According to the French Society of Neonatology, the occupancy rate of intensive care beds reserved for sick or very vulnerable newborns too often exceeds the capacities of maternity wards.
Datas “concerning”. The French Society of Neonatology (SFN) warns about the state of care for vulnerable or sick infants, in a report (PDF document) published Monday October 9. Infant mortality, working conditions, quality of care… This association of experts has compiled, for the first time, data on this medical specialty which cares for vulnerable newborns (premature children, those suffering from congenital malformations or whose (delivery caused complications), up to 28 days after their birth.
The SFN first reveals that the average occupancy rate of intensive care beds reserved for newborns is “greater than 100%, about 20% of the time”. “This means that the rate is exceeded and that in the meantime we are resuscitating babies in the corridors”, denounces Jean-Christophe Rozé, president of the SFN and professor at the Nantes University Hospital. Moreover, “23% of services say they regularly refuse critical entries due to lack of space”notes the report.
Unevenly distributed beds
Added to this is another problem: neonatal intensive care beds are unevenly distributed across the territory. “To function well, we need at least one bed for 1,000 births”, explains Jean-Christophe Rozé. However, this equipment rate varies enormously from one region to another. With 1.28 neonatal intensive care beds per 1,000 births, the Grand Est region is the best equipped, while the Occitanie and Provence-Alpes-Côte d’Azur regions bring up the rear in mainland France, with 0.8 and 0 respectively. 6 beds available for 1,000 births. “The provision of critical neonatal care remains insufficient”indicates the report, and this, “despite the recent decline in the birth rate”.
The SFN also looked at the working time of caregivers. On the medical side, among the 721 pediatric neonatologists surveyed, an overwhelming majority (80%) reported working more than 50 hours per week, and 13% more than 75 hours per week. “In addition, 49% of neonatologists surveyed reported having sleep problems related to their work, and 17% reported having had an episode of burn-out or depression., further denounces the study. Result : “at least one pediatric neonatologist position is vacant in 73% of type 3 services [les maternités équipées pour les soins de néonatalogie et pour la réanimation néonatale], and two or more are vacant in 46% of services.”
Finally, on the paramedical side, “nearly 80% of type 3 services have at least 1/3 of their nursing staff with less than two years of experience”while it is about the duration “necessary to achieve a level of competence sufficient to practice” in these services, deplores the report.
Infant mortality on the rise for ten years
The final worrying point, according to professionals, is the increase in infant mortality over the past ten years. Unlike its European neighbors, France has had an increasing infant mortality curve over the last decade. “It is striking to see that some countries are heading in the right direction, like Sweden, while others are heading in the wrong direction, like France”regrets Jean-Christophe Rozé.
The situation is so worrying that our country, which occupied third place in the ranking of European nations with the lowest infant mortality, is now in twentieth position. “We have 1,000 more children under one year old who die, compared to countries like Sweden and Norway. Among them, around 700 are less than one month old”, regrets the professor at the University of Nantes. To note that “this excess mortality is located [à la fois] among extreme premature and full-term newborns”notes the report.