Question 10763 — women

Summary

Ms. Clémentine Autain questions the Secretary of State, attached to the Prime Minister, responsible for equality between women and men, about the difficulties encountered by patients in the context of access to gynecological follow-up. At the end of June 2018, the High Council for Equality between Women and Men submitted its report on the reality of obstetric and gynecological violence that women suffer. This document reports figures alarming on several aspects of the patient-practitioner relationship, from contraceptive support, to pre- and post-natal monitoring, including obstetrical procedures during childbirth. Among the violence most singled out, episiotomy concerns one in five deliveries in France, where the WHO recommends a rate half as high, or 10% of deliveries. But women affected by episiotomies deplore above all, for half of them, the absence of information on this subject. Violence is also experienced outside the context of pregnancy, particularly for preventive examinations or contraceptive prescriptions. The testimonies of patients are accumulating, confronted with the brutality of the acts carried out such as vaginal examinations, with the judgments of their sexual practices, with the refusals of acts in the case, for example, of insertion of the IUD. All these questions are addressed in the report of the High Council for Equality between Women and Men. They must not make us forget the number of acts carried out correctly by practitioners, gynecologists, obstetricians, midwives, and which are essential throughout the stages of women's lives. At the same time, women face increasing difficulty in accessing gynecological follow-up. And for good reason, the shortage of medical gynecologists concerns the entire French territory, worsening particularly in territories already affected by medical desertification. Between 2007 and 2017, the number of medical gynecology specialists fell by 41.6%. In Seine-Saint-Denis, there are 8.25 gynecologists per 100,000 inhabitants, compared to 28.6 in Paris. Some towns in the department do not even have a private gynecologist, such as Aulnay-sous-Bois. In At best, women turn to other practitioners such as obstetrician-gynecologists. But the specialty of these practitioners is childbirth and surgical procedures, and not the broader monitoring of hormonal problems, contraception, cycle disorders, menopause or illnesses. This reality could explain the increase in acts experienced badly by patients. In the most serious cases, the patients have no alternative to the absence of a gynecologist and abandon all follow-up. The relationship of trust between patients and practitioners is complicated today. She asks him what human and financial means are planned by the Government to deal with the real and numerous existence of medical procedures poorly experienced by patients, to improve gynecological and obstetrician follow-up, and to ensure gynecological follow-up. benevolent to all women throughout the country.

Machine translation from French. The official text remains authoritative.

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