The healthcare networks which arose in France following the decrees of the 1998 obstetric-paediatric reorganisation¹ were aimed at reducing the considerable number of dysfunctions which, while focussing on serious but rare risks, were preventing the development of a screening policy for all risks depending on their frequency. The absence of risk management before childbirth meant that fewer than one in six high-risk women gave birth in maternity wards capable of caring for both mother and baby correctly, compared to five out of six women in other European countries (Naiditch 2004). The Cultural Revolution came when high-risk newborn babies were no longer transported to distant neonatal medical departments from widely dispersed maternity units with little in the way of paediatric equipment. Maternities came to be organised according to their capacity to deal with the safety requirements of the mother-baby dyad, distinguishing three type levels and organising regional perinatal networks around hospital issues, while inter-establishment transfers remained focussed on medical high-risk cases. This first “revolution” – accomplished in the 2000s – led on to a second, devisk (Dugnat 2004).

While initially focussed on care, quality and physical safety, current health policies (embodied by the 2005–2007 Perinatal Plan)^{2 , 3} try to promote childbirth as an excellent opportunity for screening and prevention in every dimension, as well as for therapeutic education and health promotion⁴. “These prevention policies aim to improve the population’s state of health by avoiding the appearance, development or aggravation of disease and by encouraging individual and collective behaviour conducive to risk reduction. They are crucial in the perinatal period due to the importance of epigenesis. Beyond these purely hospital-based organisational schemes, the organisation of formalised care networks aims, on the other hand, to improve not only access to care but also the coordination, continuity and multi-professional approach in patient management, especially regarding certain populations, certain pathologies, certain care programmes or certain health services”⁵. Healthcare networks⁶ thus aim to tackle increasing professional specialisation, poor coordination between the various professionals both in and out of hospital and insufficient coordination between the medical and social sectors, as well as the strict separation between hospital staff and other professionals (independent professionals and medical/social services) (Capgras and Dugnat 2006a).

These networks thus have a vocation to contribute to the consistency of care programmes, involving independent health professionals, doctors and teams involved in mother-and-baby preventive health, doctors and hospital teams, health establishments, health centres, social or medico-social institutions and health or social organisations, as well as the representatives of users (Capgras and Dugnat 2006a, b).

They need to ensure care management that is adapted not only in terms of diagnosis and treatment but also of health education and prevention. Within this framework, they can participate in public health actions. They require assessment in order to guarantee the quality of their structure and their services (Hardy-Baylé et al. 2004).

In the perinatal field, prevention and healthcare networks are closely linked; early and timely intervention at this period is crucial for the long-term development of the individual. At this moment in life, a curative action to treat the mother is also preventive for the future of the baby while also allowing for the provision of parenting support.

As a consequence of the numerous participating individuals and institutions, having neither the same type of governance nor the same modes of funding, various levels of resistance are met, in terms of health prevention: