The essentials Despite a summer without closures, Haute-Garonne’s maternity hospitals remain under pressure to guarantee schedules. Between medical demographics and the health professions vocation crisis, organizations must constantly adapt. Even in a department that makes more than 16,000 deliveries a year.
Summer has passed, with its difficult period of organizing schedules. No closure of maternity hospitals in Haute-Garonne. But the case of the Cahors maternity hospital (Lot), which had to close for a weekend due to lack of a pediatrician, reminded us of the fragility of the structures in a general context of shortage of health professionals. And, around delivery rooms, many essential professions are under tension. This is the case of obstetricians-gynecologists, pediatricians, midwives and, to a lesser extent, anesthesiologists. The slightest absence weighs on the organization and, for smaller structures, means the risk of closing.
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In Saint-Gaudens, the smallest maternity hospital in Haute-Garonne, the issue remains relevant with the announcement of the retirement of one of the service’s gynecologists at the end of the year. The management assures that solutions have been found and the Regional Health Agency (ARS Occitanie) indicates that it “continues to support this service given its geographical location in Haute-Garonne so that it can be strengthened.” The departmental delegation is in direct contact with the management. of the establishment to reinforce the medical attractiveness.
“We are entering the difficult part”
In the metropolis of Toulouse, maternity hospitals remain attractive, but they are not immune to the aging of the population: paediatricians, gynecologists and midwives are especially in demand. And with four establishments in the heart of the city, plus Muret, L’Union and Quint-Fonsegrives nearby, the needs are great.
Private clinics are the most affected, as indicated by Dominique Faudou, president of the Council of the Order of Midwives of Haute-Garonne, due to the few young graduates available (nationally, more than 20% of places in the second year of midwifery were still vacant) and a lack of consideration of their competencies. Due to a lack of candidates, it is sometimes difficult to provide night shifts, forcing some maternity wards to also rely on the skills of nurses for post-maternity care.
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At the Paule de Viguier maternity hospital (Toulouse University Hospital), the teams witness these tensions in human resources. “This situation has lasted almost three years and we know that we are entering difficult times. The slightest closure, in the department or in neighboring departments, impacts us but, fortunately, we work well with the 15 and the perinatal network. Everyone has learned to compose and anticipate”, testifies Professor Paul Guerby, head of the obstetrics center at the University Hospital of Toulouse, the only level 3 center and regional tourist center in western Occitania.
“We are campaigning for the opening of a level 1 structure in the hospital to relieve Paule de Viguier, which is overloaded and can only accept pathological pregnancies. Future mothers are forced to turn to the private sector and that poses a problem ethical”, explains Dominique Faudou, president of the Council of the Order of Midwives of Haute Garonne.
Of the eight maternity hospitals in Haute-Garonne, six treat pathological pregnancies in combination with neonatology services.
Maternity birth figures
According to data provided by the “Studies and Statistics” Center of the Regional Health Agency (ARS Occitanie), in 2022 there were 16,090 births in Haute-Garonne maternity hospitals. The vast majority of mothers are domiciled in the department (1,382 parturients). do not live in 31 and 108 are not from the Occitania region).
Public establishments carried out nearly 7,700 deliveries: 4,784 at the Paule de Viguier maternity hospital (Toulouse University Hospital), 2,443 at the Joseph Ducuing hospital (Toulouse) and 467 at the Saint-Gaudens hospital centre.
Private clinics therefore carry out more than half of the deliveries in Haute-Garonne, that is, 8,396 deliveries: 3,517 at the Rive Gauche clinic in Toulouse, 1,900 at the Croix du Sud clinic in Quint-Fonsegrives (Ramsay group), 1,654 at the Ambroise clinic. Paré (Elsan group), 789 at the L’Union clinic (Ramsay group) and 536 at the Occitania clinic in Muret (Elsan group).