“Poor health results”: this report which endangers maternity hospitals in Aveyron

L’hôpital Jacques-Puel de Rodez a réalisé 1 162 accouchements l’année dernière. Centre Presse – José A. Torres

A report from the Court of Auditors deplores the "poor health outcomes" of France in terms of perinatal care. Several avenues are mentioned by the institution in order to allow better care of the first trimester of pregnancy until the child is one year old. Among these recommendations, the closure of maternity wards which carry out fewer than 1,000 deliveries per year, which would entail a risk for patients. The sites of Villefranche-de-Rouergue, Millau and Saint-Affrique would therefore be affected.

In March 2023, a report from the Academy of Medicine already recommended the closure of 111 of the 452 maternity hospitals in mainland France, or 25% of establishments, which carried out fewer than 1,000 deliveries per year. The French Society of Perinatal Medicine (SFMP) considered the measure essential in order to improve management and the provision of care.

"It is imperative to rethink and reorganize our perinatal care system, because today all the indicators are red", the SFMP had warned. Very recently, the Court of Auditors delivered a new report in which the institution recalls "the mediocre health results"  of France in the perinatal field.

France in 22nd place in Europe for neonatal mortality

L’Hexagon is in 22nd place out of 33 European countries in terms of neonatal mortality. While France occupied second place in 2012. A worrying observation, all the more worrying since "the resources devoted to perinatal policy are ever greater (9.3 billion euros in 2021, up 9% compared to 2016)" while "the birth rate is falling (-5.6% over the same period)".

For the Court of Auditors, small maternity wards are considered more risky for mothers and their infants. "If the French neonatal mortality rate had been identical to that of the best European countries, nearly 40% of deaths recorded in France between 2015 and 2017 could have been avoided, i.e. 2,079 children s", estimate the authors of the report.

Less than 300 deliveries per year

Moreover, since 1998, in fact, maternity wards which do not reach 300 annual deliveries must cease their activity, "in view of the requirements of quality and safety of care". But around twenty maternity wards still deviate from this minimum threshold of 300 annual deliveries.

In Aveyron, two establishments are particularly concerned: Saint-Affrique (169 deliveries in 2021 compared to 239 in 2016) and Millau (286 in 2023 compared to 266 in 2016), according to data from the ;rsquo;Insee. The Villefranche-de-Rouergue and Rodez maternity wards respectively carried out 356 deliveries in 2023 and 1,162 last year. At the Jacques-Puel hospital, in 2022, 1,267 deliveries were carried out compared to 1,325 in 2021 and 1,241 in 2020.

A significant decrease that can be associated with a drop in the birth rate observed for several months in France. For Pascal Mazet, nursing assistant at the Decazeville hospital center, departmental secretary of the CGT Santé and PCF regional advisor, this new report can only arouse "always more concerns for public services which are regularly the target of this type of report.

"There are countless births in fire trucks" 

He still deplores the closure of the Decazeville maternity ward in 2017, "all this to save moneyes.&amp ;nbsp;The thresholds for childbirth are constantly being raised, he continues. What will be the next step ? In general, when the Court of Auditors publishes a report, the recommendations that are made inspire our decision-makers." With "all the risks that this entails for the health of pregnant women. We can no longer count the births that take place in fire trucks, between Rodez and Decazeville. It’has become something banal", deplores Pascal Mazet.

Because, several studies suggest "that a prolonged transport time can lead to a poor prognosis for pregnant women", and that a "travel time of more than 30 minutes and a greater distance are associated with a more unfavorable outcome for the newborn, as was already been identified in other studies".

A maternity ward preserved at the future median hospital

Precisely, Benjamin Arnal, director of the departmental branch of the Regional Health Agency (ARS), assured that the Villefranche-de-Rouergue maternity hospital remained " significant distance from any other maternity ward. It remains important to preserve it. The same goes for the central hospital of Saint-Affrique and Millau for which we hope that a maternity ward will be preserved.

Maternity centers in Aveyron also have to deal with recurring staff problems. Even if the management of the Villefranche-de-Rouergue hospital recently assured that "that with the recruitment of a full-time gynecological chief physician, maternity has recovered", and its future was therefore no longer on hold, that of Saint-Affrique, between April 27 and May 8, 2023, experienced an episode that had left its mark: due to lack of staff, the establishment refused deliveries.
 

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