Pregnant in France: First Steps for Your First Trimester

Félicitations! If you’re reading this, you’re likely pregnant and live in France – two reasons to celebrate. But…now what?

Too superstitious to research before, I had no clue what to do when I first found out I was expecting in Paris. If you’re a foreigner, and perhaps your French skills are limited, it can be especially hard to navigate the French healthcare system.

Here’s what I learned at the start of my pregnancy, to help you begin your journey.

Research and apply at hospitals ASAP

In France, you have to register for a spot at the maternité you’d like to give birth at. You do this on the hospital websites and can’t apply too early, especially in Paris. There is nothing to lose by applying to multiple hospitals — in fact, I would recommend it in order to increase your chances of securing a place. Note: Some maternities require proof of pregnancy before they will confirm your spot.

• Consider the type of care you will need
  Maternites in France are classified as niveau 1, 2, or 3 depending on the level of intensive care available. I had no underlying conditions and a single fetus, so I was comfortable with a niveau 1 hospital. If you are expecting multiples or have certain health concerns, you’ll want a level 2, and level 3 is for the riskiest pregnancies. You can apply to a level 3 hospital even if you aren’t high risk, but I’ve heard of women not getting the amount of attention they want during labor because there are precarious births underway that require intense care from the staff. Certain hospitals in Paris are also known for being more breastfeeding friendly, or more open to medication-free birth.
  
• Consider the distance
  Do you want to be driving across town when you go into labor? Particularly if you plan to have your pre-natal care all at the hospital, consider how far you’ll want to travel.
  
• Consider your budget
  The care at public French hospitals is generally excellent, and nearly free (that’s why we pay all those taxes!). But if you want a fancier level of care or facility, there are private hospitals where you can get this for about 5,000 – 8,000 euros.

Once accepted, you’ll need to bring the following to register at the maternité: French ID/Visa, proof of address (such as an EDF bill), date of your last period, all your lab results and sonograms (if you have), and your sécurité sociale and mutuelle cards.

Confirm your pregnancy

Go to a general practitioner to get prescriptions for a test to confirm your pregnancy and for blood work. You’ll take this to a laboratoire where you’ll give blood and urine samples. Warning — they take a lot of blood, so don’t plan on using your arm a lot that day. You should get your results a few days later.

Get a first examination

Once you have your test results, go to a sage-femme (midwife) or gynecologist for a first examination. As this was my first pregnancy, I went to an English-speaking sage-femme who was able to walk me through how the process works in France and what to expect. I found this extremely helpful.

Tips for finding a caregiver, especially if you want an English speaker: check out DoctoLib (you can filter by language), search in Facebook groups for expats and mothers in your city, ask your friends, call and ask at hospitals you are interested in, or ask your GP for a recommendation.

Your first appointment will likely include:

• A physical exam, including a pap smear if you haven’t had one recently.
• A consultation on your feelings about the pregnancy and your relationship with your partner.
• A test for risk of abnormalities to determine your risk group — level 1, 2, or 3.
• A declaration of pregnancy for your employer and sécurité sociale.
• Prescriptions for an échographie (sonogram) and more blood work if necessary.

Note about appointments (especially for Americans): Don’t be surprised if you have to drop your own pap smear sample at La Poste to be mailed to the lab, or if there is no changing room or gown offered at the office. This is normal in France.

Decide on your primary caregiver

You can have your pregnancy followed at the hospital for your entire term, or by your own sage-femme, gynecologist or GP and then transfer your care to the hospital nearer to your due date. If you choose to be followed at your hospital, it is possible you’ll see several caregivers over the course of your pre-natal care instead of just one, but this also gives you a better opportunity to meet the people who will help your deliver your baby.

Make an appointment for a sonogram

In France, your first échographie is usually at the three month mark. You are able to get one earlier in order to confirm the pregnancy is viable if that is something you wish to do, but you have to pay out of pocket for this and need an Rx. I did so, scheduling a sonogram at around two months for peace of mind. You’ll need to find an échographiste or you may be able to have this done at your hospital.

Declare your pregnancy to the French government

When you have medical confirmation of your pregnancy, you need to tell the French healthcare system through the Ameli.fr website as well as the caisse d’allocations familiales (Caf). It is important to do this before 14 weeks to ensure that you are fully reimbursed for the cost of your medical care.

If you don’t already have your carte vitale (French healthcare card), you’ll have to pay out of pocket and file feuille de soins to get reimbursed after you have coverage.

Once you are confirmed at a hospital and your pregnancy is declared to the government, the French system clearly lays out what your pre-natal care will look like for the rest of your pregnancy. You will receive a lot of information from both the hospital and government on proper care and diet and I found that there is a lot of support available.

Finally, here are some helpful documents for understanding what’s ahead (all in French):

• Le guide Ma maternité – Je prépare l’arrivée de mon enfant (PDF)
• Grossesse : démarches et accompagnement (Ameli)
• Grossesse : examens médicaux (outlines all your medical appointments)

Have you given birth in France? Leave a comment sharing your experience and what your first steps were!