French maternity hospitals' closure rate: Over a third (40%) of hospitals have remained shut for three decades.

Will France Implement a Maternity Ward Halt?

French maternity hospitals' closure rate: Over a third (40%) of hospitals have remained shut for three decades.

Deputies from the Liot group are readying a proposal to stem the rise in infant mortality, a worrying trend in France. Their solution? A three-year moratorium on maternity ward closures, with exceptions only when patient safety is at stake. Since the 1990s, 40% of maternity wards have shut down.

Academy of Medicine's View

The Academy of Medicine believes the closure of these maternities can be traced back to a 1998 decree, which ranks them. Type 1 maternities handle straightforward deliveries, while Type 2 and 3 require intensive care or neonatal intensive care units. The goal was to secure births, but the decree also led to overcrowding in better-equipped maternities, causing Type 1 maternities with insufficient births to close.

The Great Shift

More women are now being directed to well-equipped maternities due to safety concerns, causing a significant drop in births at Type 1 maternities. In 1996, these wards accounted for nearly 60% of births, while today they handle only 20%. Type 2 and 3 establishments currently dominate, with more than half of births taking place in Type 2, and a third in Type 3 maternities.

Underutilized Maternities: Out of Service

The drop in Type 1 maternity births has led to their closure as per the 1998 decree, which demands a minimum of 300 births annually for a maternity to retain its obstetrics service. Financial strain and difficulty meeting regulations are common issues faced by underutilized maternities, leading to their closure.

Small Maternities: A Lifeline for Remote Areas

A notable exception to the closure rule is for "small maternities" in underpopulated areas. However, increasing distances between maternities pose a challenge for many territories. Currently, around 900,000 childbearing-age women reside over 30 minutes from a maternity ward. Some departments, like Haute-Corse, Lot, and Mayotte, have women traveling up to 45 minutes for maternity care. Long journeys pose heightened risks, especially for newborn lives.

Decrees impacting healthcare hierarchies can lead to centralization, reducing accessibility for rural areas, setting standards and regulations that smaller facilities can't meet, causing financial strain, and increasing the difficulties of those living in underserved communities. The specific case of a 1998 decree in France requires examining French healthcare policy documents or analyses focusing on that period.

1. The proposal by the Liot group aims to halt the closure of maternity wards in France, which have seen a significant decline since the 1990s, with 40% of them shutting down.
2. The Academy of Medicine has linked the closure of maternities to a 1998 decree, which ranked them, causing overcrowding in better-equipped maternities and eventually leading to the closure of underpopulated Type 1 maternities.
3. As a result of the decree and the shift in women giving birth at better-equipped maternities, Type 1 maternities now handle only 20% of births, with Type 2 and 3 maternities dominating, accounting for more than half and a third of births respectively.
4. Despite the rule allowing for the exception of "small maternities" in underpopulated areas, increased distances between maternities pose a challenge for many territories, with around 900,000 childbearing-age women residing over 30 minutes from a maternity ward, posing heightened risks, especially for newborn lives.

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