On November 25, during the examination of two separate texts – the social security financing bill (PFSS) and the modernization of the health system – the elected representatives of the majority tabled several amendments relating to access to voluntary termination of pregnancy (abortion). Adopted on first reading, they strengthen the role of midwives in this area.
→ READ. The Order of Physicians opposes the law strengthening abortion
Thus, they could be authorized to perform instrumental abortions up to 10 weeks of pregnancy. This technique, also known as surgical or by aspiration, has until now been reserved for doctors and is practiced under local anesthesia, while midwives only perform abortions by medication up to 7 weeks of pregnancy – an extended period. two weeks during the confinement period, in order to alleviate the travel restrictions. The latter, less complex from a technical point of view, involve taking an abortion pill by the patient, framed by two examinations, one upstream, the other of control.
Guarantee better access to abortion
Allowing midwives to perform instrumental abortions would allow better access to abortion, say elected officials. They argue that, for several years, due to the retirement of a generation of medical activists, and the closure of small maternity hospitals, the number of staff practicing abortions has been falling steadily. Suddenly, some women have difficulty finding a practitioner who can take care of them within the legal time limits.
However, the impact of such a measure could be very limited, at least initially. This is also not a claim of the profession. “Above all, we ask to be able to do the core of our job correctly, which is to support pregnancy and childbirth, when we lack the means to do so., explains Caroline Combot, secretary general of the National Organization of Midwifery Unions (ONSSF). We learned of the adoption of this text a little by surprise. However, we will be there. As we do in happy times, we will also support women in this delicate moment of their lives. “
The trade unionist believes that this transfer of skills is the product of a disengagement of doctors and hospitals, reluctant to practice an act that is not very remunerative and not very rewarding. So not sure that some like to remedy the lack of enthusiasm of others.
“Less than 1%”
How many will they be to take this path? Even the activists put forward very low figures. “It is very possible that less than 1% of midwives will agree to perform instrumental abortions in 2021, but this figure will increase over the years”, wants to believe Chantal Birman, president of the National Association of orthogenist midwives.
→ READ. IVG: the government wants to develop teleconsultation
In this profession of the intimate, all evolution is very slow, she justifies. “In 2009, when midwives were authorized to provide gynecological follow-up for women, very few were interested. Today, they do it without difficulty. “ The particular nature of abortion could nevertheless constitute a major obstacle in a profession focused on childbirth. Especially since, on a technical level, if the instrumental abortion corresponds in part to technical ando-uterine gestures that midwives know how to perform, “These must imperatively be formed”, warns Marie-Anne Poumaer, president of the National Union and Union of Midwives (UNSSF).
One figure is revealing: while since 2016 the law authorizes them to practice voluntary medical terminations of pregnancy, only 3.5% of liberal midwives are currently “Contracted with a health establishment », For this purpose, according to the Order of Midwives. According to the organization, the mobilization of midwives can still contribute to 10% of all abortions in France.