In 1992, in the public sector, 18% of child deliveries took place in small maternity centres having less than 15 beds. In 1981, the percentage has fallen to 11%. In the private sector, the two proportions were respectively 30% and 11%. From the demographic point of view, the process of urbanization and the sharp decrease in the overall birth rate explain the trend. From the medical point of view, as the small maternities cannot have sophisticated equipment, the risk to the mother and the child is likely far greater than in maternities in large cities. However, there is no clear-cut empirical evidence. Moreover, the closing down of a maternity centre in a small city means loss of individual jobs, of collective prestige and the start of overall decline. Furthermore, people have a greater felling of safety with a neighboring maternity centre. In France, the subject is extremely controversial. The article shows some directions to cope with the debates.