Nathalie Sage-Pranchère is a his­to­ri­an and CNRS researcher at the SPHERE lab­o­ra­to­ry. She was one of the speak­ers on the round table at 7th Bio­med­ical Ren­dez-vous at UTC. Her research focus­es on the social his­to­ry of health­care in the con­tem­po­rary era, with a par­tic­u­lar empha­sis on the his­to­ry of peri­na­tal care, foetal and neona­tal ill­ness­es and, more broad­ly, the his­to­ry of the health­care pro­fes­sions. Let the read­ers appre­ci­ate meet­ing her!

The Bio­med­ical Ren­dez-vous at UTC brings togeth­er key play­ers in the devel­op­ment of med­ical prac­tices, plac­ing at the heart of the debate the aim of bio­med­ical engi­neer­ing: to improve the way patients deal with and expe­ri­ence dis­eases, by facil­i­tat­ing med­ical action in all its forms (diag­no­sis, screen­ing, treat­ment, recov­ery). Nathalie Sage-Pranchère was there­fore keen to be present. Her forth­com­ing book will look at the his­to­ry of rhe­sus incom­pat­i­bil­i­ty dis­ease, from the first obser­va­tions in the late 19th Cen­tu­ry to an under­stand­ing of the ori­gin of the dis­ease with the dis­cov­ery of the rhe­sus fac­tor in the ear­ly 1940s. ‘This explo­ration of the past allows us to take a fresh look at peri­ods and con­texts that defy our con­tem­po­rary evi­dence (asep­sis is a recent ‘inven­tion’ ; mater­ni­ty wards were for a long time places of assis­tance and antecham­bers of aban­don­ment, etc.). It sheds light on the roots of cer­tain cur­rent prac­tices (the strict super­vi­sion of preg­nan­cies) or cer­tain pro­fes­sion­al posi­tions (the med­ical sta­tus of mid­wives)’, explains the researcher, whose assid­u­ous atten­dance at pae­di­atric sur­gi­cal ser­vices in child­hood fuelled a deep-seat­ed curios­i­ty for the med­ical world. ‘What’s more, my dis­cov­ery of the con­tem­po­rary issues sur­round­ing peri­na­tal care, the man­age­ment of female repro­duc­tive health and child health has rein­forced this inter­est. Today, my research inevitably brings me face to face with the ques­tion of the link between tech­nol­o­gy and the human beings, whether in my objects of study or in those I use to pro­duce them and make them known. The way I look at it is through a use-based approach, tak­ing care nev­er to see tech­nol­o­gy as an end in itself.

Humanising medicine and patient safety

The his­to­ry of the new­born is marked by a major turn­ing point in the sec­ond half of the 18th Cen­tu­ry, when poli­cies began to be imple­ment­ed through­out Europe to improve birth con­di­tions and reduce mater­nal and neona­tal mor­tal­i­ty, pri­mar­i­ly through the train­ing of mid­wives. The first resus­ci­ta­tion prac­tices for new­born babies were devel­oped at the same time. ‘The phys­i­cal sur­vival of the new­born became as pre­cious as its spir­i­tu­al sur­vival, which had pre­vi­ous­ly been cen­tral in almost unan­i­mous­ly Chris­t­ian soci­eties. This devel­op­ment was at the root of all the changes that fol­lowed: care for pre­ma­ture babies from the 1880s onwards with the inven­tion of the incu­ba­tor, the devel­op­ment of mater­nal and child pro­tec­tion, the emer­gence of cut­tingedge foetal med­i­cine with the devel­op­ment of increas­ing­ly sophis­ti­cat­ed imag­ing tech­niques from the 1970s-1980s, and so on. ‘Accord­ing to the his­to­ri­an, progress that is still pos­si­ble in terms of infant mor­tal­i­ty is cer­tain­ly based on tech­ni­cal advances, but above all on pub­lic poli­cies that pay atten­tion to the liv­ing and work­ing con­di­tions of preg­nant women, as well as to the qual­i­ty and acces­si­bil­i­ty of med­ical resources for mon­i­tor­ing preg­nan­cy and child­birth. ‘All this implies a suf­fi­cient num­ber of health­care pro­fes­sion­als, sub­stan­tial invest­ment in health­care insti­tu­tions, and a non-account­ing approach to med­ical sup­port. The human­i­sa­tion of med­i­cine, which is absolute­ly com­pat­i­ble with patient safe­ty, also requires health­care pro­fes­sion­als to receive more train­ing in the human and social sci­ences, so that they can approach patients as peo­ple rather than as poten­tial dis­ease sites.

KD