Giving birth in France is changing, shows new report

The way women give birth in France is changing, as the number of caesarean sections and episiotomies have dropped

The way women give birth in France is changing, as the number of caesarean sections and episiotomies have dropped since 2010, amid a fierce debate on their use.

Those were the findings of a new study by The National Institute for Health and Medical Research (l’Institut national de la santé et de la recherche médicale (Inserm)) and the Direction of Research, Studies, Evaluation and Statistics (la Direction de la recherche, des études, de l’évaluation et des statistiques (Drees)), reported in French newspaper Le Monde today.

The report considered a representative sample of 14,142 births. More than 2,150 children are born every day in France: 785,000 a year.

The number of caesarean sections had been rising to 2010, up from 10.9% in 1981 to 19.6% in 2012. However, the rise has now stabilised around the 20% mark, and there were fewer women choosing to have caesareans between 2010-2015, especially if they had one for a previous birth.

The study comes as a debate continues over the issues of non-consensual episiotomies (a procedure that sees the mother’s perineum cut during childbirth, ostensibly to avoid further harm from tearing), “useless” caesareans, and “dangerous” use of oxytocin injections before birth.

Marlène Schiappa, the secretary of state for female and male equality, has commissioned a report into the issues, while birth lobby group Ciane (the Interassociative Collective for Birth, Collectif interassociatif autour de la naissance) and the National College of French Gynaecologists and Obstetricians (Collège national des gynécologues et obstétriciens français (CNGOF)) have called for “a political initiative to progressively decrease the number of episiotomies in France to under 30%”, down from the “47% seen in 2002-2003”.

In 1998, over two thirds of births (71.3%) to first-time mothers in France involved a episiotomy.

The groups called for doctors to no longer do “systematic” episiotomies, in order to increase recovery levels and prevent the sometimes-serious injuries they can cause.

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The debate also continued around the use of oxytocin injections, which the group also considered to be too high. The synthetic hormone is often used to accelerate contractions, especially if they have been slowed by the use of a painkiller epidural, but is also said to put women at higher risk of postpartum hemorrhage.

“When you use anaesthetic or other drugs, you change the conditions for birth,” explained Paul Cesbron, a gynaecologist and former head of maternity at the Creil hospital (Oise), speaking to Le Monde.

“I’m not against their use, but they have been presented as a panacea [to all ills], and they are medicalising maternity on principle.”

The study also found a worrying trend in lower baby weights, with a rise in the number of underweight babies born between 2010-2016, especially in urban areas. This has been attributed to rising pollution levels, which were seen to be as damaging as smoking to unborn babies.

Similarly, the number of obese pregnant women has also increased, as has the number of mothers aged 35 and over, and while smoking levels had decreased rapidly, the numbers of mothers smoking during their pregnancies was shown to have stabilised.

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