NOTOur maternities are on the brink of rupture and it is for this reason that we, gynecologists-obstetricians, pediatric neonatologists, anesthesiologists-resuscitators, midwives, child nurses, psychiatrists, psychologists and users, are appealing to the government as to all French. We must collectively realize that it is imperative to rethink and reorganize our perinatal care system, because today all the indicators are red.
The infant mortality rate, an essential marker of medical and social progress, has been rising since 2012 after falling for more than two centuries. France is at 25e European rank, when she was in 2e position twenty years ago. If we had maintained our level of excellence, 1,200 child deaths could be avoided each year.
In addition, the stillbirth rate (fetal death after six months of pregnancy) also places our country at the bottom of the pack, at 20e european rank. The High Authority for Health estimates that more than 50% of serious incidents affecting mothers and children in the delivery room are preventable.
Alarming indicators
Finally, the authors of the last confidential national inquiry into maternal deaths believe that 70% of deaths related to pregnancy, childbirth or their consequences were “avoidable” Or “possibly avoidable” over the period studied (2013-2015).
When we know the situation of maternities, how not to make the link between these alarming indicators and the deterioration of working conditions? Recent surveys have shown that burnout affects 50% to 75% of obstetrician-gynecologists, 65.7% of executive midwives and 49% of pediatric neonatologists suffered from sleep disorders related to their activity.
Most caregivers in maternity wards and neonatal units work more than 50 hours per week, nearly half work at least five 24-hour shifts per month. Consequences: experienced professionals leave the hospital, abandoning care but also research and training (essential for the future of perinatal medicine), and young people are deserting perinatal care.
According to the latest enational perinatal survey (ENP 2021)the proportion of maternity wards that have to call on temporary workers or temporary workers several times a month is 28.1% for gynecologists-obstetricians, 32.2% for anesthetists-resuscitators and 28% for midwives.
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