For several years, the number of premature births has been steadily increasing.
To improve the daily lives of families, often upset, France intends to draw inspiration from the Swedish model and allow babies to be cared for at home by medical teams.
Each year, approximately 60,000 babies are born in France prematurely, that is to say before 37 weeks of amenorrhea (8 and a half months of pregnancy), or one every eight minutes.
Among these babies born before term, 85% are medium premature, 10% very premature (6 to 7 months of pregnancy) and 5% very very premature (below 6 months of pregnancy).
“Very favorable results” in Sweden
According to the results of the latest national perinatal survey, the prematurity rate has been increasing for several years: it rose from 4.5% in 1995 to 6% in 2016. Today, it represents nearly 8% of births, says the association SOS préma, at the forefront on the subject.
There are several reasons for this: the first is that the age of childbearing continues to decline, but a late pregnancy generally presents more risks for the baby.
In vitro fertilization, likely to cause more complications, also partly explains this increase.
The way of life of future mothers also comes into play: consumption of tobacco, alcohol, social insecurity, but also work-related stress and fatigue favor preterm births.
About half of these births result from a medical decision to terminate the pregnancy due to maternal or fetal pathology.
In this context, the Ministry of Health last month published a decree aimed at "improving the quality of life of the families of these newborns hospitalized often for long periods".
France would like to implement, in experimental form at first, “an organizational model similar to that in force in Sweden and which gives very favorable results”.
It is a “care of premature newborns at home provided directly by neonatology units”, explain the services of the ministry.
“Stress reduction”
The baby's hospitalization time would thus be reduced: the parents would go home earlier with him and would be guided for care or feeding by medical personnel trained in the specific needs of these newborns.
Such support “would change everything”, rejoices Charlotte Bouvard, the president of SOS préma, who campaigned with the French Society of Neonatology for this change in France.
“Studies have shown that it improves infant development and the parent-child relationship,” she explains.
“In many cases, skin-to-skin or breastfeeding, facilitated by the presence of the baby at home, represents care in its own right,” she continues.
Emmanuelle Bagout, 30, did not benefit from this opportunity.
When she returned home, six weeks after the birth of her baby boy, born premature at 33 weeks, she did not feel joy but "a great loneliness".
“He spent almost a month in the neonatal unit, he hardly ate, I went to see him every day at the hospital”, remembers this Lyonnaise, three years after the birth.
"When he left the service, he weighed 2.3 kilos, took only a few grams a day, we clearly lacked a follow-up", she regrets.
"Having the daily visit of a nurse at home to reassure us would have changed everything", according to her.
Three-year experiment
Relocating the neonatology department to the parents' home only has advantages, in the eyes of Pierre Kuhn, head of department in Strasbourg and one of the project leaders in France.
"In the Scandinavian countries that have implemented it, it has reduced hospitalization costs, allowed faster food empowerment, a reduction in the risk of infection, a drop in maternal stress and an increase in parental satisfaction", he lists.
The French experiment, conducted over three years, will go through a call for projects to select around ten teams.
According to the ministry, it "will fuel the reflection with a view to a possible sustainability of the system".
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