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Supporting or questioning the perinatalhealth care system: which role islegitimate for a 21
st
Century citizen?
Collectif interassociatif autour de lanaissance (CIANE, France)
(A coalition of childbirth organisations)
http://ciane.net
A presentation by Madeleine Akrich & Bernard Bel
 
1st International Conference on Childbirth: Birth with Love and Wisdom.Sofia (Bulgary), 29-30 May 2010
2 
Feminists challenging medical expertise
Until 1980 at least, in France, evaluatingcritically medical interventions andprotocols was mainly the task of healthprofessionals.
However, access to fertility control and topain relief during childbirth (epidural)challenged this role of physicians asdecision makers: they should also respectthe
choice
of every woman.
 
1st International Conference on Childbirth: Birth with Love and Wisdom.Sofia (Bulgary), 29-30 May 2010
3 
The rise of patient organisations
During the 1980-1990s, grassrootpatient organisations(AIDS, rare diseases) contributed to a public debate aimingat
redefining the relation between patients and theircaregivers
, which led to a new medical legal system, in2002 (under minister Bernard Kouchner). The newapproach emphasized the individual and collective rights ofpatients.
Until 2002, consumers of maternity services actedmarginally in this radical change.
But the 2002 law created some opportunity for theemergence of new childbirth movement
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