In New Caledonia, the PMA journey “a real hassle” and a lot of “waste of time”

For more than 270,000 inhabitants, New Caledonia has only one center which practices medically assisted procreation (MAP) or medically assisted procreation (AMP). In this Gaston-Bourret territorial hospital center (CHT), a gynecologist and a biologist. Two people to handle all PMA requests from the French Overseas Territory (TOM) located in Oceania. So if they are absent, for vacation for example or sick leave, the entire activity is at a standstill.

“But we remain reasonable,” says 20 minutes Clotilde Dechasset, the gynecologist of the archipelago who emphasizes that in fact, New Caledonia, like many French departments, is facing a “shortage of doctors”. But recruitment is more complicated than elsewhere because of the 23,000 km and 24 hours of flight that separate the archipelago from the metropolis. That’s a big difference. Replacing a doctor on the go is almost impossible. And if the feeling does not pass with the only doctor, the couple has no choice.

PMA or “the last wheel of the carriage”

“Patients are dependent on our schedule and waiting times will be extended,” continues Charlotte Mauroy, the biologist. “We would like to have more of us,” she adds, “ideally two gynecologists and two biologists because today we cannot see everyone. Some patients give up. » Déborah Guerot, 38 years old, local representative of the Collectif BAMP association, would also have liked to have “more choice to have different opinions”. Additionally, for some women, time is running out.

A few months can be decisive for getting pregnant. Elodie (first name has been changed at the request of the person), 39 years old, who began her PMA journey at 32. After the four IVF (in vitro fertilization) reimbursed by the local health insurance fund (Cafat), still no results. Like other patients, Elodie faced many hazards during her journey and, each time, “it’s a waste of time, from one day to the next, everything stops”, remembers Déborah Guerot bitterly. As when the only biologist at the time went on sick leave, Elodie was “ready to take the plunge” but, without him, it was impossible to continue. A month later, another attempt, but the health crisis decided otherwise. New total shutdown.

Unforeseen events that can be fatal

In this journey strewn with pitfalls, “very difficult”, as Elodie describes it, the move of the hospital in 2017 will also have caused her to lose precious time. Especially since the PMA service was the last to be put back in place, “like the last wheel of the carriage”, underlines Elodie. PMA “does not seem to be a priority, behind other care”, confirms Clotilde Dechasset. “It makes it longer,” she adds. So many unforeseen events that disrupted her pregnancy plans and gave way to “a lot of pain and sorrow”.

So some go for their IVF or artificial inseminations in mainland France, to save time. Elodie thought about it for the last attempt, thinking “that with a change of environment, another approach, another technique, things could be different”. But you have to pay a lot of money: count on more than 1,000 euros for a return ticket per passenger. Add to this the cost of the intervention which is not covered by Cafat when it is carried out outside New Caledonia. “There are therefore a lot of inequalities between patients,” underlines Charlotte Mauroy. Déborah Guerot also chose to go abroad. She finally managed to get pregnant after seven to eight years of inseminations and IVF thanks to an egg donation in the Czech Republic “over the last year”.

Still a long delay in legislation

In the only PMA service in the entire archipelago, Clotilde Dechasset and Charlotte Mauroy manage between 900 and 1,200 requests per year for infertility from heterosexual couples alone. Because the overseas community has fallen behind in caring for single women and homosexual couples. “A societal and political question”, analyzes the gynecologist. So the implementation of the bioethics law, even if it is delayed more than two years after its vote, requires “a lot of work” from the two professionals. “We prioritize certain things so we fall behind on others,” adds Clotilde Dechasset.

Being just two also means being alone when faced with their choice, making sometimes difficult decisions, without any colleagues to share or advise. This is without counting political meetings, media requests, etc. “We have a very versatile cap for which we are not really trained,” comments Clotilde Dechasset. The duo is also negotiating for the creation of a sperm bank, the absence of which is considered a “real lack” by Déborah Guerot. The latter is also campaigning to open up the possibility of egg donations in New Caledonia.

Difficult but not impossible

Fortunately, neither Clotilde Dechasset nor Charlotte Mauroy want to leave the archipelago. “It’s hard, but we want to continue,” they say in one voice. Besides, the grass is not necessarily greener elsewhere. Déborah Guerot emphasizes that in Mayenne, where she lived before moving to Nouméa, “there was no AMP center” and that there are none in French Polynesia either.

Elodie “did not mourn [d’avoir un enfant] because it never existed”, but she is “pacified” with the idea that she will never give birth. The young woman, however, has good news to announce: she will welcome a little girl into her home through adoption and start the family she has always dreamed of.

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