French Midwives: “The Medical Value of our Profession Has Never Been Recognized”

A front-page story by Phillippe Euzen in LeMonde on December 16 follows the saga of French midwives as they demand a change in the way their profession is defined in public hospitals.  Following is a translation of part of the article.

“They wear white masks to show that they feel themselves to be invisible and unheard.  Between 2000 and 4000 midwives protested in Paris on Monday, December 16, 2013 to reclaim the recognition of their competence and skill and to influence the negotiations taking place in a work group convened on November 7 by the Minister of Health, Marisol Touraine.  Dissatisfied with the process, they left during the afternoon of the third meeting of the group.

“ “The midwives have spent 20 years asking for changes in the statute regulating their practice, but there has been no political will to respond,” states Caroline Raquin, the president of the National Syndicate of Midwives (Organisation national syndicale des sages-femmes, ONSSF).  At the demand of the ONSSF and supporting organizations, the midwives have been on strike since December 16, demonstrating for the third time since demonstrations on November 7 and 19, which also attracted several thousand protesters.

“The midwives who work in public hospitals are asking to be covered by the statute of “hospital practitioner.”  Currently, they are included  in the paramedical professions, with such as nurses and nursing aides.  The hospital practitioner statute would bring their status closer to that of physicians, give them more autonomy in their practice and greater independence under the hospital hierarchy.  On the other hand, they would lose the statute of “functionnaire.”

“Winning the title of hospital practitioner “would only acknowledge the duties and activities which (midwives) already perform,” explains Julie Castaneda and Marie LeBartz, midwives at Lariboisiere Hospital in the 10th Arrondisement of Paris.  The medical value of our profession has never been recognized as we take on more and more competencies, notably in the management of pregnancy.  Such recognition is blocked because it would imply a increase in our salaries, which no one wants to pay.” “

In theory, the 20,000 midwives in France are independent practitioners, working in hospitals, private clinics, or, increasingly, in private practice.  Midwifery is considered a primary medical profession, and midwives can diagnose, treat, and prescribe for normal women.  (See State of the World’s Midwifery – France for more.) It is in the public hospitals where their status and their functions are diminished and where they are asking for changes. Not all midwives agree that the changes would be to their advantage; some want to keep the security of the current status, where they have job security, retirement benefits, etc.  I will continue to watch this story with interest!