Key Points

• The birth rate trend in Île-de-France has been declining for several years, although the region’s birth rate remains higher than the national average. The proportion of women over 35 is significantly higher there than at the national level, with an upward trend since 2012.
• A majority of women who gave birth in Île-de-France have completed high school or higher, which is above the national average. Nearly 70% of women work during their pregnancy, a proportion that has been steadily increasing since 2010. There has also been an increase in the number of women born abroad, underscoring the importance of equitable access to information, care, and health literacy for all women.
• A slight increase is noted among women receiving Supplementary Health Coverage (C2S) or State Medical Aid (AME), although AME is not always properly provided to eligible women.
• Since 2010, there has been an increase in the number of women who are overweight or obese prior to conception. The rate of pre-existing diabetes is higher in Île-de-France than at the national level, with one of the highest screening rates in the country. Smoking during the third trimester of pregnancy is on the decline, and Île-de-France remains the region with the lowest proportion of female smokers in mainland France (including Corsica). However, there are no data on the use of e-cigarettes and vaping products.
• Maternal mortality in Île-de-France remains one of the highest in mainland France, with associated factors such as advanced maternal age and common comorbidities like diabetes, hypertension, or obesity.
• Infant mortality is on the rise: stillbirth and perinatal mortality rates are among the highest in France, with very marked regional disparities, particularly in Seine-Saint-Denis.
• There has been a decrease in the use of episiotomies, but the rate remains above the national average, with varying practices across departments and a need to assess the impact on severe perineal tears.
• The rate of refusal of neonatal screening is higher than the national average. Relative under-screening is observed for certain diseases, such as cystic fibrosis, requiring increased vigilance.
• One of the most concerning findings in this edition relates to perinatal mental health. More than one-third of women (34.8%) report experiencing prolonged sadness or anhedonia during pregnancy, and nearly one in five women exhibit depressive symptoms two months after childbirth—rates that are consistently higher than the national average. At the same time, only 10.0% of women reported having consulted a professional during pregnancy for psychological difficulties.
• The region makes greater use of specialized care than elsewhere, but lags far behind in Early Postnatal Checkups (14.8% compared to 24.9% nationally), with disparities in access between departments—particularly between Val-d’Oise and Paris, where the gap exceeds 7 percentage points. This disparity calls for a targeted strengthening of screening and referral, particularly in areas with the least healthcare coverage.
• The restructuring of the obstetric landscape continues: a decline in Type 1 maternity units, and an increase in Type 2B and Type 3 units, consistent with the overrepresentation of extreme and very extreme preterm births in the Île-de-France region. This tiered approach to care, which is clinically necessary, must be accompanied by a focus on accessibility and coordination with local healthcare facilities, particularly for postpartum follow-up, where the rate of home visits remains below the national average.