Strengthening Primary Health Care: The New Contribution of Midwives to Gynecological Care in France

In 2009, in a context of a shortage of gynecological primary care, France introduced a reform that expanded midwives’ scope of practice to include gynecological care for non-pregnant women, alongside their traditional roles in pregnancy and childbirth

Using administrative data on healthcare utilization among French women, we analyze changes in the probability of consulting a midwife between 2007 and 2017 among non-pregnant women aged 15 to 55. Our results show an increase in midwives’ use following the reform, particularly among recently pregnant women and those living in areas with poor access to healthcare services. Overall, the effect of the reform extending the primary care roles of health professionals on the use of care depends strongly on the provision of information about these new skills to the general public. Furthermore, we show that this reform is likely to strengthen the gynecological primary care supply in disadvantaged areas.