The future of Nevers maternity is undermined by the shortage of midwives

The department of Nièvre, in Burgundy-Franche-Comté, is in a state of medical emergency. From 19 April to 10 May the health reserve is mobilized in the Nevers maternity ward. Usually, this device is dedicated to exceptional health situations, such as natural disasters, attacks, epidemics. But in this spring of 2022, in Nevers, it is a completely different problem that has generated this crisis.

READ ALSO:False remedy for medical deserts, teleconsultation booths frustrate patients and doctors

On April 11, the fourteen midwives of this institution all went on sick leave. For months they have been warning of the lack of staff in the maternity ward, which has worsened over time. In 2017, the service had 25 midwives but over the course of the eleven years they have left the liberal profession. Worse still, because without a foreman they had to alternate day and night to provide the service, without visibility on their schedules. And last summer, for not having been replaced by the traditional relay races of the month of July and August – the obstetrician students – were unable to take the holidays to ensure the proper functioning of this structure that hosts 120 children a month. An unsustainable long-term situation.

The only maternity hospital in the department

Especially since these midwives could not count on close maternity colleagues to support them. Within fifteen years, the other three maternity wards in the ward closed. First Clamecy in 2008, then Decize in 2010 and finally Cosne-sur-Loire in 2018. Alone, taking care of the birth of women in an area of ​​6,817 kilometers, the fourteen midwives ensured uninterrupted service.

Exhausted, they had to stop their work on 11 April. In the interval before the establishment of the health reserve, their patients who flocked to Nevers were assisted to treat emergencies. The others were transferred to the maternity wards of Dijon, Bourges, Auxerre, Moulins or Montluçon. To deliver, some of these patients had to travel by ambulance, sometimes up to 2.5 hours away.

Ten years of state of emergency in France

How did we get here? For twelve years, the nurses and elected officials of the Nièvre have warned of the crisis of motherhood. “In the Nièvre there was a management problem at the level of the local hospital group. This technostructure did not play its role. He should have anticipated the recruitment and listened to the malaise of these midwives “laments Fabien Bazin, socialist president of the Nièvre departmental council.

In 2010, then parliamentary assistant, he tried to move the lines by proposing with his deputy Christian Paul – now mayor of Lormes, another town in the Nièvre – a “rural shield” in the Assembly. This bill consisted in particular in proposing a local network, limiting the travel time of patients to twenty minutes from a general medicine hospital and forty-five minutes from a maternity hospital. Its objective was to oblige the regional health authorities to guarantee the territorial distribution of assistance offers, according to these constraints – without specifying the terms of these obligations.

Accounting logics

What about this text which was to be examined during a parliamentary lodge on March 24, 2010? “This had given rise to a passionate three and a half hour debate in the National Assembly. The right had proposed an arsenal of measures exactly similar to ours. Then, in the process, all these proposals were buried “, Fabien Bazin grinds. And to continue, targeting some of the elected representatives of the majority of him: “The governments of François Hollande, then Emmanuel Macron, have continued to cut the beds and manage the caregivers according to accounting logics. We organized the collapse of hospital services.

READ ALSO: Five solutions to end medical deserts

In fact, in the Nevers maternity ward, in the last ten years, the hospital structure has been demolished according to drastic budgetary constraints. “A former director had fired the gynecologists, who had experience, to replace them with younger, lower-wages. In the following years, precarious workers followed one another and this precariousness weighed on the working conditions of midwives “relates to Marianne The deputy Perrine Goulet (Modem – ex LREM), from the first electoral college of Nièvre.

Potentially serious health consequences

Decisions that led to many problems in the service according to the concerned comments of pregnant women on Google’s rating platform. In August 2021, Joanna, a patient, went to Nevers hospital last summer: “3 months pregnant and taken by the fire brigade in the middle of the night due to a heavy bleeding, I was visited by an intern who must have been very tired because in the middle of her sentences she had stopped to yawn! She asked me the same questions 3 times without hearing the answers. I mean, I come out with a prescription for Spasfon and a 5 day suspension. Fortunately, the next day I see my midwife, who after an actual examination, notices a detachment of the placenta, so seriously treated “says the young mother. To the Department Council, Fabien Bazin assures that up to now there have been no serious cases in Nevers, but delicate situations: “A few months ago a woman gave birth in the maternity room, luckily we trained volunteer firefighters”Breathe.

READ ALSO: Medical deserts: when delays in treatment lead to tragedy …

The story of the Nevers midwives illustrates the crisis of shortage of midwives that affects the whole national territory. “We are at the highest level of tension, due to a lack of personnel. For years we have been warning the authorities about the lack of financial and social evaluation of the profession “explains to Marianne member of the National Council of the College of Midwives. This Thursday, May 5, International Midwife Day, the profession intends to make itself heard and alert the government to this issue.

In Nevers, elected officials and nurses have their sights set on students, who graduate from midwifery school in June. They want to offer them scholarships and possibly higher compensation. “The maternity ward has ten positions to fill, it is absolutely necessary that we hire at least three midwives”Perrine Goulet insists. At the risk of endangering the health of patients, children and staff.

Leave a Comment