Pregnancy

 

Please keep in mind that the following information summarizes the experiences of some English-speaking mothers in Toulouse. Your situation could be different. Although extensive information is provided in this section, you may also want to consult the Guide Des Mamans for other pregnancy-related information. (See “Reference Books”.)

CHOOSING A DOCTOR

The intent of this information is not to influence the choice of obstetrician, but to let pregnant expatriates know that many English-speaking women have been under the care of the following four doctors and speak positively in terms of the care received. (For their contact information and a complete list of English speaking OB/GYNs, see Chapter 13.):
· Dr Kobuch
· Dr. Alexander Halasz
· Dr. Bruno Zabranecki
· Dr. Jean-Marc Munoz.

You may want to visit several doctors and clinics and ask lots of questions in order to find the one that best meets your needs. Note: In France, two echographies (sonograms) are required during pregnancy, from the fourth month. (Because of current controversy regarding the safety of sonograms, you may wish to look into this and discuss it with your doctor.)

DOCTOR VISITS

You can expect to have an internal exam and will be expected to undress in front of the doctor. There is no gown provided. During the exam the doctor will also check blood pressure, weight, and, when appropriate, listen for the baby’s heartbeat and measure the baby’s size. Usually visits will be once a month at the beginning of pregnancy, then once every two weeks starting around the 7th month, then once a week during the 9th month. Additional visits would be scheduled if there problems of any sort.

BLOOD TESTS (ANALYSES DE SANG)

Should your doctor require a blood test to determine blood type, a prescription will be provided, to be taken to a laboratoire d’annalyse (lab). Be sure to verify if you need to be à jeune (on an empty stomach). After receiving the results, you will be issued a Carte de Groupe Sanguin indicating blood type. The doctor may also require a blood test to determine blood make-up and immunology, as well as an HIV test. Urine samples will be necessary periodically during the pregnancy (about 3-4 times). If there is the possibility that an épidurale (epidural) will be used, a blood test will be performed to confirm that it coagulates, which is necessary for the treatment of certain problems that may be encountered with anesthesia by epidural.

Toxoplasmose (Toxoplasmosis)
Blood will be drawn and tested for toxoplasmosis every 3 or 4 weeks throughout the pregnancy, (unless you are immunized). To avoid toxoplasmosis, be sure to cook meat well, wash all fruits and vegetables before preparing them for consumption, wear gloves if in contact with the soil (gardening, etc.) and avoid any contact whatsoever with cat feces.

FER/ACIDE FOLIQUE (IRON/FOLIC ACID SUPPLEMENTS)

Folic acid supplements should be prescribed during the first few months of pregnancy, to avoid the risk of spina bifida. The doctor will usually also recommend iron supplements during pregnancy and while breast-feeding. Iron is a prescription drug in France and a new prescription will be needed each month. It is recommended that you bring other prenatal vitamins from your home country, if you wish to take them, as they are not readily available here. However, be sure to show them, to your doctor so that the prescriptions you will receive for folic acid and iron can be adjusted accordingly. (ALL prescription medicine taken during pregnancy should be shown to the doctor.)

ANESTHESIOLOGIST

It is necessary to meet with the anesthesiologist approximately 4 weeks prior to the anticipated due date in order to discuss your medical background. If you think you may want or need to have an epidural, be sure to provide the necessary blood records and have him examine your back to determine if that it will be possible. (There is an English-speaking anesthesiologist, Dr. Richardot, at the Ambroise Paré clinic in Toulouse.)

SAGE-FEMME (MIDWIFE)

In France, a sage-femme (midwife) is similar to the nurses who specialize in labor and delivery in the USA and UK. They study for 3 years in a special school for midwives and are qualified to deliver babies. Usually, your doctor (or associate) will deliver your baby at a maternity clinic while a mid-wife will deliver the baby at a hospital. If there are complications (breech, etc.), a doctor will deliver the baby in an operating room. It is also possible to have a midwife attend your birth at home.

Both prospective parents may meet with the midwife in advance. She will answer questions and advise you on breathing, stretching, muscle strengthening exercises, and how to position your pelvis during delivery. She may also provide information about what to bring to the hospital or clinic and provide a tour of the maternity ward. Call 4-6 weeks prior to the due date to schedule a series of appointments, (usually once a week). If there are any problems or complications during the pregnancy, tje doctor will usually advise going straight to the clinic or hospital so that a midwife can examine you to determine your, and the baby’s, condition. In such cases, upon arrival at a hospital or clinic, ask for the midwife and provide the name of the pediatrician who will perform the post-delivery examination of the baby.

If you are not fluent in French, ask your doctor to provide a brief summary of your medical background concerning previous pregnancies for the mid-wife who will not have your medical file.

An English-speaking midwife:
· Mrs. Fabienne Stock, 20 rue Michel de Montaigne, Toulouse
(Tel: 05 61 22 92 29)

CHOOSING A CLINIC OR HOSPITAL

The doctor will usually ask that you use the hospital or clinic with which he is affliliated for the birth. Most often, the doctor will use a clinic, which are well equipped to handle regular problems that arise in connection with the birth process. (In case of serious problems, the baby will be taken to the neonatal section of CHU Purpan.) The doctor may want to have a pediatrician available at the birthing if delivery problems are anticipated. If there are no complications, mothers who delivered vaginally stay in the clinic or hospital for at least 5 days after the baby is born. This ensures that the risk of jaundice will have passed, enables the nurses to teach you how to care for a newborn, and offers the reassurance that the baby is feeding properly. Mothers who had a Cesarean delivery remain in the clinic or hospital for 8 days.

Clinique Sarrus Teinturiers has a pool for use during labor and/or delivery, as well as low beds for birthing and dim lighting. Note: this is the only clinic in Toulouse that will allow the father to be present during a Cesarean section.

At Ambroise Paré and Clinique Sarrus Teinturiers, private rooms are available in the order in which women deliver their babies. If a private room is not initially available, one may become available in a day or two. Be sure to tell the nurse that you want a private room so that your name can be put on the waiting list. If you have a private room you can rent an extra bed so that someone is able to stay with you. Many, but not all, clinics allow the father to stay at all times and sleep at the clinic for an extra fee. Fathers are encouraged to participate in preparation courses at certain clinics. It is best to ask, as clinics do differ.



WHAT TO TAKE TO THE HOSPITAL OR CLINIC

The following medical records are required for maternity admissions:
· Carte de Groupe Sanguin (blood type card)
· All lab work (sonograms, blood tests, x-rays, etc.)
· Any special instructions from your doctor
· If you are not fluent in French, it is helpful to also provide a brief summary of your medical background concerning previous pregnancies, for the mid-wife who will not have your medical file (request this from your doctor in advance if you are not fluent in French)

The following is a sample list of what items need to be packed in advance for the maternity stay at the clinic. Hospitals tend to require fewer or no supplies. Check with your doctor or mid-wife, as their list may vary. Note: If a particular item of clothing for the baby is on the list provided by your doctor, mid-wife, hospital or clinic, BRING IT, even if it seems unecessary for the season. (Some mothers have reported that fathers have been made to return home to retrieve missing garments from the provided lists.) Most items can be found at the large supermarkets such as Leclerc and Carrefour.

For the Baby:
Non-alcohol disinfectant Eosine sans alcool
6 umbilical wraps bandes ombilicales (type Nylex)
Cleansing cream lait de toilette
Cleansing water eau de toilette
Cotton (buy Bogram pre-cut cotton in long clear plastic bags) coton
Diapers/nappies (Pampers are available) changes complets, 1er âge
6 undershirts brassières coton or body coton
Some wool clothing or sweater (even in the summer) brassières laine
6 pajamas or sleepers pyjamas or grenouillères
6 pairs of socks or booties chaussettes or chaussons
1 blanket couverture bébé or molleton
3 washcloths serviettes de toilette
Bibs or cloths (for when the baby spits up) bavoirs
Brush (for cradle cap) and comb brosse et peigne
Laundry bag sac à linge


For the Mother:
Gown to use during the delivery chemise de nuit
Night gown or dress chemise de nuit
Bathrobe robe de chambre
Slippers pantoufles
Nursing bras and pads soutiens-gorge d’allaitement
Disposable underwear (buy the large size) slips à jeter - grande taille
Sanitary napkins (2-3 boxes of “super” pads) serviettes hygiéniques
Kleenex mouchoirs en papier
3 towels and 3 washcloths serviette de toilette et gants de toilette
Toiletries (shampoo, lotion, body powder, etc.) nécessaire de toilette
Blow dryer (to keep your stitches dry) sèche cheveux
Liquid soap savon liquide
Water in a spray can (used instead of ice chips during labor) atomiseur
Pillow (optional, you may want to bring the one you are used to) oreiller
Anti-bacterial soap Cytéal
Local disenfectant (for your stitches) Eosine sans alcool

Other suggested items:
· Food for anyone accompanying you for the duration of the labor (the clinic or hospital may or may not have a cafeteria or vending machines)
· Formula (if not breast-feeding) for after the baby is born
· Breakfast fruit for yourself, as breakfast tends to be minimal
· Sweeteners or jams for flavoring plain yogurts
· Snacking food for yourself and visitors

INDUCED LABOR

If having a large baby, or in the event that the due date is reached without giving birth, the doctor may choose to induce labor. In order to reduce the stress to the baby, French doctors prefer to induce labor if the baby does not arrive within 2 weeks beyond the due date.

LABOR AND DELIVERY

Under normal circumstances, the father will be allowed to be present during labor and delivery. If he wishes, he may also accompany the baby after birth when he/she is being cleaned by the mid-wife.

PAYMENT

Payment is expected for each doctor’s visit and all other services at the time the service is rendered. Prices for medical and other services are fixed. A normal vaginal delivery at a clinic costs about 1.000€. If not on the French insurance system, the clinic or hospital will expect you to pay a deposit of approximately 800€. (See Chapter 13, “Medical and Health Care”.)

PEDIATRICIANS

An in-hospital, post-birth pediatric visit is mandatory in France. If you don’t have a pediatrician, there are usually pediatricians that work with the clinic or hospital that can be called to see your baby. The pediatrician may be present at the birth upon request.

GROUPS AND ACTIVITIES FOR PARENTS-TO-BE
· Naissance et Rencontres, an association for meeting other young parents, organizes activities several times a month. Although several of its members may speak English, the activities do take place in French. Contact: Mme Isabelle Moulin (Tel: 05 61 75 66 85).

· La Leche League, an American-based breast-feeding group, has two chapters in the Toulouse area. Help and support is provided by telephone to new mothers who may have questions concerning breast-feeding. The groups are also a nice way to meet other young mothers, and meet every month. Although meetings take place in French, many of the members speak English. Fathers are welcome. Contact, Toulouse Rive Gauche: Mme Elisabeth Le Roux, 23, rue du Roussillon, 31830 Plaisance du Touch (Tel: 05 61 07 39 28). Mme Leroux speaks fluent English.

· Haptonomie: Drs. Magali Nicolai and Jacques Palusci teach a massage method that mother and father practice in order to “get in touch with” their unborn baby. Contacts: Dr. Magali Nicolai, Bâtiment A, 14 allée des Grillons, 31320 Castanet-Tolosan, (Tel: 05 61 75 79 95). Dr. Jacques Palusci, 40 bd Silvio Trentin, Toulouse (Tel: 05 61 75 79 95).

· Santé et Communication: Meetings in French every month in preparation for the birth. Fathers are welcome. For more information, consult Guide des Mamans (see Chapter 27, “Reference Books”.). Contact: 05 62 19 08 67.


AFTER THE BABY IS BORN…

1. Deliver baby’s blood to Purpan Hospital. You are required to deliver a sample of the baby’s blood to the Purpan Hospital within 24 hours of the baby’s birth. The clinic or hospital may deliver the blood for you.
2. Register the baby’s birth at the Cité Administrative. You must register the baby’s birth at the Cité Administrative, 34 rue des Lois, near Place du Capitole, within 3 days of the baby’s birth. The office hours are Monday to Friday 08:00 to 17:00 and they are open during the lunch hour. You will need two copies of the l’Acte Intégral de Naissance (French birth certificate) and your home country passport to obtain a Report of Birth.
3. Report of Birth to the home country. In order to obtain an American passport and social security number for your baby you need to contact the Consular Presence Office of the United States of America, in Toulouse. Other nationalities should contact their consulate well before the baby is born to prepare the paperwork required in a timely fashion. The papers required will be similar to those required by the US authorities. (See Chapter 26, “Embassies and Consulates”.)

Consulate of the United States of America
25 allées Jean Jaurès • 31000 Toulouse
(Tel 05 34 41 36 50 or 05 34 41 36 51)
By appointment only, Wednesdays from 09:00-12:00 and 14:00-17:00

You must call first, both to request the necessary paperwork and to schedule an appointment to bring the completed paperwork, for processing and issuance of the child’s passport and social security number. The child’s presence is no longer necessary, unless requested by the consular officer. Processing the paperwork takes approximately two hours. You will be asked to arrive by 10:00 or 10:30, or earlier if possible, and will need to bring the following completed documents:
· Report of Birth Abroad application (provided by the consulate)
· Passport application Form DSP-11 (provided by the consulate)
· Two copies of l’Acte Intégral de Naissance (French birth certificate)
· An original marriage certificate bearing the state seal
· Certified evidence of the termination of any prior marriages
· Three identical photographs of the baby which meet passport specified dimensions. The consulate will provide the names of photography studios that are able to make these photographs in the Toulouse area. They will also explain the exact size of the pictures in French so you will know what to ask for at the photography studio.
· Mother’s and/or Father’s passport
· Fees ($50) must be paid in cash and will be accepted in US dollars or French francs.

NOTE: If only one parent is American, the American must have proof of having lived in the United States for at least five years after the age of fourteen.

Vocabulary - Pregnancy

Am I pregnant? Suis-je enceinte?

My last period mes dernières règles

Pregnancy la grossesse

Sonogram/scan l’échographie

Induced labor provoquer l’accouchement

Labor le travai

Fetal monitor un moniteur

Contraction la contraction

Dilatation la dilatation

Pain la douleur

Epidural la péridurale

Episiotomy l’épisiotomie

Cesarean césarienne

Birth naissance

Push poussez

Breast le sein

Breast-feed allaiter or donner le sein

Stitches les points

To suckle têter