Dyears a recent column published by The Monde, Israel Nisand, professor emeritus of obstetrics gynecology and former president of the National College of French Gynecologists and Obstetricians (Cngof), assumes the right to speak in place of midwives. (“Today, we no longer have enough midwives to deliver babies,” The world of July 27).
Far from calling into question the closure of maternity wards in France and the transformation of others into birthing factories in the current hospital shortage of midwives, he intends to make them guilty of thinking only of their comfort by asserting their “rights” rather than their ” homework “.
According to him, it is because they choose to work as a liberal that this is so. He intends to impose on them, by coercion, the medical and patriarchal order with this kind of proposal: “Midwives should be required to practice for a minimum time what they have been trained for (…). Let’s create an internal internship for midwives over a period of twice six months in two different maternities, paid by the State up to 2,000 euros gross. »
Clearly, Israel Nisand is in the wrong era and in the wrong mandate. The time is definitely over when, from 1945 to 1995, the National Council of the Order of Midwives was chaired by a male obstetrician-gynecologist. Just as the midwife, responsible for teaching at a midwifery school, was placed under the authority of such a doctor until 2016. While the quality of the midwife’s medical acts, identical to those doctors, was only recognized as equivalent by Medicare in 2016, ignoring for a long time any professional equality.
professional monopoly
The current situation, which midwives have constantly denounced, is the result of perinatal reforms where the authorities, from the 1970s, relied mainly on the expertise of obstetrician-gynecologists to guide their policies in this area, as recalled by sociologists at the origin of a report produced in 2021 on behalf of the National Observatory of the demography of health professions.
Obstetrician-gynaecologists have been able to promote a professional monopoly with the idea of pregnancy as potentially pathological and childbirth inherently risky, as Israel Nisand himself defined it in 1998, in an article published in the journal Obstetrics Records: « Childbirth can only be considered normal two hours after birth. » It is necessary, each time, the presence “permanent staff of a midwife, an obstetrician, an anesthetist and a pediatrician”. Moreover, the follow-up of the reproductive and sexual health of women can only fall under the exclusive competence of the doctor.
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