adventures of an american housewife in the south of france

Knocked Up Abroad: The Great Doctor Search

A few months ago, I mentioned that we were still in the thick of The Great Doctor Search.  I thought I'd give you all an update on how that's going, now that it's (mostly) resolved.  The resolution could not come quickly enough seeing as I am, clearly, at the point where I should have all this figured out.

29 weeks - people are starting to stare at me.

First of all, I'll explain how the hospital vs. private clinic and doctor vs. midwife thing works around here.  Note: this is based on my conversations with my doctors and midwives and my (possibly) limited understanding of the situation in Montpellier, so if any readers understand the process differently, please feel free to correct me. Basically, you have 3 choices of where to give birth here:  public hospital, private clinic, or at home.  If we had been going through this pregnancy in the U.S., we'd be researching birthing centers, but unfortunately, no such thing exists in the south of France.  Going to a public hospital vs. private clinic depends on where your doctor practices.  Home births only account for about 2% of births here and, as a culture, home birth is not widely supported.  Personally, I have no problem with the idea of home birth, but Michael and I decided that being in a foreign country and for our first birth experience, it was not for us. If you are seeing a doctor affiliated with a public hospital, the way the process works is that you see your OB/GYN for monthly appointments and then work with a midwife associated with the practice/hospital for your pre-natal classes.  When you deliver at the public hospital, you are delivered by the midwife(s) on duty, not your regular OB/GYN, and not necessarily the midwife you've been seeing for your pre-natal classes. If you are seeing a doctor affiliated with a private clinic, the same process is in place during pregnancy (seeing your OB/GYN for monthly appointments and working with a midwife for your pre-natal classes) but when you deliver at the clinic, you are most likely delivered by your OB/GYN.  The midwife(s) on duty are still there to see you through most of the labor process (again, not necessarily the midwife you've been seeing for your pre-natal classes), but more likely than not, your regular OB/GYN will be there to deliver the baby. This information gave us a lot to think about.  During the pre-conception and early pregnancy part of this journey, I had been going to my regular gynecology practice which is affiliated with a public hospital, meaning that the baby would be delivered by the midwife on duty that night.  I have absolutely no problem with having a midwife deliver our baby, in fact I would actually prefer it, but we had another set of circumstances to consider:  language barrier.  My biggest fear in this whole process is being in a situation during the labor/delivery where a complication arises and we are with people who do not speak English and we cannot fully understand what is happening and what our options are.  We decided that we wanted to do everything we could to avoid that scenario, and delivering in a public hospital gave us the highest probability of being delivered by someone we didn't know, possibly who would not speak English. At this point, I was researching doulas in the area with the idea that if we had a bilingual doula, the whole language barrier issue could be resolved and I could put my fears to rest.  I also really loved the idea of having an experienced "coach" solely dedicated to helping us through the labor process in the most natural way possible.  Several of my friends have had great experiences with including doulas in their birth and I was excited at the idea of finding one here.  Well, after speaking to my doctors and midwife, I learned that at the public hospitals and private clinics here, you are allowed ONE birthing partner in the room with you.  Which meant Michael or a doula.  So that decision was easy. So!  We finally decided that we needed to find an English speaking doctor, whose philosophies on labor and birth aligned with ours, and who practiced at a private clinic.  We were narrowing our search, but I was afraid we were making it a bit too limited.  How would we find someone who met all this criteria?  Michael spoke with a few of his co-workers, and one of them recommended we speak with an English midwife who would be delivering their 5th child via a home birth in September.  He explained this midwife's beliefs, which strongly aligned with ours, and we figured she would be a good starting point to finding the right doctor here in Montpellier. So right before my trip back to the States, I called up the midwife and we had a great conversation.  She gave me the lowdown and recommended that I see a doctor here (we'll call her Dr. B) who worked at a private clinic and had a very low rate of intervention during birth.  She told me that the private clinic Dr. B was affiliated with had private rooms, a birthing pool (for labor only, you are not permitted to deliver in water at the clinic), supportive midwives, and that Dr. B is almost always in attendance for the birth.  She seemed to be just what we were looking for!  I called up Dr. B and made an appointment for the week after we returned from our trip. When we returned back to Montpellier, I was very excited about meeting Dr. B.  Then I realized that I had no idea if Dr. B spoke English.  I looked back at the notes I had taken during my conversation with the midwife and saw that I had written "private clinic - yes.  English - maybe."  I figured this appointment could finally mean the end to our Great Doctor Search or it could be very, very short.  Luckily, the appointment went great.  Dr. B speaks English (well, mostly.  She's not exactly fluent, but we're comfortable with her level of comprehension) and she took the time to answer our many, many questions, and made us feel at ease.  We'd found a winner! We've also been continuing to see the English midwife (we'll call her Mrs. M) for our pre-natal classes. Mrs. M told us that, provided she does not have a home birth scheduled when I go into labor, she is willing to come to our apartment and help me labor at home as long as possible (something I would really like to do).  There is also a possibility that Mrs. M may be allowed to attend the labor and delivery at the private clinic as a translator, not as a midwife since she is not employed by that clinic, which would really put my mind at ease.  We'll see if we're allowed to do that and I will keep you all posted. I am really happy to have that part of the process (mostly) figured out!  Now we need to move on to other preparing our home for a baby.  More on that next week! À bientôt!    

6 Responses to “Knocked Up Abroad: The Great Doctor Search”

  1. Susan Davis says:

    Goodness! You are certainly approaching this very systematically and wisely! Having someone who can tell you what’s up in English is a definate plus!
    The cescerian delivery rate is starting to drop in the U.S. due to young people asking alot of questions. It rose to a huge percentage of delivered due to insurance malpractice concerns. With good public healthcare in France, I’ll bet their C-section rate is much lower.

    Sounds like you’re just about ready for the next leg of this journey!

    • Natalie says:

      Thanks Susan! Yes, according to the CDC, the C section rate dropped in the US for the first time in a decade from 32.9% in 2009 to 32.8% in 2010. (the report can be found here if you’re interested:

      I recently read this article which does a great job of explaining why the rate of C section has risen so sharply in the US over the last few decades. According to our midwife, the C section rate at the public hospitals around here is about 23%. (For reference, the WHO recommends that the C section rate should not be higher than 10-15%)

      Right now the only thing that Michael and I can do is try to educate ourselves as much as possible by preparing for different scenarios and hope for the best! I’m trying to implement a lot of positive thinking without setting myself up for disappointment, since I know that rarely does labor and birth go according to plan.

  2. Jen says:

    Wow, Natallie. I am surprised about the one person rule. I also applaud u for sticking to the methods you hoped on at the outset and not settling. U look magnificent as per usual. :)

    • Natalie says:

      Thank you Jen! Yes I was rather surprised about the one person rule as well. It’s not like I want all of my friends in the room, but having a doula or my mom or something would have been nice!

  3. Lauren says:

    Thanks very much for sharing this. I realise it’s been some years since your post however I am moving to Montpellier from Australia and am due in November. I would really love to get the details of your Doctor & Midwife so I can also make contact.

  4. Lily says:

    Thanks for sharing this. I know the post was a while but I am moving to Montpellier soon in summer and just started the pregnancy journey. I would really appreciate if you could share the details of your doctor and midwife. thanks in advance.

Leave a Reply

Design by RoyCreative