Cuts blamed as stillbirth tragedy shocks FranceFebruary 4th, 2013 by Angus Mackinnon in Obstetrics & gynaecology /
France has launched an investigation into a stillbirth that occurred after a full-term pregnant woman was sent home from an overrun maternity unit in a case that has raised concerns over the impact of EU-driven austerity on the country's renowned health system.
A military campaign in Mali was knocked off the top of France's news agenda on Monday as commentators demanded to know how such a tragedy could have happened in a country that prides itself on its state-of-the-art medical facilities.
A Paris prosecutor began looking into the case after the parents of the stillborn child filed a complaint of criminal negligence while Health Minister Marisol Touraine has commissioned an emergency administrative and medical enquiry into what went wrong.
The baby was discovered to have been stillborn overnight Thursday-Friday at the Port Royal maternity unit in Paris.
The expectant mother had come to the clinic during the day on Thursday and on the previous Tuesday seeking to have her labour induced.
On both occasions she was sent home because, according to her partner, there was no bed for her, despite the couple warning staff that the baby was "not moving much".
Whether the prospective father's account was accurate will be addressed by the investigation but the head of the maternity unit, Dominique Cabrol, has already confirmed that the clinic was "at saturation point" on Thursday.
AP-HP, the body that runs public hospitals in Paris said in a statement: "We now have to get to the bottom of why woman was sent home, whether there were no beds and if so, why was she not transferred to another maternity unit."
Politicians from across the political spectrum questioned whether the tragedy was the result of cutbacks in staff numbers.
Paris hospitals have been told to make 150 million euros ($200 million) of cutbacks this year as part of a drive to cut the national deficit in line with European Union rules.
Medical professionals say cuts have not helped but believe a recent reorganisation of maternity services in Paris is also to blame.
Under a 1998 reform, maternity clinics are classed on a scale of 1-3, with type one being for women who are expected to have a trouble-free pregnancy and type three for those liable to have complications.
In practice, what has happened is that demand for type three clinics has outstripped supply, creating bottlenecks, according to Jean Marty, the chairman of the body that represents French gynaecologists.
"People think they will be safer in a type three clinic with the result that they are flooded with patients and at the same time the administration has been trying to close type one establishments to recover the additional costs," Marty told AFP.
"We see the results today with patients who should be in type three clinics being sent back. It is not human error, it is a structural problem."
Cochin-Port-Royal is a huge maternity unit by French standards with some 5,000 births last year and advanced facilities for dealing with premature and complicated births.
France's National College of Midwifes (CNSF) also pointed the finger at the changes, saying: "Every new study shows France's infant mortality results worsening."
"If all the most advanced means were not being made available for all pregnant women, the cases where they are really needed would be able to access them in good time."
(c) 2013 AFP
"Cuts blamed as stillbirth tragedy shocks France." February 4th, 2013. http://medicalxpress.com/news/2013-02-blamed-stillbirth-tragedy-france.html