Published on
Updated
Reading 2 mins.
In a press release, the ANSFL, the national association of liberal midwives, points to the exclusion of home birth in the CNAM negotiations on the pricing of the overall care of pregnancies. To the detriment of women who wish to make this choice.
Negotiations have started between the CNAM (National Health Insurance Fund) and the two unions of Midwives (ONSSF and UNSSF) about the quotations of the global support for birth (GA). At the heart of this global support, the possibility of being followed by the same midwife or the same small group of people throughout the pregnancy, childbirth and postpartum follow-up. A reality and an interesting framework in the wish of a birth in birth center, in technical center, or at home.
Problem: the CNAM has posed as a pre-requisite that this access to global support should not concern AAD, home births, pointing to a lack of framework.
Home birth, more framed than it seems
However, for Eliette Bruneau, liberal midwife and president of the ANFSL, denigrating home birth for lack of a framework is an aberration that does not take into account the reality of what is being put in place. “Certainly, there have been many works and a very studied framework, for example for birthing centres, but to date there is a real dialogue in France between all the perinatal networks, the organizations representing gynecologists (CGNOF) pediatricians , anesthesiologists, midwives, the SMUR to arrive at a framework and harmonize all of this. We do not yet have the recommendations of the Haute Autorité de Santé but, as such, neither do the technical platforms” she recalls.
Follow your pregnancy week by week
A free choice of parents called into question?
Faced with the decision of the CNAM, the liberal midwives do not understand. “We don’t know what this global support package will give. But we are worried. Why exclude this type of support for home births? This questions us about the rights of women, their choice but also the recognition of the skills of midwives. This goes against the National Parenthood Support Charter published in March 2022 which affirms as the first major principle to “Recognize and value as a priority the roles, the project and the skills of parents”” regrets Eliette Bruneau.
With the direct effect of complicating the journey of parents who wish to choose their home birth: “We do not prohibit, but that inevitably discourages, since the invoicing will be more expensive, and that it will inevitably induce difficulties in finding a professional to practice a home birth despite everything“.
Remember that home birth is currently chosen by about 2,000 women per year in France, or only 0.2% of births. A still marginal choice compared to other countries (Belgium, the Netherlands, Germany, Australia, Austria, Canada, etc.) which make it easier to use this option.