Five questions on birth centers

1. What is a birth center?

The delivery center is a health facility whose medical direction is ensured by the midwives. They guarantee delivery, with low risk of complications and excluding multiple pregnancies, of the women who have followed.

The delivery center is a partner of a health institution authorized to provide gynecological-obstetric assistance, which guarantees direct and safe access for medical situations that require it and in conditions compatible with the emergency. It is a member of its own specific regional perinatal system. Until 26 July 2022 this requirement is considered satisfied if the birth center is a member of a perinatal health network (C. de la santé publique, art. R.6323-27, R.6323-30, R.6323 -31).

2. What are the missions of a birth center?

A birthing center takes care of the medical supervision of the pregnancy and post-natal care of the women followed, of the preparation for childbirth and of parenting, taking into account the overall support needs of future parents, delivery and postnatal care of the mother and the child. Accommodation is provided only during childbirth and for subsequent monitoring purposes.

It can organize public health, prevention and therapeutic education actions, in particular with a view to promoting access to women’s rights, or training for midwives. The birth center does not deal with obstetric emergencies, but its staff must be available to deal, at any time, with the birth of a woman enrolled in the facility and for the first response to any complications.

Before registering, the delivery center informs women who wish to be followed and give birth in the facility, about its functioning and the treatments offered, in particular about the mandatory nature of the pre-anesthesia visit organized by the maternity ward of the health company. . Upon registration, the delivery center obtains consent for the transmission to the latter of the medical information necessary in the event of transfer and treatment (C. de la santé publique, art. R.6323-26, R.6323 -28, L. 6323-4-2).

3. How are relations with the partner healthcare facility organized?

The delivery center stipulates a partnership agreement with the authorized health authority for the activity of gynecological-obstetrical assistance.

This document provides in particular the modalities for the reorientation of the woman during pregnancy, in particular in the case of re-evaluation of the level of pregnancy risk, as well as the conditions for the transfer at any time of the woman and the newborn during pregnancy. and after childbirth, especially in case of urgent complications. Identifies the situations that can give rise to a transfer and provides for the secure transmission of medical information between the two facilities, the conditions in which they discuss their practices and risk management, in a process of continuous improvement of the quality and safety of care , the conditions for scheduling the pre-anesthetic consultation as well as their financial relationships.

The agreement is sent as soon as it is signed to the director general of the competent regional health agency (ARS), who is informed of any changes (C. de la santé publique, art. R.6323-29).

4. Under what conditions is the delivery center authorized?

Applications for the creation of a birth center are presented to the director general of the ARS who authorizes them or not. It is worth accepting the silence maintained by the director general of ARS on a first request of six months, and on a request for renewal of two months.

The authorization is granted for seven years, renewable, when the project meets the needs of the population and allows compliance with the technical operating conditions as well as the care of women and newborns according to the recommendations established by the Alta Sanitary Authority.

The delivery center draws up and transmits to the ARS an annual activity report, the content of which is established by order of the Minister responsible for health (C. de la santé publique, art. L.6323-4-3, R. 6323 -32 , R.6323-33).

5. What is the technical organization of a birth center?

The rooms of adequate size, adjacent to the affiliated establishment, the material systems and the bio-cleaning procedures guarantee patients conditions of accessibility, safety and hygiene in compliance with current regulations. The organization and equipment, in particular an emergency trolley, allow for the emergency transfer, if necessary lying down, of pregnant women and newborns.

The procedures for the medical follow-up of women and the organization of the availability of professionals are the subject of a statute established by order of the Minister responsible for health. Midwives justify a minimum childbirth experience in the two years prior to starting their activity in the facility. The number of staff is sufficient to guarantee the quality and safety of hospitality and care.

The staff is regularly trained, in particular in the management of maternal, fetal or neonatal pediatric emergencies (Code of public health, articles D.6323-36 to D.6323-41).

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