Question 9363 — health establishments

Summary

Ms. Pascale Martin questions the Minister Delegate to the Minister of Health and Prevention, responsible for territorial organization and health professions, on the temporary and permanent closures of small maternity wards. Recently, the maternity ward of the Sarlat hospital center, in Dordogne, announced the suspension of deliveries from May 31 to June 12, 2023, due to the impossibility of recruiting a pediatrician. This maternity had already experienced periods of closure in previous months. At the end of April 2023, the Bergerac maternity ward, in the same department, was temporarily closed, with some patients discovering the closure on the same day of their scheduled birth. These suspensions of childbirth make the management of pregnancy and childbirth precarious and do not meet the needs of women living in rural territories. In fact, some patients have to travel more than an hour to the maternity ward to which they have been redirected. On May 31, 2023, in Côtes-d'Armor, a woman gave birth in the fire truck, without a medical team, because the Guingamp maternity hospital has been closed there since the end of April. These closures also encourage choppy medical monitoring, punctuated by the presence of different medical professionals who do not necessarily have sufficient knowledge of patients' medical records. This situation is the consequence of the destruction of the public health service carried out over many years by successive governments and which has reached new heights since the election of Emmanuel Macron. Maternity wards in small hospitals are also suffering the effects of the “Rist” law, particularly in areas rural. A report by Professor Yves Ville, published in March 2023, on behalf of the National Academy of Medicine, recommends the closure of all maternity wards which carry out fewer than a thousand deliveries per year (which represents 111 maternity wards out of 452 in France). In a country which has 1,000 more obstetrician-gynecologists than ten years ago and where the number of midwives has never been so high, this recommendation raises questions. The argument security is used in the report to justify the closure of small maternity wards; However, it has been proven that the number of deliveries carried out in an establishment is not significant in maternal and infant mortality. Conversely, the longer journeys that women who are redirected to an establishment far from their home must make are a real risk factor, just as the discontinuous medical monitoring that these changes in maternity wards can entail. The MP therefore asks the Minister to assure her of her intention not to respond to the recommendations of the City report and to prevent the permanent closures of maternity wards carrying out fewer than a thousand deliveries per year. She also asks what measures she will put in place to prevent temporary closures from increasing.

Machine translation from French. The official text remains authoritative.

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