🚨 Rising neonatal mortality: 100 pages to change the model
🔍💡 Perinatality: a ministerial report links the rise in neonatal mortality to flaws in the pathway — prevention, post-partum, precariousness — and describes tested levers in the field (outreach in PMI, prevention of shaken baby syndrome, mother-child PASS). 👶
📌 This report provides prevention actors with a quantified overview of perinatal health in France, useful for arguing a project to a funder or a local authority. It describes already tested systems — outreach calls in PMI, prevention of shaken baby syndrome in maternity, breastfeeding helpline, coordinated follow-up of vulnerable newborns — that can inspire local actions. It also highlights the fragile areas of the pathway: post-partum, homeless women, language barriers, literacy. Finally, it allows one to situate their action within the announced reforms and identify where the field can complement the healthcare offer.
Source:
📒 For a perinatal policy that meets the challenges. Change the framework, change the model for women, newborns, and their families
✍️ Marie-Pierre Bonnet (anaesthetist-resuscitator), Elsa Kermorvant (paediatrician), Prof Loïc Sentilhes (gynaecologist-obstetrician). General Secretary of the mission: Sonia Baudry. September 2026📜🔗LINK to the source
1️⃣ ANALYTICAL SUMMARY
A neonatal mortality that has risen, in a framework that has remained unchanged since 1998
According to the data cited by the mission, the infant mortality rate has increased from 3.5 ‰ in 2011 to 4.1 ‰ in 2024, resulting in nearly 2,700 deaths before the age of one; the rise is concentrated in the neonatal period (1.5 ‰ to 2.0 ‰) (p. 5). France would be above the European average (4.0 ‰ compared to 3.3 ‰ in 2023) and very premature infants would account for more than three quarters of the neonatal excess mortality (p. 9, 41). The report describes a fragmented governance — the national birth commission has not met since 2018 (p. 11) —, decrees from 1998 considered obsolete (p. 8-10) and significant inequalities: excess mortality in the DROM (p. 69), among women born outside Europe (p. 63) and among homeless women (p. 64).
From national governance to field practices
The report makes recommendations in four areas: governance and data (national body, sustainability of the ENP, ENCMM and SNOOPI); pathways and prevention (100% coverage of pre-conception consultations, campaigns on tobacco, infant sleeping arrangements and shaken baby syndrome, support for breastfeeding, early prenatal care in a go-to model, postpartum reimbursed at 100% up to 42 days); inequalities (Mother-Child PASS, accommodation places, perinatal health literacy); professions (staffing, ratios, recognition). Several boxes present reproducible systems and annex 5 proposes quality indicators to be made public for users (p. 93-94).
2️⃣ KEY POINTS OF THE DOCUMENT
1️⃣ A degradation concentrated in the first days of life
The increase in infant mortality would be entirely linked to neonatal mortality, which accounts for 75% of deaths before one year; France would have dropped from 3rd to 23rd place in Europe between 2000 and 2023, with a stable prematurity rate (6 to 7%) (p. 5, 41).
2️⃣ A prevention that still poorly reaches women
According to the ENP 2021 (declarative data), 28% of women received folic acid before pregnancy (p. 19) and 44% say they have not received advice on baby sleeping (p. 52); nearly 27% smoked in the year preceding pregnancy and more than 15% resumed two months after childbirth (p. 21).
3️⃣ A breastfeeding that stops early, due to lack of support
Nearly 3 out of 4 women start breastfeeding, but only 1 in 2 is still breastfeeding at 2 months and less than 20% at 4 months; 84 maternity units are labelled "Baby Friendly" (17% of births) (p. 24-25). The SOS Breastfeeding line (Île-de-France) received more than 8 000 calls in 2025 (p. 26).
4️⃣ Residential homelessness, a major risk factor
According to the REPERES study (Samu social, Solipam, 2026), women in homelessness change accommodation on average 36 times between the 6th month of pregnancy and the 3 months of the child; neonatal mortality there would be eight times higher and the renunciation of care would reach 17.6% (p. 64).
5️⃣ Promising initiatives, to be evaluated
The Crying Plan (CHU de Lille) would be associated with a decrease of about 50% in cases of shaken baby syndrome treated, at an estimated cost of €200 per birth (team data, p. 52-53); COCON would reduce the lost to follow-up to 7.3% at 12 months compared to nearly 40% (interim evaluation, p. 61).
3️⃣ ACTION PATHWAYS FOR LOCAL ACTORS
1️⃣ Integrate the management of crying and parental anger
Draw inspiration from the Crying Plan (p. 52-53): a short session on infant crying, the anger it provokes and shaken baby syndrome, with identification of a resource person in case of exhaustion. The format can be transposed to a parent-child reception centre, in PMI or in a parenting workshop.
2️⃣ Relay the rules of safe sleeping
Check that the materials distributed (posters, social media, birth kits) do not show a baby lying on their stomach or surrounded by objects, in accordance with the HAS 2020 recommendations cited on p. 52. Prioritise targeting vulnerable families, which the report designates as a priority audience.
3️⃣ Test the outreach by phone
The ARIANE model (p. 59-60) is based on a systematic call to pregnant women and a semi-structured questionnaire (housing, isolation, couple, mental health); about 70% express at least one need. A local structure can adapt this logic of ‘ proportionate universalism’ with the PMI of its department.
4️⃣ Make perinatal information accessible
Mobilise the FALC tools, interpreting and translation (p. 30), promote the paper maternity booklet for women distanced from digital (p. 51) and rely on the LISA guide (p. 67). Unmet need: the report does not detail tools for co-parents or for people with disabilities.
5️⃣ Map the support networks after discharge from maternity
Establish a local directory of support for breastfeeding and post-partum (PMI, independent midwives, lactation consultants, associations, peers, helpline) (p. 25-26), targeting the first 15 days. Raise awareness among employers about the breastfeeding break (p. 26).
6️⃣ Facilitate access to the rights of vulnerable women
Identify the services in the area (PASS, mother-child PASS, health care rest beds, mobile teams) and support the opening of rights from the beginning of pregnancy (p. 65-67). Participate in medical-psycho-social staff meetings when they exist (p. 66). Necessary adaptation: the report does not specify the role of associations outside of care in these pathways.
4️⃣ ADDITIONAL REFERENCES
On the blog Health Practices
🔗 Organisation of perinatal care in the territories: affirming a public health logic (IGAS report, January 2026 — article from 7 August 2026). Additional reading: IGAS primarily attributes the increase in mortality to social and population factors.
🔗 Modernisation of maternal and child protection in service of the child's journey and support for parenting (article from 24 September 2026).
🔗 From pregnancy to the arrival of baby, with serenity. Nutrition, physical activity and well-being (article from 12 June 2026).
and https://www.pratiquesensante.com/blog/tag/perinatalite-376
External references
1️⃣ ARS Île-de-France / No Side in Health — "Health literacy in perinatality" (LISA guide), 8 April 2025. Three notebooks (Understand, Act, Go further) to adapt information for pregnant women; cited p. 67 of the report.
2️⃣ HAS — " Partnership in health and partner patients. Guide and practical sheets ", adopted on 28 May 2026, published on 30 June 2026. Tools to involve users and families in pathways, in training and research; completes section III.1 of the report.
3️⃣ Public Health France — " Perinatal health and early childhood in France between 2012-2024 ", national bulletin, 8 July 2026. Source of surveillance data (and not a methodological guide) useful for updating regional indicators.
5️⃣ FREQUENTLY ASKED QUESTIONS (FAQ)
1️⃣ Why is baby mortality increasing in France?
The increase concerns the first month of life and mainly affects greatly premature infants. The report does not isolate a single cause: it mentions the organisation of care, staffing, prevention, maternal age, obesity, multiple pregnancies and social inequalities (p. 5-6, 19-24, 41). The IGAS places more emphasis on population factors.
2️⃣ What is a local perinatal centre (CPP)?
It’s a structure that maintains consultations for pregnancy, for gynaecology, for paediatrics, for sexual health and for postnatal follow-up where there are no longer any deliveries. The report proposes to experiment with birth follow-ups, a permanent midwife service and accompanied transport (p. 33-37).
3️⃣ What does the report change for the post-partum?
It proposes 100% coverage of consultations up to 42 days (instead of 12), a PRADO focused on vulnerable mothers, a first appointment within 48 hours after discharge and the declaration of a treating physician as soon as pregnancy (p. 49-51).
4️⃣ What place for perinatal mental health?
According to the report, 15 to 20% of women would experience post-partum depression (40 to 50% after a premature birth). It recommends linking each maternity unit to a perinatal psychiatry unit and fully reimbursing postnatal care for vulnerable women (p. 53-54).
5️⃣ How to help a pregnant woman without health coverage?
The report proposes an accelerated opening of rights without a waiting period, the automatic linking of the newborn to the parents' coverage, and the integration of blood tests and ultrasounds into city PASS (p. 65-66).
6️⃣ What future for PMI?
The resources for PMI would have decreased by about 25% in the 2010s, and 30 to 40% of the teams' time would go to non-healthcare tasks. The report proposes national funding based on the number of children aged 0 to 6 years and a refocusing on prevention (p. 58-59).
7️⃣ Why did a member of the mission not sign?
The midwife of the mission deemed the points without consensus too numerous, especially regarding the liberal healthcare offer: place of CPP, birth houses, PRADO, evaluation of early prenatal care and perineal rehabilitation (p. 100-102).
6️⃣ REWRITING IN FALC
What is this report about?
Some experts wrote a report for the Minister of Health.
The report talks about pregnancy, birth, and the first months of the baby.
In France, more babies die than before.
About 1 baby in 250 dies before the age of 1.
These deaths mainly occur in the first month of life.
Babies born very early are the most affected.
Poor women or those without housing are at greater risk.
What does the report propose?
Better organise the health of mothers and babies across the country.
Help women prepare for their pregnancy with a doctor or a midwife.
Better explain the dangers of tobacco and alcohol.
Better support mothers who want to breastfeed.
Better follow up with mothers after birth, for 6 weeks.
Do not separate the baby from its parents, except for medical reasons.
Provide a stable home for pregnant women without housing.
Key points
The first month : this is the most dangerous period for the baby.
Prevention : many women do not receive the right advice. For example, how to lay the baby on its back.
Breastfeeding : many mothers stop quickly. They lack support after maternity.
Housing : without housing, the baby is at greater risk of dying.
Actions that work : in Lille, parents are taught how to manage the baby's crying. There are fewer shaken babies.
7️⃣ CROSS-SECTIONAL ANALYSIS — VALUES OF HEALTH PRACTICES
Literacy : The report calls for the inclusion of perinatal health literacy in national objectives and cites FALC, interpreting and LISA guide (p. 30, 67), without proposing a graded tool itself.
Empowerment : The birth project, shared decision-making and parents as partners in neonatal care are recommended (p. 56), but users did not participate in the drafting.
Participation : User collectives have been heard (p. 86) and the report proposes three user seats in the national body (p. 91), as well as participatory research approaches (p. 56).
Community health : The collective dimension appears in peer support for breastfeeding (p. 25) and CPPs as resource places (p. 33), but remains secondary compared to the care approach.
Ethics : The report refuses to blame women for maternal age (p. 23), notes the exclusion of non-French-speaking women from studies (p. 14) and raises the ethical question of the use of PADHUE (p. 98).
Human rights : The best interests of the child are established as a principle for homeless families, with unconditional accommodation during the first 1000 days (p. 64-65).
Intersectorality : The report calls for breaking down silos between maternity, psychiatry, PMI, ASE, MDPH and social housing (p. 53-54, 64), with an inter-ministerial circular for homeless mothers.
Partnership : A distribution of roles is formalised: DSRP at the regional level, CPTS at the local level, with agreements, perinatality referent and common indicators (p. 62).
Fight against discrimination : The report mentions refusals of care as a sign of persistent discrimination (p. 64) and the higher mortality of migrant women, which it links to precariousness and language barriers (p. 63).
8️⃣ EVALUATION OF THE RELIABILITY OF THE RESOURCE
Scientific relevance — good, with reservations
Authors recognised academics and numerous hearings (p. 84-87); recent institutional sources (Insee, ENP 2021, ENCMM, SpF, IGAS 2026, Court of Auditors 2024 and 2026).
Choice made to cite little scientific literature, for the readability (p. 7): several figures are not sourced precisely (proportion of very premature infants in excess mortality, international comparison of nursing staff).
Data partly declarative (ENP) and some internal discrepancies: alcohol consumption during pregnancy (3 to 12% p. 21, approximately 8% p. 53); cannabis (1 to 3% p. 22, 2 to 5% p. 53).
Results of the frames to be interpreted with caution: Crying Plan (data provided by the team), COCON (interim evaluation). The authors themselves remind that an association does not establish causality (p. 6).
Reading to be cross-referenced with the IGAS (2026), which primarily attributes the rise in mortality to population factors, and with the position of the non-signatory midwife (p. 100-102). The perspective of the mission remains predominantly hospital-based.
Operational relevance — average
Recommendations mainly addressed to the State, to the ARS and to the establishments; few direct levers for associative actors.
Directly usable: practice frames (p. 21, 25-26, 46, 52-53, 59-61, 67, 70) and annex 5 (quality indicators of maternity units, p. 93-94).
9️⃣ STRATEGIC HASHTAGS
#healthpractices #Perinatality #1000FirstDays #InfantMortality #MaternalHealth #HealthLiteracy #MovingTowards #SocialInequalities
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