Instrumental abortions: midwives will be able to perform them more easily

Instrumental abortions: midwives will be able to perform them more easily

To overcome the difficulties of access to abortion in certain territories, midwives have been authorized since December to perform instrumental abortions themselves, everywhere in Europe. But the signed decree provides for constraints that complicate things. It will be rewritten according to the Minister of Health.

While the “guaranteed freedom of abortion” has just entered the French Constitution on March 4, 2024, on the ground, access to abortion is not yet so easy. Particularly at issue is the inequality of access depending on the territory which forces women to travel and consult several practitioners to receive care.

A decree to open abortion to midwives

To compensate for this lack, and strengthen access to abortion, the Albane Gaillot law, promulgated in March 2022, allowed the extension of the abortion period from 12 to 14 weeks of pregnancy, but also authorized midwives to perform instrumental abortions, that is to say by aspiration, in hospital establishments.

After an experimental phase in 26 establishments, the decree sealing this possibility was signed in December 2023. But on closer inspection, it does not really make the journey easier for women.

But the obligation of three doctors for each intervention

Under the guise of allowing midwives to perform instrumental abortions, the decree set conditions, which ultimately limit the possibilities offered to these professionals. According to the texts, they can only carry out these abortions if “the organization of the health establishment allows the intervention, on site and within deadlines compatible with the requirements of safety of care, of a doctor competent in voluntary terminations of pregnancy by instrumental method, of a gynecologist -obstetrician and an anesthetist-resuscitator”.

Three doctors must therefore be present, in addition to the midwife, at the time of the procedure. Unrealistic conditions in many health centers, especially for smaller local structures.

Midwives are stepping up to the plate

For the profession, the blow is severe, it is the sign of a worrying backpedaling. “I remind you that the profession of midwife is a medical profession, even if we don’t necessarily know it. In Europe, 80% of deliveries are carried out by midwives. And this decree is all the more incongruous since the delivery of a full-term pregnancy is much more risky than a voluntary termination of pregnancy. denounced the co-president of the National Association of Orthogenic Midwives, Claire Wolker, among our colleagues in Marie Claire.

A new decree announced by the Minister of Health

Fortunately, their arguments were heard. On March 7, the Minister of Health and Solidarity, Catherine Vautrin, interviewed on Europe 2, announced: the text must be rewritten and from the end of March, midwives will be able to practice instrumental abortions more widely. .

In this new version, a midwife will be able to carry out an instrumental abortion with a single doctor present in the establishment where she practices, compared to three previously. The government, on the other hand, has not touched the conscience clause of doctors (which can also be a barrier), but has expanded the number of people who can perform this act.

Instrumental abortions: midwives will be able to perform them more easily

Instrumental abortions: midwives will be able to perform them more easily

To overcome the difficulties of access to abortion in certain territories, midwives have been authorized since December to perform instrumental abortions themselves, everywhere in Europe. But the signed decree provides for constraints that complicate things. It will be rewritten according to the Minister of Health.

While the “guaranteed freedom of abortion” has just entered the French Constitution on March 4, 2024, on the ground, access to abortion is not yet so easy. Particularly at issue is the inequality of access depending on the territory which forces women to travel and consult several practitioners to receive care.

A decree to open abortion to midwives

To compensate for this lack, and strengthen access to abortion, the Albane Gaillot law, promulgated in March 2022, allowed the extension of the abortion period from 12 to 14 weeks of pregnancy, but also authorized midwives to perform instrumental abortions, that is to say by aspiration, in hospital establishments.

After an experimental phase in 26 establishments, the decree sealing this possibility was signed in December 2023. But on closer inspection, it does not really make the journey easier for women.

But the obligation of three doctors for each intervention

Under the guise of allowing midwives to perform instrumental abortions, the decree set conditions, which ultimately limit the possibilities offered to these professionals. According to the texts, they can only carry out these abortions if “the organization of the health establishment allows the intervention, on site and within deadlines compatible with the requirements of safety of care, of a doctor competent in voluntary terminations of pregnancy by instrumental method, of a gynecologist -obstetrician and an anesthetist-resuscitator”.

Three doctors must therefore be present, in addition to the midwife, at the time of the procedure. Unrealistic conditions in many health centers, especially for smaller local structures.

Midwives are stepping up to the plate

For the profession, the blow is severe, it is the sign of a worrying backpedaling. “I remind you that the profession of midwife is a medical profession, even if we don’t necessarily know it. In Europe, 80% of deliveries are carried out by midwives. And this decree is all the more incongruous since the delivery of a full-term pregnancy is much more risky than a voluntary termination of pregnancy. denounced the co-president of the National Association of Orthogenic Midwives, Claire Wolker, among our colleagues in Marie Claire.

A new decree announced by the Minister of Health

Fortunately, their arguments were heard. On March 7, the Minister of Health and Solidarity, Catherine Vautrin, interviewed on Europe 2, announced: the text must be rewritten and from the end of March, midwives will be able to practice instrumental abortions more widely. .

In this new version, a midwife will be able to carry out an instrumental abortion with a single doctor present in the establishment where she practices, compared to three previously. The government, on the other hand, has not touched the conscience clause of doctors (which can also be a barrier), but has expanded the number of people who can perform this act.