in Auvergne, a “small hospital on wheels” to support pregnant women
Do not forget the patient files or the computer from the Clermont-Ferrand university hospital center (CHU), attach the monitoring and the ultrasound scanner well to avoid unpleasant surprises in the bends. Nathalie Dulong and her teammate of the day, Julie Duclos-Médard, are starting to get in the know.
For six months, since September 2022, these midwives and their colleagues have been pounding the countryside on the small roads of Cantal, Puy-de-Dôme, Haute-Loire and Allier, between mossy pastures and roofs of lauze, aboard their “little hospital on wheels”, Opti’care. They set out to meet pregnant women furthest from perinatal structures, whose pregnancy monitoring is sometimes disrupted by distance, in these lands deserted by those who provide care. On board, all the medical equipment to provide ultrasounds and biological examinations.
While there are a few mobile care structures for women (La Mammobile, for breast cancer screening in the Orne, Gynécobus for gynecological prevention in the Var), Opti’soins is a first in obstetrics in metropolitan France. – inspired by a similar project in Mayotte, la Répémobile. The experiment, backed by a research project – led by the Perinatal Health Network of Auvergne and the CHU of Clermont-Ferrand, funded by the Ministry of Health and the Auvergne-Rhône-Alpes region –, starts from a finding : “The distance of more than thirty minutes by car from a structure or a health professional authorized to monitor a pregnancy complicates access to appropriate and regular monitoring, preventing the prevention of certain complications, all the more so if pregnancy requires more medical follow-up”explains Dr. Anne Debost-Legrand, principal investigator of the project.
Decrease in the number of gynecologists, closure for forty years of small maternities – on the grounds, in particular, of a number of births considered insufficient and a lack of specialist doctors – in favor of more technical centralized structures deemed more secure by the health authorities… This concentration has a consequence: the number of women of childbearing age more than 45 minutes away from a maternity ward more than doubled between 1997 and 2019 in France, according to a study by health geographer Emmanuel Vigneron carried out for The world, in 2019, with 430,000 more. The number of those more than thirty minutes away has increased by nearly two million.
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