ensure the fundamental protection of children, even before he or she is born...

Profession: Psychologist at the maternaity hospital of Aubervilliers
Mission: To identify and help mothers who are in distress
Conviction: Resist unnecessary anesthesia
 
How did you become a psychologist at the Aubervilliers maternity ward?
Before I came, there was no clear program to protect children; it wasn't until 2007 that the hospital began training staff to identify psychological and social frailties in mothers. Pregnancy is the first place to identify possible abuse towards a child.
Here at Aubervilliers, we are in a disadvantaged area, with unemployment, violence, and one of the lowest literacy rates in France... In this very sensitive field, our work consistents mainly of identifying and serving the interest of the child even before he or she is born. At first, I came to just look at patients' files; but today, it has changed a lot. I am being constantly referred to patients. It was difficult to convince the teams at first; but now, everyone – from secretaries to nursery assistants to doctors – is aware of this prenatal vulnerability.  
 
What is the cooperation like between the professionals working in the maternity ward?
I quickly realized that it was urgent to mobilize our entire network. In our maternity ward, there are about 30 employees, 24 maternity beds, 6 neonatal cradles, and about 900 births a year. We form a trio between the midwives, the psychologist and the social worker: we work as a multidisciplinary group. Even if there is no request from families, we meet them. We run tests to check for issues from the fourth month of pregnancy: it is optional and lasts just one hour. It is noticeable whether the mother has ever had trouble and whether she has children who have already been abused or neglected. The medical and social status of the patient is established early, and there is where conversations can reveal a lot. We can become aware of psychological, social and financial difficulties and by the end of the interview, we can offer solutions.
In our team, everyone is on standby: sometimes, mothers confide in people outside the medical profession such as the secretaries. Every month, we meet to review all the issues. Apart from medical care, technical procedures and knowing how to observe and notice things is very important. In 2016, the whole department received training from a midwife coordinator from the state on how to identify and assist women victims of violence. By mobilizing all professionals, expectant mothers will be more willing to enter our psych screening; at first, they do not see why it is valuable to talk, and they are sometimes ashamed of their background and can feel that they have failed...
 
What are the alarming signals?
Often they are silent because they want to show that everything is fine, while actually this is not the case...  A woman who has given birth in several different maternity wards can be an alarming sign. Or a woman who does not have an apartment, who lives with relatives, means that she is financially vulnerable. There are also women who have addictions: in general, they bring it up quickly to see if it's dangerous for their child. Or a husband, who is too aggressive during the consultations, who does not let the mother speak, is also a flashing warning sign. The teams no longer have a fear of asking questions: we go all in in honesty.  Today, the protection of the child is at the heart of the maternity ward. 
 
After giving birth to a woman in distress, how does it go?
Normally, we keep the mother up to three days. Sometimes it is at the moment of birth that she has no more barriers, that she frees herself. We observe the mother-baby relationship to assess the situation. The child is a very good indicator of the state of the mother. If it is too quiet or too noisy, it can be significant. There is much concerning information that can be flagged and reported, and if Child Welfare thinks there is an immediate real danger for the child, it can intervene. There are also cases where the risk factor is so great that it is unthinkable to let the mother and baby leave together... so we keep them until we can find accommodations elsewhere.
How do you work with la Voix de l’Enfant?
Martine Brousse is part of the hospital's board. We told her that there were many moms in very dangerous situations, and she had the idea of making a maternity kit, which would be given to mothers who need it when they leave the hospital. Martine has the ability to quickly identify the problem and assess needs. So now we have a pink bag for baby girls, a blue bag for baby boys, complete with bibs, towels, diapers, a rattle, a blanket, pajamas... It is very important to provide these new belongings that she's never owned before. Psychologically, the mother will assume her new role when she receives the bag. These are new posessions that will only belong to her, and that brings value to her in her maternal position. I can tell you that no one is disappointed! Much more than just material help, this bag touches on the question of self-esteem, the dignity of the mother. We do not have many, unfortunately and are obligated to distribute them sparingly.

Demain (tomorrow), what does it mean to you?
We come at a time when the government is divesting itself of social concerns. I wish there were more and more people who can resist this innate residual indifference... that people will continue to resist feeling helpless about social problems and rise to the occasion to actually confront them.