For several years, the number of preterm births has been steadily rising: to improve the daily lives of often upset families, France intends to draw inspiration from the Swedish model and allow medical teams to care for babies at home.
5% of very premature babies
Every year, approximately 60,000 babies are born in France prematurely, that is, before 37 weeks of amenorrhea (8 and a half months of pregnancy), or one baby every eight minutes. Among these preterm babies, 85% are moderately preterm, 10% are very preterm (6 to 7 months pregnant), and 5% are very, very preterm (less than 6 months pregnant).
According to the results of the latest national perinatal survey, the prematurity rate has been on the rise for several years, rising from 4.5% in 1995 to 6% in 2016. Today, it accounts for almost 8% of births, according to the association SOS préma. at the forefront on this issue. There are several reasons for this: first, the childbearing age continues to decline, but late pregnancy generally poses a greater risk to the baby.
In vitro fertilization, which may cause more complications, also partly explains this increase. The lifestyle of future mothers also plays a role: tobacco use, alcohol use, social insecurity, as well as work-related stress and fatigue contribute to preterm birth. About half of these births are the result of a medical decision to terminate a pregnancy due to maternal or fetal abnormalities.
In this context, the Ministry of Health published a regulation last month aimed at “improving the quality of life for the families of these newborns, often hospitalized for long periods.” France would like to put into practice, first, in an experimental form, “an organizational model similar to that in Sweden, with very favorable results.”
This is “care for premature newborns at home, carried out directly by neonatology departments,” the ministry’s service explains. In this way, the time of hospitalization of the baby will be reduced: the parents will go home with the baby earlier, and the medical staff, trained in the special needs of these newborns, will refer them for care or feeding.
Such support “would make all the difference,” says Charlotte Bouvard, president of SOS préma, who, along with the French Society of Neonatologists, advocated for this change in France. “Research has shown that it improves infant development and parent-child relationships,” she explains. “In many cases, skin-to-skin or breastfeeding, facilitated by having a baby at home, is caring in itself,” she continues.
Emmanuelle Bagu, 30, did not take advantage of this opportunity. When she returned home six weeks after giving birth to a baby boy born prematurely at 33 weeks, she felt not joy, but “a great loneliness.” “He spent almost a month in the neonatal ward, hardly ate, I went to see him in the hospital every day,” Lionez recalls three years after giving birth. “When he left the service, he weighed 2.3 kg, took only a few grams a day, we clearly lacked additional examination,” she regrets. A daily visit from the nurse to our home to reassure us would change everything, she said.
According to Pierre Kuhn, head of the department in Strasbourg and one of the project leaders in France, moving the neonatology department to the parental home has only advantages. “In the Scandinavian countries that have implemented it, it has reduced hospitalization costs, allowed for faster feeding, decreased risk of infection, reduced maternal stress, and increased parental satisfaction,” he lists.
The French experiment, which will run for three years, will go through a design competition in which about ten teams will be selected. According to the ministry, this “will encourage reflection on the possible sustainability of the system.”