The 2021 National Perinatal Survey (ENP 2021)—the sixth since 1995—was conducted in March 2021 among 12,723 women (in mainland France) and provides a comprehensive overview of medical practices during pregnancy and childbirth, as well as the demographic and social characteristics of women and families. For the first time, the survey included a follow-up of women two months after childbirth, with a particular focus on their mental health. The ENP also includes a section detailing the characteristics of maternity wards. The results will be published on October 6, 2022.

During pregnancy, several indicators point to an improvement in women’s health and preventive measures:

• The number of women using psychoactive substances during pregnancy is decreasing. Thus, the proportion of women reporting tobacco use in the third trimester is declining (12.2% in 2021 versus 16.3% in 2016), as is the proportion of women reporting cannabis use during pregnancy (1.1% versus 2.1%).

• More and more women are getting vaccinated against the flu during pregnancy: 30.4% of women were vaccinated, a very sharp increase compared to 2016, when this proportion stood at only 7.4%. The 2020/2021 vaccination campaign, however, was marked by an unusual demand for flu vaccinations from the public, against the backdrop of the COVID-19 pandemic.

However, progress still needs to be made in certain areas:

• Prevention of neural tube defects through folic acid supplementation is still initiated too late, as fewer than one-third of women begin supplementation before pregnancy, as recommended.

• Only 16.0% of women reported receiving advice on how to limit the transmission of cytomegalovirus (CMV).

It is noted that deliveries are less medicalized, and mothers report high satisfaction with their care:

• The frequency of labor induction is increasing (25.8% versus 22.0% in 2016), but the use of interventions to accelerate labor is decreasing.

• However, the cesarean section rate has remained stable since 2016 and accounted for 21.4% of births in 2021. The main reason for cesarean section is having previously given birth via cesarean section.

• While 82.7% of women received epidural analgesia, an increasing number are also using non-pharmacological methods more frequently (mobility, bathing or showering during labor, massage, etc.) to manage pain associated with contractions.

• However, more than 90% say they are satisfied or very satisfied with the medical care they received during their prenatal care and with the care provided by healthcare professionals in the delivery room.

• The data nevertheless reveal that approximately 10% of them report having been subjected to inappropriate comments or behavior from healthcare providers during their pregnancy, delivery, or stay in the maternity ward.

The postpartum period: a critical time for care and prevention:

• Following childbirth, many women received a home visit from a midwife (79.1%).

• Almost all report having received advice on how to put their child to sleep. In contrast, only half of the women received advice on how to soothe their crying child.

New data has been obtained regarding women’s mental health:

• The proportion of women who consulted a healthcare professional for psychological difficulties during pregnancy is on the rise (8.9% in 2021 compared to 6.4% in 2016).

• The data reveal that 16.7% of women experience postpartum depression, as assessed using the EPDS scale two months after childbirth—though it is not possible here to determine the link to the deterioration in the mental health of the general population associated with the pandemic context.

It should be noted that the field survey took place during the third wave of the COVID-19 pandemic, and this specific context must be taken into account when interpreting certain trends described in the report. Furthermore, data regarding the overseas departments and regions (DROM) will be the subject of specific reports by department.

All indicators described in the 2021 ENP are of paramount importance for women, professionals, and public authorities. They aid in decision-making and the evaluation of health initiatives for women and their children during pregnancy, childbirth, and the postpartum period.

Find all detailed results and additional data in the press kit below.