2023-08-24 16:36:09
In several French territories, including Île-de-France, mortality is on the rise. In 2021, 2,700 children died before their first birthday.
In France, thousands of parents know the suffering of a child gone too soon. Sometimes this pain only shows up a few hours, days or weeks after birth. A recent INSEE study revealed that in 2021, 3.7 out of 1000 French children died before their first birthday. A phenomenon that is still difficult to pin down.
Infant mortality is a scourge that does not uniformly concern all areas of France. This Thursday, The Parisian sounded the alert on the situation in Île-de-France. In this region “the increase is faster and greater than what is observed at the national level”, as explained by epidemiologist Babette Matulonga.
The case of Île-de-France is not isolated. If in 100 years France has gone from 101 deaths per 1000 births to 3.7, the trend is no longer the right one. There has been no question of a decline since 2005. Worse, between 2014 and 2017, this rate “increased slightly” notes INSEE.
Some departments are doing well. Others, mainly the overseas territories, are particularly badly off, with a number sometimes three times higher of deaths per thousand deaths. In order, Mayotte (8.9), Guyana (8.2), Guadeloupe (8.1), Martinique (7.2) and finally Reunion (6.7), which remain largely above above the national average.
“I would never send my daughters to give birth in a small maternity ward!”
How can France, a first-class world power with an advanced health system, experience such a phenomenon? In its page dedicated to infant mortality in the world, Unicef advances several general causes. The first point, and certainly the most prevalent, is precariousness.
A birth in an environment considered “very poor” increases the probability of early death by 40%. The mother’s level of education also played a role, with a lower probability when she completed secondary school.
“The other countries of Europe also have these general problems, they cannot on their own explain the excess mortality specific to France”, supports Jean-Christophe Rozé, pediatrician and head of the neonatal medicine department at the Nantes University Hospital.
For the specialist, the faults of the French health services fish on two occasions and cause “1000 tragedies per year”. First, in the case of extremely premature births, those occurring at less than 28 weeks of amenorrhea.
For years, French practitioners were afraid to give birth to these babies too young for fear that they would carry a handicap. “Poor medical judgment” among older doctors, he admits. Apart from this bias, in these cases of extreme prematurity, he underlines the lack of availability – and the disparate distribution – of resuscitation beds.
Another problem is death during (or shortly after) “low risk” births. When the mother is in good health and the delivery seems to have gone well but an unforeseeable accident occurs “like a jamming of the umbilical cord”. Rare cases to which it is difficult to react due to lack of practice.
A particularly real problem during “low security” births, in “small maternities” with reduced numbers or during home births. “I would never send my daughters to give birth in a small maternity ward!”, He assures.
The consequences of these situations, immediate death or sequelae that will lead to death in the first days of life.
“A priority” of the government
France must tackle this problem head on because the situation is deteriorating. In 1980, France was the 5th country with the lowest infant mortality in the OECD. In 2020, the country tumbled to 18th place, behind Greece, the Czech Republic or Lithuania. Even within the EU alone, France is also a bad student.
A downgrade of which the government is “aware”, as explained to BFMTV.com Charlotte Caubel, Secretary of State to the Prime Minister for Children.
“The government is aware of the increase in infant mortality in certain territories. To respond to this, many actions have already been taken”, points out the member of the executive.
Among the systems in place, that of the “first 1000 days” deployed since 2020, a mission on maternity hospitals launched on May 3 “but also an improvement in the care and follow-up of premature children”.
To go further, the Secretary of State assures that this problem is “one of the priorities of the work of the foundations of children’s health which are being finalized”.
For Jean-Christophe Rozé, who also chairs the French Society of Neonatology, France does not need to procrastinate. Effective solutions have already proven themselves in the countries of Northern Europe, particularly in Sweden where the reduced number of maternity wards, but with more staff, has saved many young lives.
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