Sozialmedizinische Maßnahmen

During the seventies and eighties of the 20th century, France reported a considerable decline in the overall rate of preterm deliveries. The figure for all births before 37 weeks gestation dropped from 8.2% in 1972 to 4.9% in 1988, and births before 34 weeks accounted for 2.4% of all births in 1972 and 0.9% in 1988. This development was paralleled by the creation of a national program for the active support of women, children and families. This program was aimed at improving medical care, together with financial and social support, in particular for education and improved working conditions for mothers inside as well as outside of the home. Surprisingly, in the nineties a rise in the rate of preterm deliveries was noticed and in a national survey in France the number for all deliveries before 37 weeks was 6.8% in 1998 and 2.0% for the early preterm deliveries. A similar development was also seen in other countries. This could not be explained by changes in socio-medical support programs. Instead, it was related to a rise in the mean age of pregnant women as well as to the development of assisted reproduction. The example of France demonstrates that a political initiative for the support of women, children and families is not only effective in reducing the number of preterm deliveries but also has a positive effect on the national fertility rate. In Europe, France together with Ireland, with 1.89 children per women, rank at the top of the list of national fertility rates. The mean for Europe is 1.41 and countries like Spain and Italy, with fertility rates of 1.22 and 1.25, are at the end of the list.