TRUE OR FALSE. Is it true that there is a lack of a gynecology specialty in a third of French departments?

A few days before March 8, International Women’s Rights Day, National Rally deputy Jean-Philippe Tanguy deplores that “in a third of French departments […] there is no specialty in gynecology”. This proportion is exaggerated. There is no French department where there is no gynecological follow-up.

After the inclusion of the right to abortion in the Constitution, voted on Monday in Congress, and before International Women’s Rights Day, March 8, some recall that there is still a long way to go for women’s rights , and particularly in access to care. “In a third of French departments, particularly in rural areas, there is a lack of a specialty in gynecology, “Women are unfortunately increasingly forced to sacrifice their health.”, deplores the National Rally deputy of the Somme, Jean-Philippe Tanguy, on LCI. True or false ?

13 French departments without a medical gynecologist, none without an obstetrician gynecologist

This is false, this proportion is exaggerated. First of all, it should be noted that there are two categories of gynecologists: medical gynecologists, who follow women throughout their lives, particularly for contraception, infections and even menopause; and obstetrician-gynecologists, who are responsible for this care but also for pregnancy monitoring and who perform surgery.

According to the latest data from the Demographic Atlas published by the National Council of the Order of Physicians, as of January 1, 2023, 13 French departments have no medical gynecologists. 13 out of a total of 101 French departments, this is much less than the “third party” mentioned by Jean-Philippe Tanguy. And if we look at the obstetrician-gynecologists this time, there are some in every department. We can therefore say that there is no French department without possible gynecological follow-up. In addition, midwives are also authorized to offer gynecological follow-up.

Two medical gynecologists per 100,000 women in France

On average, in France, there are two medical gynecologists and nearly 15 obstetrician gynecologists per 100,000 women, whether in hospital or in an office. Allier, Creuse, Meuse, Yonne or Hautes-Alpes, mainly rural departments, have no medical gynecologists. In a parliamentary report published in 2021 on “the situation of women in rural areas”the senators note a “deficit in terms of access to care in rural areas”, and in particular because of the lack of medical gynecologists. And the situation will not improve in the short term for this specialty, because a third of its practitioners are over 60 years old, according to data from the Order of Physicians.

Medical gynecology is particularly affected by the shortage of doctors because for almost 20 years, France stopped training medical gynecologists. The specialty was not recognized at European level. It was finally reestablished in 2003, after mobilization of the profession, but this created a vacuum that was difficult to fill.

There are more and more obstetrician gynecologists and the profession is younger, but their distribution across the country remains uneven. According to a report published in 2022 by the College of Teachers in Gynecology-Obstetrics (CEGO) and the National College of French Gynecologists-Obstetricians (CNGOF), “only 50% of interns trained in gynecology-obstetrics wish to continue and are actually continuing an on-call activity […] A significant proportion of young obstetrician-gynecologists are not satisfied with the public or private hospital environment and renounce all hospital activity for an exclusive activity of office consultations.”