Not another roadblock, says Israel Nisand, former French gynecology president
France postpones shutdowns of maternity wards: 'Merely vote-winning tactics,' criticizes Israel Nisand, ex-president of French College of Obstetricians and Gynecologists
In a bold stance, Israel Nisand, a retired professor of gynecology, has called out a newly proposed three-year moratorium on closing maternity wards a "terrible idea" during an appearance on France Inter. The moratorium was passed in the first reading by the National Assembly the day prior, intending to assess maternity units offering fewer than a thousand births annually.
The objective behind this proposal is to combat the surge in French infant mortality, which has risen from 3.5 deaths per 1,000 live births in 2011 to 4.1 by 2024.
: Why are nearly 40% of maternity units in France shuttered? Professor Nisand emphasizes that "to maintain a maternity ward, you'll need a gynecologist, a pediatrician, and an anesthesiologist-reanimator," but "for small maternity units, we no longer have the budget to retain these essential skilled professionals in the event of complications."
"In the name of women's and children's safety, we should pool resources rather than spreading them thin," argues Nisand.
Regarding maternity closures, Nisand pins the increase in infant mortality to inadequate care during delivery rather than the ward closures themselves. He points out areas lacking pediatricians to attend to sick children and the shocking statistic that 80 women die annually from childbirth-related complications. He stresses that young doctors today prefer to work in teams, making collaboration crucial to managing complications efficiently.
Nisand unambiguously dismisses the moratorium proposal, calling it "mere political demagoguery." He claims that without an obstetrician, pediatrician, or reanimator, branding a facility a "maternity ward" amounts to aesthetic window dressing, offering no real security.
Access to care remains challenging in some regions
Regarding the issue of maternity ward remoteness, leading to insufficient coverage in certain French areas and women needing to travel over 45 minutes by car to deliver, Nisand advocates for a "customized, solution-focused" approach rather than "politicking to maintain a town's name on a birth certificate."
He cites the example of Sweden, where, despite greater distances, they have managed by implementing adapted transportation like helicopters and "hospital hotels" for expectant mothers and scheduling more deliveries. Backing up this approach, Nisand reminds us that many Scandinavian countries have managed to navigate similar challenges successfully.
It's crucial to note that the recurring problem of maternity ward closures in France stems from systemic healthcare delivery issues, particularly a lack of sufficient and equally distributed neonatal intensive care facilities, raising concerns about accessibility for pregnant women in remote areas [5]. The solution might involve reconsidering the allocation of resources within the healthcare system, ensuring our priorities lie with the safety and wellbeing of mothers and infants.
In light of the proposed moratorium on closing maternity wards, it would be more beneficial to pool resources and collaborate, rather than spread them thin, as suggested by Israel Nisand, a retired professor of gynecology. Adequate health-and-wellness resources, including medical-conditions care and women's health facilities, should be equitably distributed, regardless of geographical location, as demonstrated in Sweden's successful management of similar challenges.
