Clélia Gasquet-Blanchard, a professor at the School of Public Health and affiliated with the Spaces and Societies laboratory, argues that medical decisions related to childbirth, which were once primarily focused on patient safety and reducing infant mortality, are now increasingly influenced by financial considerations. She refers to this shift as the "industrialization of births," where certain procedures are favored not for medical necessity but for their profitability. According to Gasquet-Blanchard, physiological births—those that occur naturally without complications—should be quick, while more complex births offer opportunities for procedures that are reimbursed by social security. Despite reforms like the "Bachelot" law of 2009, which aimed to expand the roles of midwives and increase the number of vaginal deliveries, caesarean sections remain more profitable for hospitals. This is partly because they typically require longer hospital stays—five days compared to two or three for vaginal deliveries. Healthcare workers, she says, are caught in a system that prioritizes productivity and profit, leading to increased administrative work, faster work paces, and rigid hierarchies. This has left public healthcare workers struggling with complex and vulnerable cases, often unable to meet their ethical standards due to time constraints. Economist Nicolas Da Silva has described this trend as "healthcare capitalism," which has led to a two-tier system in childbirth. In the private sector, care tends to be reserved for patients with the most financial resources or the most complex medical needs. Public hospitals, while offering similar levels of medicalization, are often less interventionist and suffer from a poor public image. Midwives now handle more than 60% of the 700,000 births that occur annually in France, reflecting a growing reliance on their expertise in the system. Public authorities have promoted fertility while also implementing policies that have led to unintended consequences. In 1998, the French government required maternity wards to have a minimum of 300 births per year to retain their obstetric activity authorization. Over the past 25 years, this policy has resulted in the closure of 40% of French maternity wards, mostly those designated as level 1, which handle low-risk pregnancies. Some have merged with other units, while others have joined higher-level maternity wards (level 2 or 3) that handle more complex cases. Nathalie Sage Pranchère, president of the Society of the History of Birth, notes that this consolidation has created a situation where high-risk pregnancies are more common, as women are spread out across the country. Between 2000 and 2017, the percentage of women of childbearing age living more than 30 minutes from a maternity ward increased by a third, reaching 7% (about 900,000 women). The risk of neonatal death doubles when the journey to a maternity ward exceeds 45 minutes and nearly quadruples if childbirth occurs outside a maternity ward or more than 45 kilometers from the nearest one. This focus on managing high-risk pregnancies paradoxically increases other risks, leading to significant variations in perinatal mortality rates based on region and socio-economic status. In 2024, the perinatal mortality rate reached 12 per 1,000 in communes where the population is among the most disadvantaged, compared to 9.5 in areas with the least disadvantaged populations. Maternity wards now compete for labels such as "baby-friendly" or "good obstetric care" to attract patients and avoid closure. In the private sector, even the term "natural caesarean" has been used, suggesting that parents are active participants in the procedure. Suicide is the leading cause of maternal mortality in France, with one death every three weeks, and this risk continues for up to a year after childbirth. Solutions exist, but they require strong political commitment, according to Nathalie Sage Pranchère, a specialist in the history of medicine and health practices. She emphasizes the need to train more professionals, particularly in the social sciences, and to ensure that these workers are properly employed and compensated. Technical advancements must be accompanied by public policies that address the living and working conditions of pregnant women and ensure the quality and accessibility of medical care throughout pregnancy and childbirth. In her book Faire naître - What capitalism does to maternity, published in 2026, Clélia Gasquet-Blanchard calls for an "emancipating maternity" that moves away from financial accounting and focuses on the well-being of mothers and babies. At the Montreuil hospital, increasing the time spent with patients has reduced health complications. Another approach is the use of "birth houses," which are managed exclusively by midwives and provide expert care for low-risk pregnancies with fewer medical interventions. These facilities, located near hospitals, have been successful in countries like Germany and the United Kingdom, where there are 150 and 170 such units, respectively. In France, the experimental deployment of birth houses began in 2015, but only nine currently exist, despite positive scientific evidence. If two more open by 2027, as hoped, it will still be "not going fast enough," according to one midwife.