2024-05-13 05:30:52
A new degree published by the Official Journal and the order of midwives announced on April 24, 2024 a relaxation of the conditions of practice. Instrumental abortion can now be performed by midwives.
What the new degree says
This new degree validated on April 23, 2024 is quite simply a relaxation of the first degree established on December 16, 2023. Since this first authorization, midwives were authorized to practicevoluntary termination of instrumental pregnancy only under certain conditions. The text had triggered the anger of a large number of professionals in the sector who considered the conditions too restrictive.
This degree initially aimed to extend the practice of surgical abortion to small centers and medical deserts to facilitate access to care. “It was absolutely necessary to rewrite this decree, to make the text more flexible,” declares Caroline Combot, president of the ONSSF, the main midwives’ union. Because the instructions established by this first degree did not allow the surgical intervention to be performed due to a lack of doctors in certain establishments and hospitals. Consequently, the content of this text still did not alloweasily access the fundamental right to abortion.
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Before this degree authorizing instrumental abortion by midwives
According to Family Planning and an information report from the National Assembly, 130 abortion centers have closed over the last ten years, due to lack of staff and overly strict practice conditions. However, since 2016 andauthorization of midwives to prescribe abortion medication, the termination of a pregnancy has been extended up to 14 weeks of pregnancy and 16 weeks of amenorrhea. But this is not enough, some establishments are forced to refuse care and send patients far from their homes. This condition can make access to care difficult.
The first degree established on December 16, 2023 highlighted too great constraints for midwives. Among them, the performance of at least 30 abortion procedures by instrumental method, under the supervision of a doctor. But also the simultaneous presence of four doctors (general practitioner, gynecologist, obstetrician and resuscitator anesthetist) within the establishment. The executive bases numerous constraints on the effective application of the experiment, on a security argument.
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This degree alleviates the conditions linked to voluntary termination of pregnancy
Only large maternity wards, particularly those in university hospitals, meet these strict conditions. These instructions limit the freedom of women to resort to voluntary termination of pregnancy due to lack of personnel and places of care. This first degree was part of the project of constitutional law “relating to the freedom to resort to voluntary termination of pregnancy”. If midwives are fighting to obtain more freedom to practice instrumental abortion, it is essentially to make the act more accessible to isolated people living in rural areas and medical deserts.
This new level established on April 23, 2024 will make it possible to ease the conditions for practicing an instrumental abortion. “With this decree, I will be able to ensure real continuity of care for my patients,” rejoices Delphine Giraud. “They will be able to find the same person in consultation and in the operating room, it is very reassuring for them.” The new instructions allow midwives to perform instrumental abortion with the presence of a single doctor within the establishment. In addition, the observation of IVGs has gone from 30 to 10. Professionals will still have to follow theoretical training in orthogenics or have significant professional experience in the subject.
The simplified training and organizational conditions provided for by the new text must make it possible toimprove access to abortion in the territory, particularly within smaller healthcare establishments.
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Written by Camille V.
Sources
– A new decree relaxes the conditions of practice of midwives for instrumental abortion www.service-public.fr. Accessed on May 1, 2024.
– Voluntary termination of pregnancy: your support www.ameli.fr. Accessed on May 1, 2024.
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