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Impact of maternity unit closures on access to obstetrical care: The French experience between 1998 and 2003

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  • Pilkington, Hugo
  • Blondel, Béatrice
  • Carayol, Marion
  • Breart, Gérard
  • Zeitlin, Jennifer

Abstract

As in many other countries, the number of maternity units has diminished substantially in France, raising concerns about the reduced accessibility of obstetric services. We describe here the impact of closures on distance and mean travel time between pregnant women's homes and maternity units. We used data from the 1998 and 2003 French National Perinatal Surveys and from vital registries to measure indicators of accessibility: straight-line distance to the nearest maternity unit, number of units within a 15-km radius and reported travel time to the unit for delivery. We analyzed these measures for all births, births in rural versus urban areas and according to regional rates of maternity closures. From 1998 to 2003, 20% of maternity units closed (reducing the number from 759 to 621) with regional variations in the rate of closure from 0.0% to 36.0%. Mean distance to the nearest maternity unit increased (6.6-7.2Â km, pÂ

Suggested Citation

  • Pilkington, Hugo & Blondel, Béatrice & Carayol, Marion & Breart, Gérard & Zeitlin, Jennifer, 2008. "Impact of maternity unit closures on access to obstetrical care: The French experience between 1998 and 2003," Social Science & Medicine, Elsevier, vol. 67(10), pages 1521-1529, November.
    • Handle: RePEc:eee:socmed:v:67:y:2008:i:10:p:1521-1529
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    References listed on IDEAS

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    1. Combier, E. & Zeitlin, J. & de Courcel, N. & Vasseur, S. & Lalouf, A. & Amat-Roze, J. M. & de Pouvourville, G., 2004. "Choosing where to deliver: decision criteria among women with low-risk pregnancies in France," Social Science & Medicine, Elsevier, vol. 58(11), pages 2279-2289, June.
    2. Mayfield, J.A. & Rosenblatt, R.A. & Baldwin, L.-M. & Chu, J. & Logerfo, J.P., 1990. "The relation of obstetrical volume and nursery level to perinatal mortality," American Journal of Public Health, American Public Health Association, vol. 80(7), pages 819-823.
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    Cited by:

    1. Mennicken, Roman & Kolodziej, Ingo W.K. & Augurzky, Boris & Kreienberg, Rolf, 2014. "Concentration of gynaecology and obstetrics in Germany: Is comprehensive access at stake?," Health Policy, Elsevier, vol. 118(3), pages 396-406.

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