In Nevers, Nièvre’s last maternity hospital is severely lacking in midwives

Due to a lack of sufficient staff, the maternity ward had to close for several days in April. A representative case of the lack of midwives nationwide.

International Midwife’s Day, celebrated on May 5, had a bitter taste in the chronically understaffed French maternity wards. That of Nevers in particular, which temporarily closed its doors from 11 to 19 April. The 14 midwives on duty were all on sick leave, for a collective burnout. The activity could only resume thanks to the mobilization of the health reserve, made up of volunteer carers and able to intervene promptly.

This maternity hospital, which is located in the Nevers hospital, is the only one in Nievre. 1200 babies are born in the department every year. Within ten years, the other three maternity wards closed their doors: that of Clamecy in 2008, then that of Decize in 2010 and finally that of Cosne-sur-Loire in 2018.

Aurélie Perier, a midwife, for 23 years in Nevers, has witnessed the slow deterioration of working conditions. “We have been warning of the situation for years. There is unprecedented bleeding from midwives in our hospital, putting patients’ safety at risk“, explains. Four years ago, the service still had 26 midwives to provide care, day and night, on weekends and holidays. Many left in liberal or to other maternity wards.

Guillaume Rameau, the only man on the team, is concerned about the health of women and babies. “In the delivery room we can have up to six patients a day, in addition to emergencies and consultations. Two midwives to manage everything are not enough“, He warns. “We have the lives of mothers and children in our hands, we have no room for mistakes.According to data from the Ministry of Health, 80% of normal births are performed by a midwife.

During the eight days of closure of the maternity ward, expectant mothers were transferred to the maternity wards of the neighboring departments: Dijon, Bourges, Auxerre, Moulins or Montluçon. Sometimes more than two hours from their home. Temporary stability has been restored since the reopening of the service. But for how long? Volunteers from the health reserve who support Nevers midwives will leave the day after May 13. The management, which we have tried unsuccessfully to reach, has launched a recruiting campaign.

National shortage of midwives

For Guillaume Rameau, the extreme case of Nevers “it is only the tree that hides the forest.“Maternity wards, even in big cities, struggle to recruit midwives. “Our profession suffers from a cruel lack of recognition whileremember, we all go through the hands of a midwife.“Regrets an economic logic”deleteriousin the hospital, which, according to him, does not give priority to the health of mothers and children. A sign of the times, the birth preparation courses in Nevers were canceled a year ago due to lack of sufficient staff.

For Aurélie Perrier, pay in the hospital setting should be improved. The midwife compares her profession to that of hospital dentists, whose salary at the beginning of their career is double. “Our profession will not be able to attract new recruits without a salary commensurate with our skills“, she says.

According to the Inspectorate General of Social Affairs, the share of midwives in hospitals has continued to decline in recent years. In 2012, 73% worked exclusively in health facilities and 20% carried out a liberal activity (combined or not with a paid activity). In 2021 they are only 59%, while liberals now represent 34% of the workforce.

For mothers-to-be who live more than a 45-minute drive from a maternity hospital, the state introduced financial assistance in April. They can now benefit from non-medical temporary accommodation or a hospital hotel.

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