MMadam Prime Minister,
The National Association of Centers for Termination of Pregnancy and Contraception, (Ancic), an association of abortion professionals created in 1979, has been working since the final vote of the Veil law to defend the rights of women to have control over their body and those of abortion professionals in their practice.
After welcoming the vote, in March 2022, of the Gaillot law aimed at strengthening the right to abortion, impatient for the release of the implementing decree which extends the competence for the practice of IVG by instrumental method to midwives in health establishment, we are today stunned by article D.2212-8-1 of this decree.
For a midwife to be able to perform an instrumental abortion, this article requires that three doctors be available on site, and that a fourth be available on site or remotely. Never has the publication of any law or decree since 1979 worried professionals like us as much.
For training for all professionals
Article D.2212-8-1 constitutes a danger for access to instrumental abortion for women, and strong discrimination of a medical profession, that of midwife, vis-à-vis a another, that of a doctor. Ancic, but also other associations and learned societies such as Ansfo [Association nationale des sages-femmes orthogénistes] and the CNGOF [Collège national des gynécologues et obstétriciens français]were requested for a rereading of the draft decree.
A meeting on November 30, 2023 bringing together numerous representatives of abortion professionals made it possible to conclude, unanimously by the assembled health professionals, that the practice of instrumental abortion by midwives should not have any limits. term other than the limit imposed by law.
The conclusion of this consultation was that the ability to perform instrumental abortions did not lie in the difference between these two medical professions, but in the training of all professionals performing these procedures. While neither the resuscitation doctor nor the embolizing doctor are obligatory on site for a delivery in maternity units not carrying out more than 1,500 deliveries per year, article D.2212-8-1 requires the availability of four doctors, on site or remotely, alongside a midwife, to perform an instrumental abortion.
The risk of slowing down access to instrumental abortion
Remember that complications during childbirth are incomparably more numerous than during an abortion. Doctors in health centers can perform instrumental abortions under local anesthesia even though no obstetrician-gynecologist, resuscitator or embolizer is present on site.
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