“There is an imperative to rethink and restructure our perinatal care system”

noOur obstetrics is on the brink of rupture, and it is for this reason that we, gynecologist-obstetricians, pediatric neonatologists, anesthetists-resuscitators, midwives, children’s nurses, psychiatrists, psychologists and users , is appealing to the government, as it is to all French people. Together we must recognize the imperative to rethink and restructure our perinatal care systems because today all indicators are red.

Infant mortality, an important indicator of medical and social progress, has been rising since 2012 after falling for more than two centuries. France ranks 25th in Europe, up from 2nd 20 years ago. If we maintain our level of excellence, 1,200 child deaths can be prevented each year.

In addition, the stillbirth rate (death of a fetus after six months of pregnancy) also puts the country at the bottom of the list, ranking 20th in Europe. The Higher Health Authority estimates that more than 50 per cent of serious accidents in which mothers and children are injured in delivery rooms are preventable.

warning indicator

Finally, the authors of the latest Confidential National Survey of Maternal Deaths concluded that 70% of deaths related to pregnancy, childbirth or their aftermath were “avoidable” or “probably avoidable” during the study period (2013-2015) .

How do we not link these worrying indicators to worsening working conditions when we know what is happening to mothers? Recent surveys show that burnout affects 50% to 75% of obstetricians, 65.7% of midwifery managers, and 49% of pediatric neonatologists suffer from sleep disturbances related to their activities.

Also read: Articles reserved for our subscribers “Our obstetrics should not sit still”

Most nursing staff in maternity wards and neonatology units work more than 50 hours per week, and nearly half of them work at least five 24-hour shifts per month. The result: seasoned professionals are leaving hospitals, giving up nursing but also research and training (which are crucial to the future of perinatal medicine), young people are giving up perinatal care.

According to the latest national perinatal survey (ENP 2021), the proportion of obstetricians and gynecologists who need multiple visits to temporary workers or temporary workers is 28.1%, anesthetists-resuscitators are 32.2%, and 28%. For midwives.

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