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HEALTH

Stillbirth tragedy sparks French healthcare alarm

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 about the impact of austerity on the quality of France's renowned health service.

Stillbirth tragedy sparks French healthcare alarm
Patrick Houssel (second right), chairman of central Paris' University Hospitals, speaks during a press conference on Monday. Photo:Francois Guillot/AFP

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".

"A baby should not die in Paris in 2013 because there is no place for the mother in hospital," the woman's partner, named as Stéphane told French daily Le Parisien on Sunday.

"The appointment had already been booked. They told us not to come straight away but to wait until 11 o'clock but at 11 there was no place for us," he added.

The partner said his wife had already visited hospital the week before, concerned that the baby was not moving too much.

"In the end a midwife came to see us and told us to go home because she did not think it was urgent," he told Le Parisien.

"Saturation point"

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 reorganization 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."

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HEALTH

France brings in free contraception for all women aged 18-25

Free birth control for all women under 25 will be available in France from Saturday, expanding a scheme targeting under-18s to ensure young women don't stop taking contraception because they cannot afford it.

France brings in free contraception for all women aged 18-25
A doctor holds an interuterine contraceptive device (IUD) before inserting it in a patient. Photo: Adek Berry/AFP

The scheme, which could benefit three million women, covers the pill, IUDs, contraceptive patches and other methods composed of steroid hormones. Contraception for minors was already free in France.

Several European countries, including Belgium, Germany, the Netherlands and Norway, make contraception free for teens. Britain makes several forms of contraception free to all.

France announced the extension to women under 25 in September, saying surveys showed a decline in the use of contraception mainly for financial reasons.

The move is part of a series of measures taken by President Emmanuel Macron’s government to boost women’s rights and alleviate youth poverty. The free provision is supported by women’s groups including the association En Avant Tous.

“Between 18 and 25-years-old, women are very vulnerable because they lose a lot of rights compared to when they were minors and are very precarious economically,” spokeswoman Louise Delavier told AFP.

Leslie Fonquerne, an expert in gender issues, said there was more to be done.

“This measure in no way resolves the imbalance in the contraceptive burden between women and men,” the sociologist said.

In some developed countries, the free contraception won by women after decades of campaigning is coming under attack again from the religious right.

In the United States, former president Barack Obama’s signature health reform, known as Obamacare, gave most people with health insurance free access to birth control.

But his successor Donald Trump scrapped the measure, allowing employers to opt out of providing contraception coverage on religious grounds — a decision upheld by the Supreme Court in 2020.

Poland’s conservative government has also heavily restricted access to emergency contraception as part of its war on birth control.

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