2023-10-09 15:01:26
Published on Oct 9, 2023 at 5:01 p.m.
The hospital crisis does not spare critical care services dedicated to newborns, whose organization “urgently needs to be reviewed”, warn professionals in the sector. Neonatal mortality, which occurs during the first month of a baby’s life and which accounts for 74% of infant deaths, is much higher in France than the European average: in 2021, it concerned 2.72 newborns per 1,000 live births.
Increase in the age of mothers, increase in multiple pregnancies, or even precarious situations: several factors combine to explain such a difference between France and its neighbors. Among these factors, the deterioration in the quality of care offered to premature newborns or those requiring critical care.
The French neonatology society is publishing this Monday the results of a series of surveys to evaluate the provision of neonatology care, particularly in intensive care and intensive care. She is concerned about “very worrying results”.
Refuse entries due to lack of space
The audit depicts a provision of care that is both insufficient and unevenly distributed. The decline in the birth rate that France is experiencing does not in fact translate into a reduction in needs in critical care services. The “reduction in gestational age limits for the management of extreme prematurity, and the increasing number of pregnancies continued while the fetus is affected by a serious and incurable malformation” are on the contrary increasing the number of newborns who need critical care, points out the French society of neonatology.
At the same time, the company deplores bed closures – up to 5% in June 2023. Depending on the French regions, there are between 0.6 and 1.28 neonatal intensive care beds per 1,000 births. The Provence-Alpes-Côte d’Azur region is the worst off. Across the country, 23% of services say they regularly refuse critical entries due to lack of space.
Understaffed teams
On a human level, the degraded working conditions in which the staff of these services work also harm the quality of care, and echo the crisis facing French hospitals. 80% of pediatric neonatologists surveyed by the SFN say they work more than 50 hours per week, and 13% more than 75 hours. 72% of services encounter difficulties in ensuring continuity of care, and 73% are navigating with at least one vacant pediatric neonatologist position.
Finally, these services are forced to operate with teams of nurses with little experience: almost 80% of them “have at least a third of their nursing staff having less than 2 years of experience, which is generally considered to be the duration necessary to reach a level of competence sufficient to practice in a neonatal critical care service”. A period of adaptation that is all the more important as pediatrics and neonatology have no longer appeared on the nursing diploma program since 2009.
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