Baby box: because a gift for parents, it causes discomfort among midwives

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By Amanda Breuer Rivera

Launched on an experimental basis in March 2022, the “baby box” is distributed to all parents in sensitive areas leaving the maternity ward. The target. the goal? Delivering prevention messages to improve maternal and child health. An initiative that goes wrong with midwives.

Election gift or advance in public health? Launched in March, the “baby box” is distributed in 353 maternity units in “fragile rural” areas or priority districts of the city, or 77% of the establishments in France. This experiment affects 180,000 births and is to continue until August. Upon leaving the maternity ward, parents receive five items for free. Each of them symbolizes a message of prevention. The government’s goal: to improve the health of children and mothers.

What’s in this bag? A sleeping bag, a bib, a natural soap, an educational album and… a tube of moisturizer. The latter should encourage new mothers to take care of themselves. A consensual goal in the medical community, but the means used provoke the ire of midwives. “Upon returning from motherhood, some women face a lack of confidence in their ability to care for their baby, body evolution, mother-child bonding, loneliness, even depression. explains Isabelle Derrendinger, President of the National Order of Midwives (NGO). However, we do not replace a health professional with the baby box! ”

Poor post-pandemic monitoring

This distress is all the greater as suicide is the leading cause of postpartum maternal mortality. According to the Confidential National Survey on Maternal Deaths 2013-2015 (Inserm / Santé publique France), 34 women took their own lives up to a year after giving birth. However, 90% of these acts could have been avoided, particularly with better screening and monitoring of psychological and socioeconomic weaknesses. Several studies estimate that between 10 and 15% of mothers suffer from postpartum depression. “Who will they call? The baby box? “laughs Isabelle Derrendinger.

Unfortunately, the follow-up of women leaving the maternity ward has deteriorated in recent years. The Homecoming Program (Pardo) has been suspended for two years, in charge of ensuring the existence of follow-up care in the city, especially for mothers. Consultants have been seconded to monitor the Covid-19 pandemic. A void with consequences that are difficult to measure. “It is estimated that 20 to 25% of women do not have a follow-up once at home. This especially affects women who give birth for the first time. However, they are the ones who need the most support, assures Caroline Combot, secretary general of the National Majority Union Organization of Midwives (ONSSF). They call us when things go wrong: a huge weight loss of the baby or jaundice, it is catastrophic! “

“It’s a publicity stunt”

Yet the government is aware of the problem. The expert committee of “First 1,000 days” offers personalized support during the postpartum period and an information campaign aimed at the general public. Last September, the Secretary of State in charge of the family announced the introduction of a new mandatory interview the fifth week after giving birth for screening for depression. Announced for the year 2022, no date has yet been set.

So the launch of the baby box leaves you speechless. “Of course it’s a publicity stuntsays the Secretary General of the ONSSF. Do the teams really have the time to detail the prevention messages for each item at each maternity discharge? “ The answer is obvious to her, the unions have been asking for more human resources for years. “We are 24,000 practicing midwives, but we lack 10% more colleagues to reach the necessary quotas to maintain the quality of care,” sighs Isabelle Derrendinger. In the postpartum period, a midwife follows 12 to 15 mother-child pairs, that’s too many! We need to monitor the mother, baby and their interactions both medically and socially. “

Unrest in the profession

A work focused on prevention that arouses a certain discomfort in its exercise. According to a 2020 NGO survey, 55% of midwives considered leaving their profession and never returning. They do not feel recognized either professionally or financially. A 2019 report from the National Council of Midwives (CNSG) denounces the risk of burnout and institutional abuse “Lack of time to support families”. So the baby box is definitely not the expected size. “The ministry forgets us, despite our requests for assignments or participation in work on our issues! “, reports Caroline Combt. Despite various requests from the editorial staff, the Secretary of State for Children and the Family did not answer our questions.

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