Having a baby in France

December 1, 2007

Giving birth in France involves plenty of admin, so if you are thinking of moving or are living here already then there are some things that you should know.

Covering the costs
If you haven’t yet left the UK the first thing to do is to get hold of an E112 available from the NHS international services (number below). This entitles you to medical care abroad for a pre-existing medical condition, such as pregnancy. It is a passport to free scans, X-rays, consultations and ultimately childbirth and postnatal care. The only thing it doesn’t cover is the cost of a private room, though in some hospitals you are in a private room anyway. If you are moving permanently you should also look into getting an E104, which is basically a statement of all your contributions in the UK and will mean you can transfer onto the French system. You can get this from the Department of Health (number listed below).
Basically all costs should be reimbursed, you just have to fill in the feuille de soins (normally brown) and send it to your local CPAM (Caisse Primaire d’Assurance Maladie).
If you live here and are already on the French system, then your costs should be covered automatically. It may be worth signing up to a private top up-insurance (a mutuelle) company to cover anything the social security doesn’t fully reimburse, such as private rooms, TV, an extra bed for the father etc… You can sign up for one even after becoming pregnant, there is no waiting period.

Prenatal care
If you get pregnant in France and you want to have a baby within the French social security system, then the first thing to do is to go to your doctor and fill in a déclaration de grossesse. This will normally take place towards the end of the third month of pregnancy and gets sent around to the various authorities and means your pregnancy is registered. You can choose any doctor as long as he/she is linked to the state health scheme (conventionné).
If you have a specific clinic in mind which is not where your doctor would automatically send you, it is always a good idea to book a room at the beginning of your pregnancy. Note that not all gynaecologists are allowed to practise in the local hospital or clinic, so you may not have the gynaecologist who has followed your pregnancy at your birth. Bear this in mind when choosing your gynaecologist at the beginning of your pregnancy.
Usually the local doctor can recommend a gynaecologist who carries out all the monthly checks. This includes monthly blood tests to check for toxoplasmosis, measles etc. You take the blood tests to a laboratory of your choice – to find one look under Laboratoires d’analyses de biologie médicale in the yellow pages. It is also a good idea to get your blood group identified at the same time.
You will also have three scans (écographies) during your pregnancy. Very early on they will be able to determine the sex of the child, but if you don’t want to know you should tell them.
Whatever your age, the baby is now automatically checked for Down’s syndrome and other genetic disorders (nuchal fold and blood tests) and you will be offered an amniocentesis – amniocentèse – if you are considered high risk due to the results of the preliminary tests (which is reimbursed by the social security).
Towards the later stages of pregnancy you will also have to meet the anesthetist who will talk to you about the kind of pain relief you are likely to require – note that for deliveries in France pain relief tends to be all or nothing: epidurals (péridurales) are freely available and popular, even encouraged. The French are not big on natural childbirth, and very few women opt for a home birth, though this is an option provided you can find a midwife who is willing to do so.

Midwives
A midwife is called a sage femme and once your pregnancy declaration is in the system you should sign up for pre-natal classes (séances de preparation à l’accouchement) at the hospital where you will give birth. It is a good idea to attend these courses, even though you may not be expecting your first baby, partly to have a contact to call in case of problems and also because it familiarises you with the appropriate French vocabulary.

Giving birth
You will give birth in a clinic or a hospital and are liable to pay only for extras like having a single room, TV and phone (unless you have signed up for a mutuelle – see above). The average stay is five days and eight to ten for a cæsarian. Don’t forget to bring all your social security papers with you to the birth; the whole system thrives on bureaucracy and the first thing they ask you for as you come panting into the clinic is your social security status.

Breastfeeding
If you want to breastfeed your baby you must tell the midwives and doctors at the hospital beforehand, who, in most hospitals and clinics, will help you and give you a list of names and addresses of mothers who are breastfeeding in you area. You may find that some people around you will not approve of breastfeeding. Don’t let them spoil a special time between you and your baby. Below is the website of the La Lèche League in France, which also has pages in English.

Admin for the child
You cannot register the baby’s birth if you have not officially recognised the baby beforehand. Whether married or not you must recognise your child (preferably before the birth) at the mairie. If the mother (unmarried) recognises the baby on her own first, the child will bear the mother’s surname. Since January 1st 2005, parents can choose whether the child will bear the mother’s or father’s surname or both. In all cases each parent must present valid ID.
You are legally obliged to register the birth of your child within three days at the local mairie, so it is advisable to have a name ready. If the child is born on a Wednesday, Thursday or Friday, you have up to the following Monday to declare the birth. Anyone who was present at the birth can declare it. You will need to provide the livret de famille (if you have one) and the certificate issued by the midwife or doctor. But often the hospital or clinic will register the baby for you. Declaring the child is free. One of the reasons for the registration is to make sure the child isn’t given a ridiculous name, although nowadays almost any name is tolerated unless the officer in charge considers it to be harmful for the child. You are no longer required to choose a first name from the Saints’ calendar!
At the hospital, or sometimes at the mairie, you will be given a Carnet de Santé for your baby. This is a book that contains the child’s health records: vaccinations, check-ups, operations, illnesses etc.
Your baby will have a check-up once a month by the doctor of your choice (this is compulsory if you wish to receive child benefits). Your child has to have certain inoculations (like TB) in order to be admitted in a crèche or school. However, if you are against these vaccinations, you may refuse to have them done, but you will need to write a letter stating that you do not wish your child to be vaccinated.
Homeopathic doctors can give you more advice on this; they are more likely to provide health grounds for recommending against vaccination for your child if they feel this is appropriate.

Postnatal care
You will have a check-up two months after giving birth and your doctor can then prescribe ten sessions of pelvic re-education usually carried out by a kinésithérapeute (physiotherapist). The aim is to get your nether regions back into shape after childbirth and avoid unpleasant complaints such as incontinence at the age of 50.

Maternity/paternity leave for working parents
If you have less than two children you are entitled to sixteen weeks’ maternity leave (six before childbirth and ten after). If you have more than two children this goes up to 26 weeks (eight before childbirth and eighteen after it). In case of twins, you are entitled to twelve weeks before the birth and 22 weeks after
the birth. A recent change in the law allows you to shorten the leave before the birth and add on the missed days to your leave after the birth
If your prenatal maternity leave is shortened (premature birth), you are entitled to add the days remaining before the birth on to the end of your maternity leave. Your maternity leave can be lengthened in case of illness before or after and due to the birth: by two weeks before the birth and four weeks after. In both cases you will receive the sickness benefit (indemnités journalières de maladie).
In any case, you are obliged to stop work for a minimum of eight weeks, six of which after the birth. You may choose to shorten your maternity leave within those limits. Fathers are entitled to a leave of eleven consecutive days to be taken within four months of the birth and eighteen days for a multiple birth.

Benefits
In order to be eligible for family allowance, you have to provide the CAF (Caisse d’allocations familiales – www.caf.fr) with the déclaration de grossesse within the first 14 weeks of pregnancy. After the first compulsory prenatal appointment, you must have six other check-ups after the end of your third month of pregnancy (basically one per month). All this is clearly indicated on your guide de surveillance médicale, so you can’t go wrong). After each test, you must send the appropriate form to the CAF.
Allowances depend on your personal circumstances and you should contact your local CAF for more information. However, the most frequently provided one is: the Prestation d’acceuil du jeune enfant (PAJE) which includes a prime à la naissance paid once during the seventh month of pregnancy and is generally given to those on low incomes.
The allocation de base (basic benefit) starts from the first day of the month of the baby’s birth and until the child’s third birthday. It is also given under certain conditions. To obtain this allowance your child must undergo a number of medical checkups (on the 8th day, 9th or 10th month and 24th or 25th month.
If you have two or more children and they reside in France, you are entitled to the allocations familiales. This allowance does not depend on your income and is paid until the child’s 20th birthday and providing he is not earning more than 55% of the minimum monthly wage (Smic).

Nationality
When both parents are foreigners (say British) the baby takes on their nationality. When the child is 13, providing she/he has lived here for at least five years (since the age of eight), the parents can ask for French nationality on his or her behalf but they must have the child’s consent. When the child is 16 she/he can ask for French nationality, providing again she/he has lived in France for a continuous period of five years since the age of 11. The child does not need his/her parents’ authorisation. At 18, the child automatically becomes French, providing she/he resides in France at that date and has lived in France for periods of time totalling at least five years since the age of 11. If the parents are British, he/she also retains British nationality.

Useful associations and addresses:
NHS International Services Team +44 191 225 4811
Department of Health +44 207210 4850
Caisse d’allocations familiales (CAF) – www.caf.fr The government fund for family and related benefits. Contact your local one for information on your rights.
Protection maternelle et infantile (PMI) – a service provided by your département’s Conseil Général where social workers, midwives, doctors and pediatricians answer your questions.
Mouvement français pour le planning familial – www.planning-familial.org – the French family planning organisation with 67 branches throughout the country. Confidential and free information on contraception, abortion, sexual violence etc.
Centre d’information et de documentation femmes et familles www.infofemmes.com 01 42 17 12 00. Free and confidential advice on women’s rights, legal help and so on.
Breastfeeding: La Lèche League www.lllfrance.org

Useful vocabulary
Amniocentesis – une amniocentèse
Baby - un nourrisson/un bébé
Birth/delivery - un accouchement
Breastfeeding - allaitement
Breech - une présentation par le siège
Formula milk - du lait en poudre
Forceps delivery - un accouchement aux forceps
Incubator - une couveuse - On va mettre le bébé en couveuse
Maternity - la maternité - je rentre à la maternité
Maternity benefit - l’allocation de maternité
Maternity leave - le congé de maternité
Pregnant - enceinte
Pregnancy test - un test de grossesse
Prenatal – prénatal
Postnatal - post-natal
Postnatal depression - la dépression post-natale
She is three months pregnant - elle est enceinte de trois mois
She’s overdue - elle a dépassé le terme
The baby was two weeks overdue – le bébé avait deux semaines de retard
To be pregnant - être enceinte
To get pregnant - tomber enceinte
Twins - des jumeaux
When is it due? - C’est prévu pour quand?

By Helena Frith-Powell,

Written by admin · Filed Under Useful Info