Perinatal health in France: the Court of Auditors recommends an individualized analysis of small maternity units

Faced with France’s “poor health results” for perinatal care, the Court of Auditors recommended, in a report published Monday May 6, to improve the quality and safety of the provision of care, in particular by focusing “on case by case” on small maternity wards.

“While the resources devoted to perinatal policy are ever greater (9.3 billion euros in 2021, up 9% compared to 2016) and the birth rate is falling (–5.6% over even period)”, the wise men of rue Cambon questioned “the efficiency of the allocated resources”.

Their observation is clear: “The main indicators of perinatal health – stillbirth, neonatal mortality and maternal mortality – highlight France’s mediocre performance compared to other European countries. »

The report points to “significant perinatal risks”, sometimes more frequent (obesity, late pregnancies, etc.), and “strong social and territorial inequalities” affecting in particular mothers born abroad and in overseas territories. , but also an “incomplete epidemiological monitoring system”.

A perinatal health system that does not meet requirements

Overall, “the current situation does not meet the requirements for optimal safety or efficiency in the organization of healthcare provision”, according to the Court of Auditors.

The report cites in particular a regulation of the organization and technical operating conditions of maternity wards “unchanged for twenty-five years”, appearing “adapted neither to the evolution of care nor to the restructuring of the offer of care “.

The Court of Auditors notes that around twenty maternity wards still deviate from the minimum threshold of three hundred deliveries per year.

And “the growing difficulties of maternity wards providing fewer than 1,000 annual deliveries to attract and retain qualified personnel call for a case-by-case analysis of the conditions for carrying out their missions”, according to the wise people.

“In the arbitration between accessibility and security, we advocate moving towards security,” summarized the first president of the Court of Auditors, Pierre Moscovici, during a press conference, affirming that “a medical and scientific consensus is emerging in favor of larger and safer structures.”

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