Question 11559 — health establishments

Summary

Ms. Aurélie Trouvé draws the attention of the Minister of Health and Prevention to the lack of infrastructure dedicated to maternal and reproductive health in the department of Seine-Saint-Denis. This department has the highest birth rate in mainland France: 15.4 children per 1,000 inhabitants. Nearly 27,000 babies were born there in 2021. However, the department's natal and perinatal health structures are experiencing difficulties. growing difficulties, when they do not disappear altogether. The Lilas clinic, renowned for the quality of its pain management and for its commitment to women's rights and freedoms, is in the process of moving its childbirth activities to the Montreuil hospital, after years of uncertainty. As for the Livry-Gargan clinic, it permanently closed its doors this summer. The summer of 2023 has shown to be particularly complicated in the department's maternity wards: women who had chosen Vauban for their childbirth had to be urgently redirected to services that were already overwhelmed. High-risk pregnancies were less well monitored due to a lack of sufficient numbers of midwives: at the Delafontaine hospital in Saint-Denis, the summer of 2023 began with the number of midwives half as low as needed! The care situation sexual and reproductive health is also worrying: the closure of the Lilas clinic will force the reallocation of 1,000 annual abortions to the department's hospitals. This is the result of disastrous choices by the ARS of Île-de-France, encouraged by national policies which for 20 years have pushed for marketization, the profitability of care and the contraction of costs. In the Seine-Saint-Denis department, establishments hospital services are all the more important in maternal and reproductive health as private medicine is very far from meeting the needs. Because distance and cost are determining factors for women who are far away from care, whatever the reasons (youth, family difficulties, insecurity, lack of information, etc.). An alarming indicator, infant mortality is increasing again and is particularly high: 5 per 1,000 in Seine-Saint-Denis, compared to 3.3 on the national average, due to a higher prevalence of risky pathologies (obesity and diabetes in particular) and increasing precariousness. Such an observation would require that prenatal screening and monitoring efforts be strengthened. Maternal, reproductive and sexual health are essential to realizing the promise of gender equality: it is a pillar policies to promote women's rights and combat sexist discrimination. She therefore wishes to know her plan to ensure access to all women in Seine-Saint-Denis, in particular through the presence of local establishments in sufficient number and quality.

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