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Being pregnant and giving birth abroad
Residing outside France does not in any way prevent you from enjoying the arrival of your baby serenely. Provided you are familiar with the administrative procedures specific to pregnancies and births abroad, in particular with regard to medical costs. What you need to know to avoid unpleasant surprises.
Live your pregnancy abroad
The habits concerning the follow-up of the pregnancy differ completely from one country to another. It is therefore essential to be well informed upstream to know if you will benefit from optimal monitoring. If you fear the obstacle of the language barrier to dialogue with medical staff, you can ask the French Consulate for the contact details of French-speaking doctors in the country where you reside.
As an indication, here is a non-exhaustive list of obstetrical follow-up habits in France:
- Seven mandatory prenatal consultations with a midwife or gynecologist, including one during the first trimester of pregnancy. These appointments are in particular an opportunity to take your blood pressure, monitor your weight gain, listen to the baby’s heartbeat, measure the uterine height …
- Systematic supplementation with folic acid (vitamin B9) until the end of the first trimester of pregnancy to limit the risk of spina bifida ;
- A case-by-case supplementation with vitamin D and iron;
- The determination of the blood group with rhesus;
- A blood test for serum markers, recommended but not compulsory, between 11 and 13 weeks of amenorrhea, intended to assess the risk of chromosomal abnormality;
- Urinalysis to monitor possible gestational diabetes and possible pre-eclampsia;
- Screening for toxoplasmosis, rubella, syphilis, HIV, etc.
- Three compulsory ultrasounds: between 11 and 13 weeks of amenorrhea, between 20 and 22 weeks of amenorrhea then between 32 and 34 weeks of amenorrhea;
- An oral hyperglycemia test in case of risk of developing gestational diabetes (over 35, BMI over 25, family history of type 2 diabetes, gestational diabetes, baby over 4 gk);
- A mandatory consultation with an anesthetist during the 8th month of pregnancy, whether or not you have planned to do an epidural;
- Eight sessions of preparation for birth and parenthood, recommended but not compulsory;
- A vaginal sample during the 8th month to detect and manage a possible streptococcal B infection;
- Control monitoring during the last weeks of pregnancy.
What steps to take to give birth in Europe?
If your stay outside France is scheduled to last less than 2 years, the European Health Insurance Card (CEAM) allows you to benefit from coverage for medically necessary health care occurring in the European Union, in Norway, Liechtenstein, Iceland or Switzerland. The costs related to pregnancy and childbirth are also covered, provided that the purpose of the stay abroad was not to benefit from this care. In practice, you must apply for this free card from your Primary Health Insurance Fund before departure. If the card cannot be issued before your departure because it is requested too late, a provisional replacement certificate (CPR) valid for 3 months will be given to you. Once there, present your EHIC or the CPR to the care provider you consult in the State of stay.
If you have posted worker status, you are covered by Health Insurance.
If you are considered an expatriate, you are subject to the local scheme of the destination state to which you will pay your social contributions. Each country has its own regime. The Center for European and International Social Security Liaisons has drawn up descriptive notes on the regimes of countries with which France has a social security agreement: the states of the European Union, the European Economic Area, Switzerland, as well as than forty states / territories signatories to a bilateral agreement with France.
What steps to take to give birth outside of Europe?
If you are an expatriate in a country with which France does not have a social security agreement, you have the option of voluntarily contributing to the Caisse des Français Abroad. This affiliation does not exempt you from the obligations that exist in the country in which you reside but it allows you to be better covered than if you only benefit from the local system.
How to declare the birth?
To register the birth of your child in the French civil status, two procedures are possible:
- The declaration of the birth to the embassy or consulate of your country of residence. In countries where local law does not preclude it, the declaration of birth may be received by the consular civil status officer with territorial jurisdiction. In this case the embassy or consulate will immediately establish the birth certificate and keep it in their registers. The declaration must be made within 15 days of delivery. This period is extended to 30 days outside Europe and in certain European countries (Albania, Armenia, Finland, Greece, Norway, Poland, Portugal, etc.)
- The transcription by the consular registrar of the local birth certificate. In countries where the law obliges foreign nationals to declare births to the local registrar, parents will have recourse to the transcription of the local birth certificate by the civil registrar of the embassy or consulate.
Special cases: Algeria, Morocco and Tunisia
Transcription requests for documents drawn up in Algeria, Morocco or Tunisia must be sent only by post to: Central Civil Status Service – BTM- 11, rue de la Maison Blanche – 44941 Nantes Cedex 9
You will find more details on the France Diplomatie website.
Returning to France to give birth
If you plan to give birth in France, be sure to register in the maternity unit of your choice from the 3rd month of pregnancy. Even earlier if it is located in the Paris region or in a large urban area. Some structures are sometimes sold out very quickly.
Also make sure you can take the plane home: pregnant women are prohibited from flying during the last 4 weeks of pregnancy. And in any case, whatever your term, you will need to request a certificate of fitness to fly from your doctor. Internal regulations in this area vary from one airline to another and some require it early in pregnancy.