New decree relaxes conditions for midwives to practice instrumental abortion

The decree of 23 April 2024 allows midwives to perform instrumental abortion in health facilities under the same conditions of safety as applied to doctors.

This competence must be attested by the “follow-up of theoretical and practical training on voluntary termination of pregnancy by instrumental method and the action to be taken in case of complications related to voluntary termination of pregnancy”.

As of January 2016, midwives were empowered to perform drug-induced abortion.

The decree of December 16, 2023, stated that they could perform instrumental abortion, previously reserved for doctors, under the following conditions:

• have received theoretical training in orthogenics or have significant professional experience in the field;
• have received practical training (observing at least 10 abortions by instrumental method and performing at least 30 abortions under supervision).

The December decree also required the simultaneous presence in the institution of an orthogenics doctor, an obstetrician-gynecologist, an anesthesiologist and an embolization tray (to manage possible complications). Conditions that only large maternity hospitals, especially those of CHUs, meet.

With the decree of 23 April 2024, the procedures for care and the procedure in case of complications are now identical, regardless of the professional who performs the act of instrumental abortion, and midwives can practice it without the supervision of doctors.

The simplified training and organizational conditions provided for in the new text should make it possible to improve access to abortion in the territory, particularly in smaller health facilities.