A geography of the reorganization of health care: maternity catchment (service) areas in Burgundy
The organization of perinatal healthcare services in France is undergoing significant change due to the restructuring of maternity healthcare services and in particular the closure of small and medium sized maternity units. Beyond the strong local reactions and debate provoked by the closure of these maternity units, is it reasonable to say that changes of this kind affect access to maternity care by expectant mothers during pregnancy or delivery ? The goal of our study is to examine changes in the impact of successive closures of maternity units on spatial accessibility for pregnant women and identify the corresponding new catchment (service) areas. The study covers the Burgundy region, a heterogeneous combination of urban, suburban and rural enclaves, all of which are subject to centrifugal forces. The study highlights spatial inequalities in access to perinatal care and identifies factors that policy makers and public health professionals must take into consideration when addressing equity issues.