adventures of an american housewife in the south of france

Knocked Up Abroad: U.S. vs. France

Hi everyone!  We're fresh from our Sardinian getaway and I'm feeling great.  A relaxing beach vacation was a great way to spend a few days and I can't wait to tell you guys all about this island paradise that is only an hour flight away.  But first, I'm excited to share my next post with you all about being pregnant in France.  So far in my prenatal care experience, I've noticed a few things that I'm pretty sure are a little different from how things are done in the U.S.  I've only had 5 appointments, so this list is ongoing, but here are some of my initial observations: 1. Ultrasounds.  Provided that everything at the beginning of pregnancy is going smoothly, many women in the U.S. have to wait anxiously for their 12-week appointment to get their first look at the little person growing inside them.  And after that, they may only have the option to get an ultrasound once in the 2nd trimester and once in the 3rd trimester.  Here in France, most women (if they want) will get an ultrasound at each of their monthly appointments, starting at 6 weeks.  The most comprehensive ultrasounds (with extensive anatomy scans and recorded measurements) are still only done once per trimester, but it's so nice to get a little peek at our Bonbon at each appointment for visual confirmation that everything is going well.  This was most reassuring for me during my first appointment at 6 weeks to confirm the pregnancy, because my doctor was able to find a strong heartbeat.  At that point Bonbon was just an indistinguishable wiggly, little blob, but to see it moving and hear the heartbeat allowed me to really relax and focus on only positive thoughts during the rest of the precarious first trimester, a practice that I feel is very important.    (sidenote:  when I showed the picture to Michael, who unfortunately was traveling during my appointment, he put on a great big smile, pointed to the embryo and said, "the ultrasound looks great, but what's that?") Of course there are varying opinions on ultrasounds, so some people may prefer to minimize the amount of times they are performed during pregnancy, but I have to say that seeing our little Bonbon each month really puts me at ease.  The machine is right there in each doctor's office and is typically done just for a minute or two after the consultation.  During our longer 12-week ultrasound, we even got a coveted 3-D image of our baby, which is normally totally creepy looking, but somehow awesome when it's your own.  Our doctor even apologized that the 4-year old machine used to produce the 3-D image was "so old" and reassured us that they would be getting a brand new, state of the art machine in time for my 22 week comprehensive scan.  Michael and I were beyond impressed since it seems like in the U.S. these 3-D images can be hard to come by, and when you're lucky enough to work with a practice that has a machine, you have to pay out the wazoo to use it. 2.  Monthly Testing.  Each month I have to go to a lab to give blood and urine samples that are analyzed for toxoplasmosis and to measure my glucose and protein levels.  Well actually, the blood sample is taken at the lab, but I have to actually bring in a cup of my own pee from home in a little bag.  I'm still getting used to walking down the street carrying my own pee. So does all this testing mean I won't have to take the dreaded 1-hour glucose test at the beginning of the 3rd trimester?  I have no idea.  But I do know that if it's done, none of the findings should be too surprising since I'm being constantly monitored.  Again, there's something reassuring about the fact that my doctor's are keeping a steady watch on what's going on inside me.  Could all this toxoplasmosis testing be related to diet over here?  I'm going to discuss that more in a future post. 3.  Insurance Coverage.  You guys, it's amazing.  Everything is covered.  100%.  As in, we don't pay a dime.  Well, we do pay, but then we're reimbursed and the process is incredibly easy.  All these appointments, consultations, lab tests, ultrasounds, the prenatal vitamins, childbirth, neonatal care, postpartum care, you name it.  It's all covered.  I was astounded by some of the out of pocket costs to have a baby in the U.S., and the fact that it's basically free here was a big factor in our decision to start our family while we're in France.  We have an ex-pat international health insurance plan and we feel so incredibly lucky to have this coverage.  And if you have what's called a carte vitale, which indicates that you're part of France's national health care plan, you can receive even further benefits here like monthly stipends and affordable childcare.  I'm still trying to determine if we'll qualify for any of those perks, so we'll see.  Wading through French bureaucracy is not my favorite thing to do, so it's taking me a bit of time. 4.  Gender Reveal.  One of the first questions people ask you when you tell them you're pregnant is if you are going to find out the sex of the baby.  For me and Michael, this was a no-brainer.  We're planners.  We need to know such things.  We were expecting to have to wait until the standard 17-20 weeks to find out and we were surprised when many of our friends here told us that the doctor would probably tell us during the 12 week ultrasound.  I thought, no way, and figured they would tell us it's a girl and it would probably turn out to be a boy since that seems like an easy mistake to make.  But when we went to our first big scan at all of 11 weeks 2 days, our doctor said, "would you like to know if it's a boy or a girl?" As it turns out, they have a more scientific method of determining the sex that early than I thought (doctors know more than me, who knew?)  Of course we said, YES!  Afterwards, we were a little hesitant to share the news since it seemed like it could change.  But we got a final answer a few weeks ago during my 15 week appointment, so we're ready to share!   Do doctors in the U.S. ever make predictions as early as 12 weeks??  I've never heard of it. So what is it, you ask?  Don't worry, I'll tell you in next week's Knocked Up Abroad post!  But just for fun, what do you think we're having? (and if you already know, keep your lips sealed!)

who's in there? boy or girl?

I’d love to hear how your experiences compare to my perceptions of how things are done in the U.S.  Am I totally wrong?  Did you receive similar care to what my doctors are giving me?  I’m really only going off of what my family and friends have told me, so I’d love to know what you all think.  In future posts, I'll be talking a lot more about the French's philosophy on lifestyle and diet during pregnancy, which I know many people are curious about, as well as how they view childbirth.  I'll also give you some more detail about my struggle to find the right the doctor (here's a preview:  it's ongoing).  Again, if there is anything else you'd like to hear about, please let me know! À bientôt!

14 Responses to “Knocked Up Abroad: U.S. vs. France”

  1. Tessa Durdan-Shaw says:

    Thank you for sharing your pregnancy experience in France Natalie, I am totally enthralled! I obviously work with many women who’ve just had their first baby, and my sister had her first child in November, so I feel like I know too well the US healthcare system. My sister got an ultrasound at around 6 months, and the doctors told her there were some concerns over the size of the baby’s head and a potential dark spot on his brain. Not exactly what you want to hear as you’re planning baby’s arrival. They made her wait 4 excruciating weeks before they would follow up with a second ultrasound. She was panicked and upset for those weeks, and stressed beyond belief. No doctor did anything to reassure her or help her through the process. She had the second ultrasound and everything looked normal, yet no one explained to her why they were all so concerned in the first place. They also decided at 7 months that her baby was going to be too large to deliver naturally and scheduled a medically-necessary c-section (against my sister’s wishes). When she went into labor, she begged to try to deliver naturally, and they reluctantly let her. She delivered a perfectly healthy 8 pound boy in 20 minutes. He could have been 9 pounds and she still would have had no trouble delivering him. We later found out that hospitals and doctors in general get paid more to preform c-sections, and prefer it because of the “no guesswork” component. Needless to say, we were all less than impressed with her level of care. Sounds like your experience has been so much better so far! You look amazing, keep it up :)

    • Natalie says:

      Tessa – Thank you so much for sharing your sister’s experience. How scary and frustrating it must have been for her! I’ve always been very interested in the maternity care system in the U.S. and the rise in medical interventions during birth. I’m just now starting to really research and think about what I would like to try and experience during childbirth and, unfortunately, I’m running across many stories like Chelsea’s. I have to admit, a huge concern I have about giving birth in France is my language barrier and being able to be communicate what I want during labor and delivery, so we’ll see how that goes!

      I’m so glad everything turned out the way Chelsea wanted it to and, most importantly, that her son was born healthy! Bravo to her for sticking up for herself.

  2. Andy says:

    Awesome to hear the Frenchie way as we’re obviously experiencing the US way just a few weeks behind you. So far you’ve got it right and being in SF we have some of the best prenatal care available in the US from what I understand.
    As for gender, I’m guessing that you are having a little fille!

    • Natalie says:

      Andy – just curious – did they offer any ideas on the sex when you had your first ultrasound? I’m wondering if they would even try to guess if you ask…

      • Andy says:

        No guesses at all. We’re still wondering what gender our little munchkin will be. Trisha is convinced it’s a boy and while I wasn’t sure for the longest time, I’m now feeling that she’ll be a little girl. Guess one of us will be right!

  3. Liene says:

    Just had my second here in France, and have to say the experience was ten times betterr than in the US with my first. Although the first appointment with the practice I used is normally at 12 weeks, they also do ultrasounds more frequently, although only every other month. A big difference was that during the last trimester I had check-ups every week in the US, here once a month. It was actually nice, less stress and in the end, I was able to deliver my 10.7 lb baby naturally, after a Cesarean in the States with my 8.9 lb baby who was “too big” to deliver. The toxoplasmis is probably because tests showed you don’t have antibodies…. typically, French women have had them, but I didn’t look into whether this is genetic, immunization or having had it. And insurance, ours covered only 90%, but this is still cheaper than in the US.
    My guess: boy

    • Natalie says:

      Hi Liene – thanks for your input!! It’s great to hear about another ex-pat having a positive experience in France. I’m really curious to see how the doctors view C-sections here. Of course I’m not opposed to it when it’s medically necessary, but I’m wondering if the rate here is as high as it is in the U.S. I need to do some research on that!

      • Liene says:

        Much lower. Not as low as in some places, but my research showed almost by half. Of course it is super important to find a doctor you can openly discuss everything with, and who you trust.

        A girl . I was convinced I was going to have a girl… twice. Two boys later! The clothes for little girls here in France are particularly cute.

  4. Trinity says:

    I have a ton of stories since having our third. I had an U/S right before delivering Leah and it was off by a pound. I was induced a week early (39th) because I have had big babies in the past, (Ryan was 9lbs 7oz), and had gestational diabetes this time. My doctor convinced me I could handle Pitocin without pain medication, and BOY WAS HE WRONG. Always have pain medicine if induced. I had Ryan under 3 hours, Leah took 7 1/2 hours! Also, she was on 6 lbs 15 oz! They U/S was off my a pound. I’m just saying!!!!! I had the most painful contractions of my life!! No shame in pain meds! I did all three naturally, but induction is a different ballgame.

    So excited for you! Good luck with everything. See you at the wedding. Trinity

    • Natalie says:

      Ah! That sounds crazy! We’ll have to talk about this more at the wedding! I’m wondering if you have any childbirth books or other resources you’d recommend for me?

      I can’t wait to meet Leah!

  5. Matt says:

    Love the title and info! I definitely hear about c-sections being pushed way too often in the U.S. as well as the enormous cost of prenatal care and childbirth…interesting to hear the French norms as probably many Americans would look down on their system without even knowing much about it thinking it is socialist…”the government better stay outa my healthcare, I love overpaying insurance companies!”

  6. Leigh says:

    It’s very interesting the way healthcare is provided differently, in different countries. How awesome that you get such good insurance coverage! I think your observations of how it is done here, in the US, is pretty accurate. Most people that I know, only get one ultrasound, their gender scan. With my first pregnancy, I had a fabulous doctor who would run me into the ultrasound room if I had any hesitations at all. I think I had at least 3 ultrasounds with my first. When it came to delivery though, the practice I went to (and so does Tracy), is very reluctant to schedule a c-section, unless it’s medically necessary. Both Tracy and I pushed extensively (around 4 hours) with our firsts. Mine came out naturally and she had to have a c-section. I think it’s different in different countries as well as with different doctors. In my opinion, a good doctor makes a world of difference.

    I’m so happy for you! You look amazing and you will make a fantastic mother. I wish you a safe, healthy and happy pregnancy. Oh…and i think you’re having a girl :)

    • Natalie says:

      Thank you, Leigh – that’s so sweet! And that’s awesome to hear that you’ve been able to work with a doctor and a practice that you like so much and that is so progressive. Your girls are so cute! I’m really having trouble finding the right doctor for me here, but that’s mostly due to the language barrier :)

  7. Bridget says:

    Hi Nat!

    I just love your cute little bump! I’m always a little behind in reading your posts, and you probably have already read up all about Toxoplasmosis, but… It’s a protozoal disease and most immune competent people never develop clinical disease, but produce antibodies when exposed. The definitive host for the organism is cats, thus why pregnant women and AIDS patients are encouraged not to scoop litter boxes (there is a lot of misinformation about how this disease is transmitted, so while it is not necessary to avoid the litter box, I suppose it is extra cautious). My understanding is that most U.S. doctors don’t really screen for Toxo during pregnancy unless there is suspicion for acute infection during pregnancy or in a high risk patient.
    Anyway, I guess that’s all the gobbledyguck info that a fancy vet education gets you ;)
    Love you guys!

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