2024-04-03 08:00:20
Maternal mortality is not decreasing in France. The report of the confidential national investigation into maternal deaths, made public on Wednesday April 3 by Public Health France and the National Institute of Health and Medical Research (Inserm), reports 272 maternal deaths over the period 2016- 2018, or one woman every four days, and 11.8 deaths per 100,000 births.
“Maternal mortality remains rare, but we must remain vigilantsummarizes Catherine Deneux-Tharaux, research director at Inserm and scientific head of the survey, because a certain number of risk factors such as age or obesity in pregnant women are increasingly common. These events also say something about our health system. »
If France is at a correct level on a European scale and does better than Italy or the United Kingdom, it does less well than Norway or even Denmark. Above all, according to the experts (epidemiologists, obstetrician-gynecologists, midwives, anesthetists-intensivists, psychiatrists and internists) who analyzed these deaths, 60% of them are considered to be ” probably “ (17%) or “possibly” (43%) preventable.
Mental Health
To measure this mortality, all deaths occurring during pregnancy – at forty-two days (an old reference which historically corresponded to the return of menstruation) and up to one year following its end, as recommended by the World Health Organization (WHO) – were taken into account, whatever the cause of death, linked to pregnancy, childbirth and their consequences. “This period of up to one year is all the more important as the WHO emphasizes the importance of women’s mental health and most suicides occur beyond these forty-two days”she specifies.
With forty-five deaths, suicide is now the leading cause of mortality up to one year, with the peak occurring around four to five months after childbirth. These are often women who are pregnant for the first time, and who have already had a proven psychiatric history or eating disorders. One of the levers to avoid these deaths is to act, according to the director of Inserm, on better knowledge of the signs of poor mental health by all those involved.
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“And for women who already have a psychiatric history and are planning a pregnancy, we must create a coordinated care pathway between community doctors and those in the maternity ward. When the child has arrived, too often, we act as if the story is over when we know that the postpartum months are a period of great fragility for the woman”, underlines Catherine Deneux-Tharaux. Among the other indirect causes of maternal mortality, deaths linked to cardiovascular diseases (thirty-nine cases) come in second place. But these pathologies represent the leading cause of mortality at forty-two days. Here again, experts advocate better training for all perinatal professionals.
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