The Senate opposed, Friday evening, November 13, to a three-year experiment authorizing midwives to practice, after specific training, voluntary instrumental terminations of pregnancy, that is to say surgical, until at the 12e week of pregnancy, just as they can, since 2016, perform medical abortions.
When examining the Social Security budget bill, the Senate, with a right-wing majority, removed this provision introduced in the National Assembly. “The practice of instrumental abortions by midwives is not unanimous, for reasons of quality and safety of care, due to the technical nature of this surgical procedure performed under anesthesia”, defended Senator Corinne Imbert, a related LR.
Secretary of State Adrien Taquet has promised “To come back” during the second reading in the Assembly, where LREM is in the majority.
Ensure access to abortion throughout the territory
During the first reading in the Assembly, the deputies had proposed this experiment, in order to “Draw the consequences of the lack of doctors performing abortion, especially in rural areas”. The deputy Modem Perrine Goulet had underlined in session “Very important needs because, in many territories, there are not enough practitioners to perform abortions. In Nièvre for example, where my constituency is located, only one doctor provides them. “
Abortion, why the numbers are increasing
The authorization given to midwives to perform these later abortions was also included in the bill aimed at strengthening the right to abortion, adopted at first reading on October 8. “The PLFSS is an opportunity to go faster by avoiding the vicissitudes of the parliamentary shuttle that will follow the bill”, Perrine Goulet pleaded, receiving the favorable opinion of the government.
A practice in question
Basically, the Minister of Health saw in this experiment an improvement in the offer of care: “At the present time, in many centers, it is in fact general practitioners who perform these procedures although they do not necessarily have expertise in gynecological surgery”, he had explained. This experiment which “Is part of the continuity of the recognition of the prerogatives of midwives”, “Will determine their needs in terms of training and insurance before a possible generalization”, had also indicated the deputy Perrine Goulet.
But the measure had been criticized by some doctors or associations. “The primary mission of midwives is to give life – birth, had defended the deputy Emmanuelle Ménard (not registered) in the hemicycle. It is true that they can now carry out medical abortions, but a surgical act is a very different thing and must be performed by a doctor, not by a midwife. These are not the same practices! You will broaden their field of action without any impact study or reliable data on the real needs of the midwives themselves, but also of the women who decide to perform an abortion. “
Systematic third-party payer and anonymity
Refusing this experiment, the Senate on the other hand voted in favor of the systematic full third party payment in the event of abortion. “We are trying to ensure that all women who want it can, on an equal basis, have access to abortion in the best possible conditions”, argued Senator Laurence Cohen (CRCE, Communist majority).
This measure had also been adopted in the Assembly. “If abortion is covered 100% by compulsory health insurance, the exemption from advance expenses is not guaranteed in all cases and for all insured, explained the amendment. The lack of systematic practice of full third-party payment does not guarantee the respect of secrecy for policyholders who wish to keep their journey confidential. “ In particular, young girls who are minors vis-à-vis their parents or adult women vis-à-vis their spouses, the amendment specified.