Emergency News – APM / French Society of Emergency Medicine

For more than two years, deliveries at the PSSL maternity ward have been suspended. The first suspension was announced in April 2023 by the regional health agency (ARS) Pays de la Loire, in application of the Rist law, which caps the remuneration of medical temporary work, we recall (see dispatch of 04/14/2023 at 6:04 p.m.).

The suspension had been systematically extended, and reconfirmed by a decree published in the collection of administrative acts of the Pays de la Loire region on December 18, 2025.

In this text, the “temporary and partial” suspension of the authorization of gynecology-obstetrics care activity in full hospitalization of the PSSL was pronounced for a period of one year, from December 19, 2025.

The ARS, pointing to a lack of full-time gynecologists and pediatricians at the PSSL, notably motivated its decision by the fact that the establishment “fails to safely ensure the continuity and permanence of care”.

In January 2024, a defense collective was formed to challenge the population and elected officials. Called “Together for maternity”, it launched a petition collecting several thousand signatures, considering the PSSL’s local maternity as “indispensable in the territory” (see dispatch of 03/06/2024 at 5:48 p.m.).

A transformation into a local perinatal center recommended by Anap

In a letter dated November 28, 2025, the ARS asked the PSSL to “guarantee an organization of care that complies with the requirements for quality and safety of care” of the gynecology and obstetrics activity.

This reorganization could result in a transformation of the maternity ward into a local perinatal center (CPP).

In an audit carried out in 2024, which APMnews was able to consult, the National Agency for Health and Medico-Social Performance (Anap) recommended that the PSSL stop its childbirth activity.

The agency also encouraged the establishment to move “towards a multidisciplinary local perinatal center”, with consultations from gynecologists, midwives and psychologists.

The PSSL, contacted by APMnews on Monday February 9, believes that the CPP would constitute a “suitable legal framework” for its situation.

“The CPP makes it possible to structure links with the support maternity unit(s) where the deliveries take place, by maintaining a maximum of nearby services before and after delivery for the mother and child,” he describes.

The establishment reports that it has so far “not yet taken the steps” to transform its maternity ward into a CPP, a decision which would mark the definitive abandonment of its childbirth activities. “The decision to permanently close [de la maternité] has not been taken to date and is not current,” he insists.

The PSSL considers that the one-year suspension of childbirth activities should make it possible to “evaluate the feasibility of resuming activity and decide on the maintenance or definitive closure of the activity”.

“The resumption of birth activity would involve at least six gynecologists, six pediatricians providing on-call duty and as many anesthetists accepting dual responsibility for the operating room and the maternity ward,” the establishment said. The PSSL currently has “a single gynecologist” and “a single pediatrician with expertise in neonatology”.

In the autumn issue of its internal institutional journal, entitled “Pôle info”, the establishment writes that in June 2025, the gynecology-obstetrics department of the PSSL has set itself the roadmap of “developing a local perinatal center (CPP) in order to maintain the widest possible range of care for the health of women and children at the PSSL”.

The establishment specifies to APMnews that it will be required to “strengthen and develop […] the coordination of routes with the Le Mans hospital center and the Angers University Hospital in particular” and promises to communicate on these activities “when the time comes”.

The PSSL has been in joint management with the hospital center (CH) of Le Mans since February 2025, we remind you (see dispatch of 03/05/2025 at 5:00 p.m.).

In September 2025, the CH du Mans announced that it wanted to make coordination and streamlining of care pathways with other Sarthe establishments one of the priorities of its 2025-2030 establishment project (see dispatch of 09/23/2025 at 7:24 p.m.).

A financial motivation to restructure the establishment

In his wish speech, the deputy director of the PSSL reports that the operating deficit of the PSSL is greater than 12%. He considers the financial situation of the establishment “highly worrying”.

“The end of financial aid from the Covid period had a strong impact on the establishment”, contextualized Aldric Evain, also noting that despite “a significant increase”, the establishment’s activity remained lower than that of 2019.

In 2024, the PSSL deficit stood at around 8 million euros (M€), out of a total budget of around 90 M€, or around 9% deficit.

Aldric Evain reports for 2025 a self-financing shortfall of nearly €10 million and “major cash flow difficulties” which make the establishment “dependent on financial assistance from supervisory authorities”.

“This level of deficit is not sustainable. It was expected, given the contraction in activity,” he confided.

He considers that the implementation of a “restructuring” of maternity was necessary in this context, judging that it is “neither reasonable nor sustainable to maintain resources where there is no longer activity”.

In 2025, the PSSL reduced its surgical capacity from 25 to 18 beds. It has also reorganized its emergency services, notably by deploying a paramedical mobile hospital unit (UMHP) during night shifts.

An authorization request was submitted to the ARS Pays de la Loire to set up an emergency medicine branch (AMU) at the PSSL, but also at the Montval CH, the Saint-Calais CH and the La Ferté-Bernard CH, all in the same direction as the Le Mans CH (see dispatch of 01/16/2026 at 7:00 p.m.).

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