La détresse et l'enfantement : l'hyperemesis gravidarum revisité en contexte migratoire

Hyperemesis Gravidarum (HG) is a medical condition that occurs during pregnancy, which manifests itself by very severe nausea and vomiting that can require hospitalization. Patients'caracteristics include ketone bodies in the urine, altered levels of electrolytes, dehydration, and for many women a weight loss of over 5%. More recently the literature suggests a hypothesis with biological and psychological poles to explain its etiology. However two to three times more cases of (HG) are found in immigrant mothers. No study to date has explored the sociocultural dimension at play within the genesis of this disorder. The objective of this paper is to contribute to the understanding of the complexity of the meaning Vietnamese immigrants, suffering from HG, attribute to their symptoms. These attributions are analyzed in the context of the Vietnamese popular theory of health and migratory trajectories. The methodolgy involved ethnographic interviews with 19 Vietnamese immigrant mothers living in a urban area of south-eastern Quebec. We asked mothers to relate the stories of their perinatal experiences in Québec, refugee camps, and Vietnam. The produced narratives suggested that 8/19 mothers (42%) suffered from severe nausea and vomiting during their pregnancy in Québec. Mothers'attributions coincided with Sino-Vietnamese popular theory of health. They also indirectly point to a desequilibrium in their social invironment due to the absence of key members of their extended family that stayed in their country of origin. Vietnamese have a collective identity and are particularly attached to their extended family. These cultural traits help to understand how the loss of family members can have a negative impact on their well-being. A sociosomatic hypothesis is suggested to explain the high proportion of mothers suffering from HG in this sample.