by Mindy Jones
Summarizing “how to have a baby in Paris” is no easy task. Let me start by assuring you the physical process of having a baby remains the same in Paris. There’s no fancy designer birthing happening here — just the same ole labor and delivery. The options as to “who” and “how” and “where,” however, are nearly endless.
Therefore, my first bit of advice for any English-speaking pregnant woman in Paris is to join MESSAGE (www.messageparis.org). MESSAGE is an organization for English speaking parents (and expectant parents) that helps navigate the details of family life in Paris. There is a fee to join MESSAGE but it is well worth it for the wealth of information you can find on its message boards. The message boards will help you sift through details I won’t be able to get into here, such as the differences between specific hospitals, lists of English-speaking obstetricians and midwives, and the names of breastfeeding support volunteers.
Public vs. Private
If a woman is covered by the French health care system and doesn’t want to pay much out of pocket, she needs to register with a public hospital as soon as she knows she is pregnant. When I say, “as soon as,” I mean “AS SOON AS” — some of the more desirable public hospitals (consult the MESSAGE forums for names and opinions) will be impossible to get into as early as your fourth week of pregnancy! The upside of public hospitals is the majority of the costs are covered by the French health care system. The downside is lack of privacy (private rooms are possible but not so common), noise, and an impersonal feel. (I hate to paint all public hospitals with such a broad brush because, of course, experiences will vary widely. Here’s where I recommend you check out MESSAGE again.)
If you have a “mutuelle” (private insurance) in addition to the French secu, or you are willing to pay more out-of-pocket, your options open to semi-private clinics and private hospitals such as the American Hospital in the western suburb of Paris, Neuilly-sur-Seine. The costs of prenatal care and childbirth at these clinics and hospitals vary. Check with your health insurance provider(s) before registering at one of these clinics or hospitals so you know the extent of your coverage and how much will come out of your pocket. The advantage to semi-private, private clinics and private hospitals are more creature comforts, more personal care, greater likelihood of receiving a private room (though at additional cost) and much more flexibility regarding when you have to register.
Prenatal appointments happen once a month. Don’t be surprised by the lack of gowns at these appointments; modesty does not exist in a French doctor’s office.
Routine blood tests are done at regular intervals and one ultrasound is done each trimester. If you are seeing an OB/GYN at a hospital, the blood tests and ultrasounds can be done in the same building. If you’re seeing a doctor at a clinic or private office, you will need to go elsewhere to have these tests performed. Blood tests can be done at any Laboratoire d’Analyses Medicales in the city (www.annulab.com for locations) and ultrasounds can be done at any Centre d’Echographie.
Payments for prenatal appointments, lab work, and births are the same as paying for any other doctor appointment in Paris. It’s a reimbursement system. For most doctor visits, you pay out-of-pocket at the time of the visit. If you have a Carte Vitale from secu (French health care system), the doctor will take your card number and essentially file for your reimbursement for you. If you do not have a Carte Vitale, the doctor will issue you a feuille de soin, which you then fill out and send to secu (or your private insurance if you are not covered by the French system) for reimbursement. Once the paperwork is filed, turn-around times for reimbursement are quite fast, usually within a couple of weeks.
Childbirth in France is generally very medicalized. There is not the resurgence of natural childbirth in France that you find in countries such as the U.S., England and Australia. Epidurals are the norm and are often given as soon as a woman arrives at the hospital in active labor.
If you are interested in natural childbirth, it is crucial you find a doctor who supports you. There are some clinics and hospitals well-known in Paris for their belief in natural childbirth. The ones mentioned most often are Groupe Naissances, a group of doctors and midwives practicing in the Clinique Leonard de Vinci in the 11th arrondissement (www.groupenaissances.org) and the Hôpital Pierre Rouquès, Maternite Les Bluets in the 12th arrondissement (www.bluets.org).
Home births are rare but not impossible. A good place to start searching for a midwife who does home birthing is at the above mentioned Groupe Naissances. There are several midwives there who speak English and have done home births in the past.
There are a surprising number of breastfeeding horror stories circulating through ex-pat social circles. Paris has gained a reputation for being not-so breastfeeding-friendly. If you are intent on breastfeeding, it is important to tell your doctor this before the birth and inform the nursing staff as soon as you’re snug in your room with your new baby. It is often necessary to be very, very firm about your wishes.
Many clinics and hospitals still take the babies to nurseries at night so new parents can sleep. If this is true at your clinic, you can request the baby be brought to you when feeding is needed. However, if your baby cries and the nursing staff is too busy to bring the baby to you, they will oftentimes give the baby a bottle of formula. If you want to avoid this possibility, insist the baby sleep in your room.
Nursing staffs in the hospitals and clinics of Paris have rarely been trained to assist with breastfeeding. If it is your first baby or you’re in need of advice or emotional support, MESSAGE can give you a name and phone number of a breastfeeding support volunteer. Request this information long before you go into labor so you can pack their information in your hospital bag.
Hospital/Clinic Stay and Registering the Birth
I write this as an American who had her first baby in the States and second baby in Paris. In the States, it is common to be out of the hospital within 24 hours of an uncomplicated birth. In Paris, three to five days is more common. (You can leave earlier if the doctor allows but the nursing staff will look at you funny when you make the request.)
Also, as opposed to American hospitals, many clinics and hospitals will not provide you with any “stuff.” You often need to bring your own bath towels, soap, diapers and wipes for baby, maternity panty liners (available at local pharmacies) and disposable underwear for the new mom. Check with the clinic or hospital when you register to get the details of what is and isn’t provided.
You have three working days to register the birth with the mairie (town hall) of the arrondissement in which the birth occurred. The clinic or hospital staff will check with you frequently and pester you mercilessly if it hasn’t yet been done. To register, you will need your livret de famille, if you have one. If you don’t have one, you will need proof of mother’s and father’s identities and the declaration de naissance, given to you by the hospital or clinic.
Sometimes the hospital will register the birth for you but you must still gather all proper documentation. If you do not register within the timeframe, you can be faced with steep fines and your child may not be eligible for French secu benefits for the first year of his/her life.
Childbirth in a foreign country is indeed foreign. The biology is the same yet the birthing experiences completely different. I’ve summarized generally here but realize I’ve probably barely scratched the surface for a pregnant woman with a ton of questions. That’s why the best advice I can give is — surprise! — join MESSAGE. Childbirth in a different culture can be anxiety-provoking; having that kind of support system and knowledge base is invaluable. Good luck and best wishes for healthy Parisian babies!
Mindy Jones is an American living in Paris with her husband and two kids. Her first child was born in the U.S. and second child born in Paris so she has experience navigating childbirth in a foreign country. She spends most of her time chasing her kids and documenting her life in Paris on her blog, An American Mom in Paris.