The number of staff working in the birthing sector may not at any time be less than the following:
1° Midwives:
a) For any obstetrics unit with less than 1,000 births per year, one midwife is present and permanently assigned to the birth sector;
b) For more than 1,000 births per year, the total number of midwives in the birth sector is increased by one full-time midwife for every 200 additional births.
Midwives assigned to the birth sector may not have other concomitant duties in another sector or unit. However, if the obstetrics unit has fewer than 500 births per year, the midwife may also, in the absence of a parturient in the birth sector, provide care for mothers and newborns in the care and accommodation sector;
c) For more than 2,500 births per year, an additional midwife, acting as sector supervisor, coordinates care during the day;
2° With regard to doctors :
Regardless of the number of births recorded in a health establishment, it organises obstetric and surgical continuity of care every day of the year, twenty-four hours a day, in the obstetrics unit. This continuity is ensured :
– either by an obstetrician-gynaecologist with surgical qualifications ;
– or, when the establishment can only have one practitioner with obstetric skills, by both this obstetrician and a practitioner of general or visceral surgery in the establishment.
a) For units with less than 1,500 births per year, the presence of specialist doctors is ensured by :
– an obstetrician-gynaecologist, on site or on exclusive operational call, every day of the year, twenty-four hours a day, for the obstetrics unit or units on the same site.
The obstetrician-gynaecologist will intervene, on call, in the event of a risk situation for the mother or child, within a timeframe compatible with safety requirements;
– an anaesthetist-resuscitator, on site or on permanent and exclusive call for the site, whose arrival time is compatible with safety requirements;
– a paediatrician present in the health establishment or available every day of the year, twenty-four hours a day, whose arrival time is compatible with safety requirements.
b) For units with more than 1,500 births per year, the medical presence is ensured by :
– an obstetrician-gynaecologist on duty every day of the year, twenty-four hours a day, in the obstetrics unit ;
– an anaesthetist-resuscitator, present every day of the year, twenty-four hours a day, in the health establishment, on the same site, able to intervene in the obstetrics unit within a timeframe compatible with the imperative of safety; if the unit carries out more than 2,000 births a year, the anaesthetist-resuscitator is present every day of the year, twenty-four hours a day, in the obstetrics unit; – a paediatrician, present on the same site, able to intervene in the obstetrics unit within a timeframe compatible with the imperative of safety; if the unit carries out more than 2,000 births a year, the anaesthetist-resuscitator is present every day of the year, twenty-four hours a day, in the obstetrics unit;
– a paediatrician, present on the health establishment’s site or on call, able to intervene in an emergency, every day of the year, twenty-four hours a day, within a timeframe compatible with safety requirements.
3° As regards the other categories of staff, in all units, paramedical staff are assigned to the birth sector and may never be less than one nursing auxiliary or one childcare auxiliary, present at all times. If the unit carries out fewer than 500 births per year, the conditions for the presence of paramedical staff in the birth sector are the same as for the midwife.
