Expat Health Insurance & Healthcare Guide to France

An expat in Bordeaux talks about hospitals, the importance of supplementary health insurance, the need to keep your own medical records since doctors don't keep them and prescription medicine costs and availability.

Learn French! As in any other country, seek a second opinion for serious problems.

It's a small town, so most doctors don't use English much. If you must communicate in English, it would help to research some of the necessary terminology beforehand (perhaps write your questions in French).

I had all three of my children in France between 1997 and 2007, the first two with a saddle block and the last by natural birthing methods. The last experience was by far the best. While I would now say that the French tend to be overly medical and scientific about it all, on the other hand this is an excellent country to have children. The entire system is very smooth, fully paid for by French social security, and you can get all of the preparation you want with a private midwife, and/or through birthing classes. The overly medical aspect tends to make birthing seem like something incredibly risky and difficult, they sometimes are so busy warning you about possible dangers they forget to tell you the vast majority of births go just fine. But when they don't, you can be sure everybody is fully prepared to face emergencies. As someone else metioned, you are mostly assisted by highly experienced midwives during labor, with an occasional helping hand by the OB/GYN. I had prepared with natural methods and homeopathy for my last baby, and was alone to give birth in the maternity ward with two midwives at hand! No pain relievers, I had chosen to bear it out, and it was painful for a while, but then delivery began and it was such a wonderful experience to feel the contractions and push just like mother nature planned. There is no comparison with delivering with a saddle block, where you need to be coached into the pushing. Anyway, for those who are considering having a baby in France, fear not and do so. They usually keep you 4 or 5 days for the first child, and you can go home after 3 days for the others. When baby is born, you get plenty of help and advice on baby care and breast feeding, they really walk you through the entire process.

I gave birth to my twin boys at L'Arche Hospital in Nice. This is a large, teaching hospital affiliated with the University of Nice. I moved to France 1 week after finding out I was pregnant, needless to say my husband and I had not anticipated this when we accepted the expat position. I was given an epidural during my labor (which I was required to have a consultation with the anesthesiologist during my prenatal care). I was induced appropriately at 35 weeks due to cholestasis, and labored till I was 9 cm. Then I had a c-section secondary to a sudden onset of fetal distress. My sons did very well and did not need to be in the NICU and roomed in with me the entire stay. Although the nurses would offer to take them at night so I could sleep. My only complaint was the pain management after my delivery. Because I was breastfeeding I only received paracetamol (essentially tylenol) for pain. It was terrible. I had my husband bringing in Advil for me since it worked better. I stayed in the hospital for 6 days after the delivery--quite a bit longer than normal in the US. However since we had no family to help us I took advantage of the assistance from the nurses with the babies.

I feel that L'Arche is an excellent facility for medical care, but don't expect much from the decor (or lack of) or the food which was borderline horrible. My French is mediocore, and I was never offered assistance with translation. Lucky for me I am a nurse-midwife in the states and understood the majority of the medical jargon since it is all similar.

France uses a more "medicalised" approach to birth than the UK or the US. Up-sides to this were:

- I had regular scans, and the very latest technology was made available to me.

- I was monitored closely, given monthly blood tests to check for infection; Group B Strep was thus detected before birth.

- When my baby contracted an infection, he was immediately placed under treatment before he even fell noticeably ill.

Down-sides to this approach were:

- I was given hormones to speed-up labour.

- I was talked into having an epidural.

- I had an "invasive" exam each month of my antenatal care (although this wasn't really a big deal).

Because of my baby's infection, I spent 10 days in the hospital, rooming in with him. Normally, a French stay is about 5 days for a normal birth and 8 after a C-section. I had a private ensuite room and the midwives were very kind.

However, babies are not treated as individuals in France: they are expected to feed once every 4 hours, no more, no less. When he dropped too much weight, I had to fight to prevent them from "supplementing" him with formula.

I didn't share the French ideology about birthing, routines and feeding, but when my baby's weight went up again and his infection began clearing, they left me to do as I pleased. I did feel that they always had mine and my son's medical interests at heart.

Follow-up care was excellent. There is quite a long hospital stay during which I was well cared-for. You are also entitled to physio sessions for your pelvic floor, and you can attend a drop-in clinic (PMI) to monitor your baby's weight, growth, and see a doctor, free of charge.

I had an unassisted home birth after following midwife-based care throughout the pregnancy. It was a very positive experience. I planned to use a birthing pool to ease the pain, but the hot water ran out that day so I did not use it during the contractions, only at the end for the birth itself. Leading up to the birth I had a heating pad on my lower back and used visualisation and breathing to focus myself and some homeopathy recommended by the midwife. I wrote in my journal between contractions and used a birthing ball.

I have given birth in two different countries (Mexico 3 years ago & France 1 year ago) with two different philosophies.

The Mexico experience was by far, the best. Customer service from both my OB/GYN and the hospital was 5-star. However, episiotomy was nearly "required".

France was a little more bumpy...difficult to find a place to give birth. Paris is over-run with children so you must reserve a hospital or clinic for your due date the second you find out your pregnant or you risk giving birth on your own. Nevertheless, good experience overall.

Having birth here was a wonderful experience for me. I was lucky to get into a private hospital which fills up very quickly. In Paris you have to call right away to get a spot. The care was wonderful and the birth was mostly done by a midwife. In Ob/gyn had to come in at one point to turn the baby's head, but she left after that and let the midwife take care of the rest. I stayed in the hospital 5 days and got lots of help with the breastfeeding. Apparently that is not the case in most French hospitals. I did have an epidural which I wanted and it was dosed perfectly so that I could push. I didn't want the episiotomy, but ended up with one anyway. France is really big on episiotomies, though my hospital less so. Still, considering I had the biggest of 10 babies that day, the fact that I ended up with only 3 stitches is pretty good!