A report presented to the Academy of Medicine by Professor Yves Ville, head of the obstetrics department at the Necker hospital in Paris, points to “maternities where you should not give birth”. 111 would be affected in France, including 21 in Occitania and, among them, 11 have a minimum level of equipment.
Due to the lack of sufficient nursing staff, “an increased reduction in the number of maternity cases” is necessary, according to a report presented to the Academy of Medicine which judges “illusory to support” those carrying out fewer than 1,000 deliveries per year. This reduction would be 20 to 25% nationally.
Their “regrouping” with large neighboring maternities “would remove 111 settlements” out of the 452 sites currently in operation in mainland France. Already 30% of maternity wards in France have closed since 2000.
Latest to date, the Saint-Louis polyclinic in Ganges, in the Hérault, which no longer practices deliveries since December 20, 2022 because two gynecologists are missing. Another example: the Pont de Chaume clinic in Montauban.
In Occitanie, 21 maternities perform less than 1,000 deliveries per year. That is, 52% of the 40 establishments in our region. Five are even under the 500 annual births mark. But those more particularly targeted in the report combine two disabilities, few deliveries and minimal equipment for newborns, called level 1 maternity. They are 11 in Occitania (highlighted in yellow in the following list).
15 are public maternities and 6 are private clinics.
- Saint-Jean-de-Verges (Ariège) Public (977 deliveries in 2021)
- Saint-Lizier (Ariège) Public (176)
- Narbonne (Aude) Public (897)
- Villefranche-de-Rouergue (Aveyron) Public (485)
- Millau (Aveyron) Public (344)
- Saint-Affrique (Aveyron) Public (169)
- Bagnols-sur-Ceze (Gard) Public (723)
- Nîmes (Gard) Private Polyclinic Kennedy (977)
- Muret (Haute-Garonne) Private Clinic of Occitanie (509)
- Saint-Gaudens (Haute-Garonne) Public (503)
- Saint-Jean (Haute-Garonne) Private Union Clinic (841)
- Also (Gers) Public (930)
- Sète (Hérault) Public Saint-Clair Hospital (504)
- Sète (Hérault) Private Polyclinic Sainte-Thérèse (628)
- Cahors (Lot) Public (759)
- Mende (Lozere) Public (420)
- Tarbes (Hautes-Pyrénées) Public hospital center of Bigorre (948)
- Tarbes (Hautes-Pyrénées) Private Ormeau Polyclinic (777)
- Lavaur (Tarn) Public (743)
- Montauban (Tarn-et-Garonne) Public hospital center (986)
- Montauban (Tarn-et-Garonne) Private Clinique Croix Saint-Michel (762)
The idea is therefore to make them into prenatal reception and support for pregnancy and then follow-up after birth. But the deliveries would take place in large hospital structures very equipped for all medical complications, level 2, 2A and 3.
A possible reorganization on the model advocated by the report would greatly impair access to childbirth for future mothers. Particularly in rural areas and in terms of travel time to get to the maternity ward.
In some departments, such as Lot, Gers and Lozère, there is already only one maternity hospital. There, nothing would change.
In Pyrénées-Orientales, Tarn-et-Garonne and Hautes-Pyrénées, the scenario is almost identical. Because if there are indeed two maternities in each of these departments (three in the Pyrénées-Orientales, if we count that of the cross-border hospital of Puigcerdà, in Spain), they are installed in the same place, in the prefectural city.
According to this report, the closure of type 1 maternity wards (the least well-equipped) would only add very little to the travel time to give birth. 89% of births take place thirty minutes or less from the nearest maternity ward. Births more than forty-five minutes from a maternity would then represent only 3%, and only 0.9% for those more than an hour away.
The Academy of Medicine has not yet voted in plenary session on this document drafted under the leadership of gynecologist Yves Ville, head of the obstetrics department at the Necker hospital in Paris. But his conclusions, revealed in Le Parisien, cut to the quick.
Its authors believe that‘”an appropriate perinatal policy should rely on a further reduction in the number of maternity wards” and believe that a solution must be found for centers which carry out fewer than 1,000 deliveries per year, because 80% of them are permanently understaffed. Which, according to the report, represents a potential danger for patients and for newborns.
