“Concerns as France experiences lowest birth rate since 1946: Expert insights on the decline in births and its impact on healthcare”

In France, the number of births has reached its lowest level since 1946. According to the latest estimates from INSEE, only 723,000 babies will be born in 2022. This represents a drop of 19,000 compared to the previous year. . This significant decrease raises concerns about the fertility of the French.

In a press release published earlier this month, Jean-Loup Durousset, president of the Noalys hospital group, expressed his concern about the lack of family policy and the drop in the birth rate. According to him, “The birth rate has never been so low. The Minister of Health remains silent and, strangely enough, there is no longer a Ministry for the Family. We must support young people for a family policy because the closure of a maternity hospital inexorably leads to the death of a territory”. Guest of the program Your Health on BFM Lyon, Jean-Loup Durousset expressed this Tuesday, May 25, 2023 his concerns vis-à-vis the decrease in births.

A steady decline in the birth rate for almost ten years

At Natecia Hospital, what concrete declines are you currently observing?

The number of births at Natecia Hospital reached its highest peak in 2014; with 4559 births. Since then, we see a steady decline. This year, we expect between 2100 and 2200 deliveries. This represents a halving over a nine-year period.

How do you explain this gradual decline in the number of births?

There was a phenomenon that could be anticipated, because between 1987 and 1993 we already experienced a drop in the number of births. This led us to consider that the number of women of childbearing age followed this similar trend. However, there is also an international phenomenon of declining fertility. Initially, France had a fertility rate of two children per woman. But over the years, this figure has increased to 1.8 and we see that the trend is still downward.

The decline in births: a national phenomenon

Is the downward trend in the number of births similar in urban and rural areas, both in the north and in the south of the country?

Apart from Brittany, which is experiencing a slightly less pronounced decline, the downward trend in births is observed nationally. However, it should be noted that some overseas territories, such as Mayotte, experienced an increase in births in March 2023. For the rest of the country, the national average indicates a drop of around 8% in births in March 2023.

Do you feel a threat to your establishment in the Rhône?

We are faced with several important issues. First of all, the economic balance of our establishment is fragile, in particular due to the recent crises, such as the COVID-19 pandemic, that we have gone through. In addition, we are facing a staff shortage, which further complicates the situation. Furthermore, we constantly have to adapt to the decline in births, which requires continuous adjustments. Unfortunately, the rate at which we can adapt is slower than the rate at which births decline. This creates major difficulties for our establishment, as we constantly have to deal with rapid changes and adjustments.

What is the threshold of births from which an establishment risks closing?

The closing threshold of an obstetric establishment depends on its configuration. If the establishment has a large area, such as thirty thousand m2 of buildings, it differs from a smaller establishment. To rehabilitate, it is necessary to diversify activities and find practitioners who can supplement with surgical or medical activities.

In the Rhône-Alpes region, there are fifty-three obstetric establishments. Among them, twenty-two establishments achieve less than a thousand births. If we applied the rule which formerly recommended the closure of maternities carrying out less than a thousand births, this would mean that half of the departments would no longer have maternity wards.

In the Rhône, we are relatively well off. It should be noted that among the French departments, there are four which carry out more than two thousand deliveries per month. These are Île-de-France (Paris), the North, Bouches-du-Rhône with Marseille and the Rhône with Lyon. However, in the rest of the country, there are departments where the number of deliveries is less than one hundred.

Concretely, what are the changes you hope to have in order to deal with the situation?

Several elements must be taken into consideration. First, there is a lack of concern about the economic health of health facilities. There is no symposium or grouping of actors involved to promote exchanges and discuss the situation. This lack of coordination is detrimental. It was suggested to the regional health agency to bring together the actors concerned in order to coordinate efforts, share difficulties and draw up a common observation.

Postponed motherhood and contraceptive advances

Do you notice a trend where women become mothers at older ages?

It is obvious that the concept of parenthood has evolved in recent years. The traditional view of parenthood of thirty years ago is no longer the norm today. In our establishments, we welcome parenthood as it is present, whether young couples, older couples, blended couples, homosexuals or others. It is crucial to accompany these new parents and to set up campaigns to celebrate the pride of being a parent, whatever the situation. It is regrettable that there is no longer a ministry of the family, as if the traditional family had become pejorative.

Has the evolution of contraceptive methods, including vasectomy in men, also contributed to this phenomenon?

Both phenomena played an important role. First, access to different contraception for men has had a significant impact, with an increasing situation of male contraceptive methods in health facilities. As far as women are concerned, there has been a discrepancy between the average age of childbearing. Ten years ago the average age was twenty-eight, today it is thirty, and it could reach thirty-one tomorrow.

TO KNOW

Contrary to popular belief, the COVID crisis and repeated confinements have not led to an increase in births. The gloomy period of the pandemic has not fostered a feeling of optimism necessary to conceive a child. From January to March 2021, a 20% drop in births was observed.