[Transcultural approach in perinatality]

Over the last years, our approach to the perinatal period has become more complex with the integration of new tools designed for better comprehension and cultural awareness. In this area of medical practice, perhaps more than in others, the complementary contribution of different approaches, ways of thinking, and practical interventions is essential. Pregnancy, delivery, early mother-infant interactions, and construction of the parent-child relationship involve not only profoundly intimate, intrapsychic and intersubjective events but also medical, social, and cultural events which all become a part of the process of transmitting life in an open group. The junction between somatic, intrapsychic, intersubjective and cultural elements was analyzed in the everyday clinical setting of a multicultural suburban area near Paris. The therapeutic impact of this perspective was noted. Two therapeutic processes specific to the perinatal period were studied: the need to assist vulnerable migrant mothers in reconstructing their defense systems (possible because of the psychic transparency and the primary maternal priority of this special period of life) and direct work with the baby. Working directly with the baby and not only the mother creates an open triad around the baby. This baby/mother/therapist group relationship develops progressively and is initially perceived as a virtual group before developing into a more concrete transferential relationship based on familial and social resources. The perinatal clinic is by definition a very pluridisciplinary and very context-related unit.