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Having a Baby: Pregnancy and Birth in France

The administrative details you need to know if you are giving birth in France. Who to contact and what to expect from the French system throughout the pregnancy and the post-natal period: maternity leave, midwives, vaccinations and the Livret de Famille.

This is a guide to the legislation and administrative details of having a baby in France - the more personal decisions are just that, personal.

On Becoming Pregnant

Once a pregnancy is suspected it should be confirmed in an initial examination with a doctor, gynaecologist or midwife. Family health history and information about allergies will be required at this point. The doctor or midwife prescribes tests to determine the woman's blood type and identify the presence of diseases that may present risks such as rubella and toxoplasmosis.

After this first official examination (Premier examen prénata) the doctor (or examiner) issues a three-part document to declare the pregnancy. This is the déclaration de grossesse. Within three months - no later than the fourteenth week of pregnancy - this must be sent as follows (to avoid risking the loss of allowed benefits):

Pink sheet is sent to the health insurance fund (Caisse d’Assurance Maladie, CAM)
Both blue sheets are sent to the family allowances fund (Caisse d'allocations familiales, CAF)

The Caisse d'Assurance Maladie issues the dates of medical examinations, details of permitted maternity leave and a health booklet to explain the steps of pregnancy and care.

Detailed information on the process from pregnancy to post natal care, and the health and maternity allowances is published by l'Assurance Maladie en Ligne (Ameli.fr), the French national health insurance organisation.

For information from Ameli on pregnancy and birth: Click here (in French)

The maternity record book

The maternity record book (Carnet de santé maternité) has two principal functions:

It documents every medical procedure throughout pregnancy and acts as the "bond" between the medical personnel and the expectant mother.
It provides a document for administrative follow up.

This multi-part book must be taken to every medical consultation. It is composed of detachable layers corresponding with the various stages of a pregnancy. It states the point at which a particular examination is required, and where to go and where to send documents.

Every examination or process by a doctor or a midwife will be filled in. This entitles the mother 100 percent reimbursement on certain expenses. This document is confidential, although a doctor has the right to inform the father of the baby on certain details, if it is considered necessary.

A woman who does not fulfil the conditions of examination as laid out in the carnet de maternité may find their rights to refunds and employment allowance are jeopardised. In the case of an unmarried couple, the couple must decide and declare who will receive the benefits - be the "allocatee".

Antenatal classes are also subsidised by national health insurance. Records of medical examinations must be submitted to the medical insurer.

The CAF office issues a pass which show a pregnant woman has the right to go to the front of the queue in public places, and demand that someone gives up their seat in a public place or on public transport.

For a full brochure of the Carnet de santé maternité: Click here (PDF in French)

Employment protection and parental leave

Pregnant, employed or self-employed women receive a great many benefits and much job protection.

Women are allowed 16 weeks maternity leave in France, for the third child, maternity leave is 26 weeks. An allowance is paid during maternity off-time. A pregnant employee is not obliged to reveal her pregnancy until the time she wishes to take maternity leave. Notification can be by made verbally or by letter. By law, a job must be kept available to the pregnant employee. Parental leave is also allowed to fathers.

If a decision is made to stop work or work part time after maternity leave, the parent is entitled to a parental leave (congé parental d'éducation). Those with more than one child, who have worked for two out of the last five years, are entitled to an Allocation parentale d'enfant. The congé can be renewed until the child's third birthday.

The French government website has comprehensive information on maternity leave and benefits: Click here (in French)

Benefits and allowances

There is a range of benefits and allowances available when a child is added to a family (by natural birth or adoption). These vary depending on the number of children, the income of the parent(s) and other factors. The relevant CAF office can advice a parent/parent-to-be on their precise entitlement.

Prestation d'Accueil du Jeune Enfant (PAJE) covers all children born or adopted from 1 January 2004. This entitlement replaces previous schemes including Allocation Pour Jeune Enfant (APJE). If a child is born into a family already receiving APJE for older children, CAF applies a transitional system.

For more information on who qualifies for what under PAJE, see the CAF website: Click here (in French)

Obligatory antenatal medical examinations

A pregnant woman is obliged to undergo seven antenatal examinations, which will be fully refunded. The first visit must take place before the end of the third month of pregnancy. After this examination, exams are monthly from the forth month. Women not immune to toxoplasmosis will have their blood tested at a laboratory, monthly. Generally, three sonograms (échographie) will be conducted during a pregnancy.

The Birth

Generally, delivery takes place in a maternity hospital and usually by mid-wife (sage femme). Parents should find and reserve a hospital place long in advance. If a private hospital or clinic is chosen, there may not be full reimbursement by state health insurance. Parents may request that the birth is performed by the gynaecologist - this will affect where the birth may take place. Generally, a hospital stay lasts three days. Epidurals (péridurale) are happily given.

Home births

Home and natural births are not common in France. While they can be arranged, it may be difficult as a result of various administrative and insurance reasons: the health and security of the baby and mother are of primary importance, and even though statistics show that there is little difference in the mortality rate between home and hospital births, there is the chance of prosecution for those in attendance if something goes wrong in a home birth. This is under the legal responsibility of non-assistance à une personne en danger meaning that someone not helping a person in danger and will face prosecution - this is a serious offence in France.

Even so, home births are becoming more sought after, so things could change in the future and the gynaecologist may be able to advise. A home birth is reimbursed by social security, but not at the rate of 100 percent as in a hospital or clinic birth.

In the Alpes-Maritimes (06) and Var (83) départements, there are some English-speaking doctors (and mid-wives) able to perform homebirths. For further information contact:

Accoucher Librement (English Dutch & French spoken)
Post: BP 10, 83570 Correns
Tel: 04 94 59 56 17
e-mail

Doulas de France is a French association of Doulas (birthing assistants, or partners). The website has an English section which explains the association and the role of the birthing partner providing support to the woman in labour and the attending mid-wife.

For the English-language site: Click here
To find English-speaking Doulas: Click here

EU Nationals

Legislation allows that an EU citizen resident in France with French medical insurance may have the delivery in their home country. Expenses are reimbursed.

See the AngloINFO INFOrmation Page The E112 Form: Medical Treatment in Other EU Countries

Registration of the Birth

The Déclaration de Naissance or birth registration is obligatory for any child, whether legitimate (born into marriage) or natural (born to un-married parents). It must be made within three days of the birth (although allowance is made for weekends). The registration is free.

The notification must be made at the local Mairie of the birth, by a qualified person, officier d'état civil. Any person who has attended the birth may make the statement but they must take the signed birth certificate extrait d'act de naissance and proof of residence.

The request for the birth certificate (demande d’acte de naissance) can be made online at Acte de Naissance en Ligne (in French).

A request for a birth certificate must include:

the full name of the baby at the time of birth
the date and place of birth
father's full name
mother's full name, including maiden name

French nationality

Any child born to at least one parent who is a French national has automatic French nationality (whether born in France or abroad).

A child born in France, where neither parent is French may receive French nationality (on request) at age 18 years if they are resident in France.

A child who has lived in France for at least five years from the age 11 onwards may receive French nationality (on request) at age 18 years.

Registration of birth at an Embassy

Embassies recommend that their nationals resident in France register the birth of the baby at their home Consulate.

The health record of the child

A health record ( carnet de naissance de l'enfant) is issued by the hospital, doctor or town hall after the birth of a baby. This notebook must be taken to every medical consultation the child has until they are 18 years of age. The medical examiner will enter the details of any procedure. This provides a record of full medical history.

Postnatal

The postnatal period (période post-natale) involves examinations for both the mother and infant. The baby is examined in the first week and then nine further times in the first year, three during second, and two during each of the next years up to the sixth birthday. Of these exams, three contribute to a "certificate of good health" - the first week, ninth month and 24th month.

The gynaecologist examines both the mother and baby at eight weeks after delivery.

Local health care centres for the Protection Maternelle et Infantile (PMI) provide clinic services clinic for mother and child. The services are free if "health carnets" are made available. The staff perform the basic postnatal checks, provide advice and help on issues such as nutrition and breast feeding. They are also permitted to administer the vaccinations.

Mother's are also prescribed and reimbursed for postnatal physical therapy.

Vaccinations

The health record also acts as a certificate of vaccinations (carnet médical peut servir de certificat de vaccinations). The doctor or clinic signs, dates and declares the vaccinations given. A child can be expected to receive the following:

First month
BCG for tuberculosis (not obligatory from July 2007)
Between 2 and 3 months
Vaccin Pentavalent: First in a course of 3 injections at monthly intervals for Diphtheria, Tetanus, Polio, Whooping cough (coqueluche) and Haemophilus b.
Note: 1 further booster injection is due when the child is between 16 and 18 months of age.
Vaccin Antihépatite B: the Hepatitis B vaccine. The first in a course of 3 injections with the third given 6 months after the first.
Note: The Vaccin Hepatique vaccination is now very rarely given to children due to a recent health scare. Some doctors believe there is a link between this vaccination and the development of multiple sclerosis.
From 1 year of age
ROR Rougeole/Oreillons/Rubéole): First inoculation against measles, mumps and rubella (German measles). Booster recommended between ages 3 and 6.
For detailed information on vaccinations from the government health department: Click here (in French)

Naming the child

Parents married in France or issued with a French family record book (Livret de Famille), should return to the town hall with the birth certificate (signed by the doctor or midwife) so that the child's name can be entered. For any information, contact the Marie of the birthplace.

Relevant Organisations

There are several official organisations in France catering to mothers and families. They are:

Caisse d'Allocations Familiales (CAF), family benefits
Protection Maternelle et Infantile (PMI). mother and infant welfare (can be reached through your local Conseil Général)
Caisse Primaire d'Assurance Maladie (CPAM), primary case of sickness insurance
To find a local branch contact the Conseil Général of the department for information on local bodies: Click here and select the region