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Professor Yves Ville, head of the gynecology-obstetrics department at the Necker hospital in Paris, recommends, in a vast plan co-written with 14 specialists, to no longer give birth in a hundred small maternities. A “heresy” according to some specialists.
Giving birth in Guingamp, Porto-Vecchio or Vendôme will (perhaps) soon no longer be possible. These “nearby maternities”, giving birth to 1,000 babies per year on average, are indeed considered more “dangerous” than the others. Result: they close, one after the other, or are threatened with closure.
The safety of mother and child pointed out
According to Professor Yves Ville, if some of these small establishments are already threatened, it is because they lack “human resources”. Conclusion: they close a few days a week, which would jeopardize “safety of care”.
“There are fewer deliveries there, you lose experience, which is dangerous.“, he advances.
According to the professor, there is urgency: “We must group together 100 maternities in France, in the name of the safety of the mother and the child. If we don’t, we’re heading for disaster.“, he declares to the Parisian / Today in France.
Another argument of the professor, detailed in the report: women “would prefer to give birth in level 2 or 3 maternities“, including intensive care services.
“We can’t give birth to women in fire engines”
Recommendations, which are not unanimous among specialists.
“These reports are written from Paris-Necker, in level 3 maternities. They do not reflect reality”, indignant Dr Kierzek. “We have already closed, for lack of staff, nearly 30% of the maternities out of the twenty last years in France. All those which carried out less than 300 deliveries per year and which posed a problem from a security point of view, have therefore already been closed., he shouts. “However, if we close new maternities, this will increase the access time (many municipalities are more than 45 minutes from a maternity hospital, editor’s note) and generate additional risks. But you can’t give birth to women in fire trucks.”
The medical director of Doctissimo specifies that these recommendations are disastrous both for the teams and for the patients.
“Young people will no longer want to join these maternities that risk closing and for women, this phenomenon will generate a feeling of insecurity. One can also wonder if it is not just a matter of profitability. In a logic of activity-based pricing, the largest maternities might want to “capture” patients from the smallest structures.”
Maternities: a cruel lack of caregivers
For her part, Laura Charlotte Bruneau, midwife, says she is “saddened” by this report.
“These small maternities are local maternities, and allow women to have a place to give birth and not have to drive 45 min-1 hour with the risk of giving birth on the side of the road… With obviously all the stress that this creates for these women and these couples. By closing these small maternities, the risk is that the large maternities will be even more congested, with overworked caregivers. Midwives, who generally already follow 2 to 3 patients in the delivery room, risk increasing to 4-5 patients to follow at the same time… or those working in postpartum, who may already have 15 to 20 patients in charge, should further increase the pace. It is not an option.”
According to the expert, the problem is therefore not the existence of these small maternities, but the cruel lack of caregivers.
“If we close the small maternities, there will be more patients in the large structures, which are already in difficulty. There will also be a problem of premises, since the large maternities are already often tight and no longer know where to put the patients. Similarly, I think it is also due to a lack of doctors that in small maternities, professionals work on call. In short, the problem is not these small maternities, but the current state of the health system and the lack of carers and means.”