Public hospital vs private clinic
The public healthcare system in France is funded in three ways: by obligatory social security contributions (usually deducted from your salary), by the government, and by the patient who also pays a small contribution to their healthcare costs2. It’s compulsory for French residents to register for public health insurance, and expats have access to it through the Protection Universelle Maladie (PUMA) system, after living in the country for three consecutive months2.
While there are some English-speaking doctors and midwives in France, this isn’t guaranteed. If you’re not fluent in French, it may be a good idea to enlist the help of a translator.
Ultimately, where you have your baby depends largely on what kind of health insurance you have. For some people, their decision is simply based on how satisfied they are with their initial visit to a public hospital or private clinic.
Public hospitals
Once your pregnancy is confirmed by a doctor, you’ll need to register at the hospital where you’d like to have your baby. You can normally do this via the hospital’s website. It’s good to book your place as soon as you can. This is because labour and delivery are almost completely free to all nationalities (if you’ve been in the country for three consecutive months), places are rare and private rooms are not always an option. It’s important to note that some hospitals require proof of pregnancy to secure your place.
Public hospitals might not be as comfortable as a private alternative, but they are often more equipped in case of a complications during pregnancy, the delivery or with your baby.
Private clinics
There are several things to consider when looking at private options: What are you willing to spend? What kind of doctor do you want? How important is convenience to you? What cover do you have on your health plan?
Many private doctors, hospitals and specialists receive funding through the public healthcare system. In fact, most people who use the public healthcare system can still access privately run clinics for an additional cost. While the public healthcare system will cover 80% of the costs whether you’re using a public hospital or private clinic, you could pay more for the 20% that isn’t covered in a private clinic2.
A popular option among expats is to make use of the public healthcare system and take out additional private healthcare insurance to cover specialist treatment and therapies.
Prenatal care
There are several compulsory prenatal tests in France. The first takes place within three months of becoming pregnant3. After this initial exam, monthly appointments continue from the fourth month.
There are between five and seven standard tests, plus the option of at least three CT scans4. In addition to this, there are usually three ultrasounds during your pregnancy where you can ask the doctor to let you know the gender of the baby – which is quite often standard practice in France. But if you want to keep the gender a secret, make sure you let the midwife and doctor know.
There are also monthly tests for toxoplasmosis which is a common infection caused by a parasite carried in cats and rodents. If a woman is infected during pregnancy, she could pass it on to her baby.
Interestingly, your due date is calculated differently in France. In France, they count 40 weeks and six days from the date of your last period to get your due date, whereas in other parts of the world it’s often 39 weeks and 6 days5.
Another major difference in prenatal care in France, compared to other Western countries, is how involved the doctor is. While you might expect any prenatal tests to be carried out by a nurse or technician, they are done by your doctor.