While this Thursday, July 1, paternity leave has just been extended, some parents want a more "natural" childbirth.
France is turning to an alternative: birth centers.
Places - always adjacent to maternity hospitals - where only midwives accompany childbirth.
The 2021 Social Security financing bill made the eight existing birth centers permanent, and launched the opening of twelve new ones.
20 Minutes
takes stock of these projects, while the decrees are expected this summer.
We feel, in some women, the desire to go back natural ... including to give birth.
Having the least medicalized pregnancy possible, being accompanied by the same midwife before, during and after and without having an epidural, this is the deal that some future mothers are looking for.
Who are delighted with the project to create twelve new birthing houses in France by the end of 2022. But the subject is still divisive on the side of caregivers ...
Twelve new birth centers by the end of 2022
An experiment carried out over five years has already enabled the emergence of eight birth centers in France. Parliamentarians have planned to perpetuate them and create twelve more. And the file is moving forward. The locations are not yet known, but the Directorate-General for the provision of care (DGOS) has been working since April on two decrees, expected by the end of the summer. One looks at the operating conditions of these places, the other on the installation conditions. The Birth Homes collective supports around thirty projects, which will have to submit their application to the regional health agencies. "An opening of the twelve birth centers by the end of 2022 seems possible," assures the collective. It's a victory, even if it's not as ambitious as we would have liked… ”
"We are entering the dissemination phase", rejoices Anne Evrard, of the collective of users Ciane. "There are a lot of requests and waiting, recognizes for his part the entourage of Adrien Taquet, Secretary of State in charge of Children. New generations often want childbirth in a less hospitable environment. And midwives are very demanding of this kind of care. “Still, in 2019, only 500 deliveries (out of 753,000 births) took place in these places. “However, there were 1,000 births at home, raises Chloé Barasinski, midwife. We are seeing the emergence of a trend in favor of unassisted births, which represents a loss of opportunity for the mother and the newborn. "" We hope to reverse this trend by doubling the offer, to bring mothers to birth centers ",one pleads with the ministry.
Gynecos outcry
Problem: on the side of gynecologists, things get stuck. “I have read that 20% of these patients [giving birth in a birth center] are finally transferred to maternity hospitals. It's a lot ! », Tackle Alexandra Benachi, vice-president of the French National College of Gynecologists and Obstetricians (CNGOF). However, a report coordinated by the National College of Midwives (CNSF), Audipog (an association providing information on perinatal care, see box) and Inserm concluded that “satisfactory safety and a low frequency of interventions”. “In five years, we have not had a disaster, adds Anne Evrard, from Ciane. The evaluation shows that the transfers between the birth centers and the operating theaters are done seriously, and that there is no childbirth outside the nails: for example,a woman who is expecting twins will not be taken care of. We are waiting for the gynecologists, who supported this experiment, to give us scientific arguments which show that their concerns are verified. "
In France, all birth centers must and must be adjoining a hospital, in order to be able to transfer as quickly as possible a woman who would need a caesarean. Some associations wanted this limit to jump, to open a structure a little further. But deputies and government refused this removal.
An insufficient geographical limit for some gynecos.
Who assure that opening physiological units, rooms managed by midwives, but in the maternity ward and not next door, would ensure greater security.
Except that since 2012, when these structures were authorized, France has only four… "We see, in this opposition to birth centers, a form of corporatism among gynecos," regrets the Birth Houses collective.
He asked for a larger scientific study, over time, after the opening of the new birth centers, to verify that the safety criteria are met.
The question of means
Another problem raised by the gynecologists: the lack of means. "Today there are large maternity hospitals, full to the brim, which have difficulty in recruiting, regrets Alexandra Benachi, of the CNGOF. It is very good to create birth centers, but this demand is ultra-minority and we must also take care of other patients. "A fallacious argument according to the spokesperson for Ciane:" These are not twenty birth centers that will dry up recruitment at the hospital.
Some gynecologists warn all the same: betting on birthing centers to imagine that women will give birth better tomorrow would be an illusion at a low price ... "Maternities have become such industries, with the closure of two thirds of them in forty years , that neither the women nor the midwives meet there ”, summarizes Amina Yamgnane, president of the commission well-treatment of the CNGOF. However, to ensure childbirth in good conditions, in the hospital, in the clinic as in more physiological places, we need resources.
On the side of the Ministry of Health, it is argued that the Ségur de la santé has revalued the salaries of midwives by 183 euros per month.
"We also have in mind to encourage the conditions of a mixed exercise in the hospital and in the city", informs the entourage of Adrien Taquet.
The ministry requested a report from the General Inspectorate of Social Affairs (Igas) on this subject, expected this summer.
"The attractiveness of the profession will not improve only with the increase in wages," criticizes Anne Evrard.
Many no longer want to work in the hospital because of understaffing and lack of autonomy ”.
Who will not go without greater confidence between gynecologists and midwives, obviously not yet evident ...
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A site to better choose your maternity ward in Ile-de-France
Many future parents were waiting for him… Since mid-June, the Ile-de-France regional health agency and the Audipog association have published a new site: accouchements.sante-idf.fr.
It shows, in each structure, public and private, the number of deliveries, the rate of episiotomy, cesarean section, epidural ...
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