Here you will find an outline of the key antenatal appointments that you can expect to attend within the French birthing system.
Maternity Record Book
Following the receipt of your declaration of pregnancy, your Caisse Primaire d'Assurance Maladie (CPAM - primary health insurance fund) will send you a Carnet de Santé Maternité (a maternity record book). This will include a schedule of medical appointments, details of maternity leave provisions, and instructions on how to open an account on the national health insurance website.
In addition France's Family Allowance Fund (Caisses d'Allocations Familiales - CAF) will make a one-off payment to you for giving birth in France, and two further payments after the birth. The CAF will also issue you with a pass which allows you to go straight to the front of the queue in some public offices, and to ask others to give up their seat for you on public transport.
In general the appointment schedule will look something like this:
- Initial appointment with your general doctor
- First consultation and blood tests
- 12 week ultrasound
- Declaration de grossesse must be submitted before the 14th week
- Interview midwife if appropriate
- Blood test for Down's syndrome
- Second consultation and blood tests
- 22 week ultrasound
- Register at maternity hospital
- Third consultation and blood tests
- Fourth consultation and blood tests
- Birth preparation classes
- Fifth consultation and blood tests
- 32 week ultrasound
- Sixth consultation and blood tests
- Consultation with anaesthesiologist as appropriate
- Seventh consultation and blood tests.
- Final preparations for birth.
The above appointments are routine, but you may be asked to attend more appointments by your health care provider. It is worthy of note that estimated due dates in France are calculated as 41 weeks from the first day of your last menstrual period, compared for example to the US and UK, where the due date is determined as 40 weeks from the last period. As only 5% of babies are actually born on their due date this may seem of little consequence, but may be important for appointment scheduling if you move to or from France during your pregnancy.
Laboratory Tests and Ultrasounds
At your first prenatal appointment, you will receive a prescription for urine and blood tests which you can take to any analysis laboratory (laboratoire d'analyses). These are commonly found on the street like pharmacies and you can walk in for a number of tests without a prior appointment.
Urine tests are required monthly to record sugar and protein levels in the body. Blood tests will be carried out for a number of reasons including the following:
- Blood type
- Blood count
- Screening for irregular antibodies
- Rubella test
- Syphilis test
- HIV 1 & 2 screening
- Hepatitis B screening
- Trisomy 21 (Down's syndrome) screening
It is important to note that you have the right to accept or refuse any screening test, whether or not it is 'compulsory'. Your doctor will explain the benefits, and outline any disadvantages or consequences the test may have.
Your blood pressure and weight will also be monitoring at your face-to-face consultations, and uterus growth and cervical changes will be examined and discussed. A vaginal smear will be carried out between 35 and 38 weeks to screen for Group B Strep (a common type of bacteria present in people which is usually harmless but may cause problems if transmitted to the baby). The heartbeat and movements of the baby will also be monitored.
Three ultrasounds are standard over the course of the pregnancy, but more may be scheduled by your doctor if deemed necessary. Please note that in France, it is common place for the gender to be discussed with you during the ultrasound examinations, so if you do not wish to know this, make sure you make this clear with your doctor at your first appointment.
The first ultrasound will determine the pregnancy due date, how many babies there are, and if the baby is developing on schedule. Measurements will be taken and compared with the results of the blood tests to determine whether or not the baby is likely to have Down's syndrome. It is recommended that you attend your first ultrasound with a full bladder to help see the baby.
The second ultrasound monitors the baby's development and also determines where in the uterus the placenta is located. An anterior placenta (near the birthing person's abdomen) may mean that movements of the baby are not as easy to detect initially. Special precautions will also need to be made in the event of a caesarean when the placenta is in this location.
The third ultrasound monitors development and determines the baby's position as the due date approaches. Most commonly, babies are found in the head-down-towards-the-cervix position. The opposite of this is the breech position, which may result in your doctor recommending a caesarean. Again this is something that can be discussed in line with your maternal rights. There is , of course, a chance that the baby may change position after this ultrasound.