Science

Cesarean section, epidurals, episiotomy …: how many in each hospital in Ile-de-France?

The Ile-de-France regional health agency posted an interactive map online on Wednesday listing the figures for “obstetric practices” in maternity hospitals in the region, such as the rate of cesarean, epidural or episiotomy.

This site (accouchements.sante-idf.fr), intended for the general public and healthcare professionals, aims to “make data related to childbirth accessible and in a transparent manner”.

For each of the 78 listed maternities, public and private, there are several statistics on deliveries, as well as the total number of deliveries in 2020 and the category to which it belongs – level 1, 2 and 3 – depending on the care that is offered. .

These data, collected from the hospitalization database (the Information Systems Medicalization Program (PMSI), “should be put into perspective with your particular situation”, warns the Regional Health Agency (ARS ).

In fact, level 3 maternities, specializing in the management of pathological, multiple and very premature pregnancies, are more likely to deliver deliveries requiring a cesarean section.

This comparison tool must also “participate in improving the relevance of care in order to reduce maternal and infant morbidity and mortality”, that is to say complications and deaths, underlines the ARS.

Even within maternity hospitals of the same categories, practices can differ a lot: among the four level 3 maternity hospitals in Paris, the cesarean rate varies from 18.7% to 30.6%.

In Ile-de-France, 77.1% of deliveries on average took place last year by vaginal route, including 85.9% under epidural (against 79.5% and 81.1% respectively in all of France ).

Just over one in five women (22.9%) gave birth by caesarean, slightly above the national average (20.5%).

Globally, this rate stands at 21% and “should continue to increase over the next decade” to reach 29%, said the World Health Organization (WHO) on Wednesday.

The international organization sees it as a sign of “an increasing number of medically unnecessary and potentially harmful procedures”, because if this surgical act is sometimes essential for the mother and her child, it also exposes them “to risks. for their short and long term health “.

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