In January of 2022, I gave birth to our son in a hospital in France. I remember marveling at the differences in our experiences compared to what I would have expected in the US. Granted, I've never given birth in the United States or worked on a labor and delivery unit. However, I was a medical-surgical nurse for six years and have been a patient numerous times. I believe I have a pretty good idea of the typical patient experience (in fact, I was the “Patient Experience Champion” on my unit!).
Some of the differences I noticed might be considered insignificant to someone without a healthcare background, but many were glaringly obvious to me. For example, my nurse left all my medications with me to take when I wanted (gasp!), and if I used my call-light I would get a response within minutes. Most of the differences were welcomed!
The American Hospital In Paris
We were five months pregnant when we arrived in Paris. Our highest priority as we started our new life in France was to find the healthcare we needed; I needed an Endocrinologist to manage my thyroid, and we needed an OBGYN to follow our pregnancy. My husband and I chose The American Hospital as our birth location because our doctor worked there (and to be honest, going to a hospital named “The American Hospital” while in a foreign country was comforting!).
It was a convenient 40-minute walk from our apartment and located just outside Paris. Once we learned more about the French medical system, we discovered that we had selected a “private” hospital, which cost a little bit more than a public one. Our experiences may not necessarily be the exact norm due to this, but many French people use this hospital as well.
Our doctor was an experienced OBGYN and had been recommended to us by another American couple. We were thrilled that we could easily make an appointment online before we left the US. France developed a website (doctolib.fr) that offers a straightforward way to make appointments for yourself or a family member (I’d love for us to get something like this in the States, but I imagine global healthcare has to come first). You can filter for providers by location, language, and more. It’s a wonderful system that makes navigating the healthcare system easy. I could probably talk at length at the differences in making appointments (quickly) in France compared to the US…
But I digress.
Parlez vous anglaise?
Since the hospital was named The American Hospital in Paris, we assumed that everyone would automatically speak English. I pictured the hospital full of Americans (maybe Canadians too, or Britians) and people greeting each other in English (“Hello, how may I help you?”. “May I have your name, please?”). On the contrary, French was spoken first, though people would speak English if you asked them to (or simply looked mystified as they greeted you in French!).
We also assumed that The American Hospital would be full of American healthcare workers. We were surprised to find out that of 400 providers, only two were American (our OBGYN, and later, our pediatrician). We were also surprised to find that many of the nurse assistants did not speak English at all.
To communicate, we would use Google Translate (as long as it was a simple task or request, like “What was my blood pressure?”). Thankfully, the nurses who cared for us all spoke English (with varying degrees of fluency). Additionally, the kind gentleman who served us three meals every day we were there (did he ever go home???) spoke English fluently.
Some requests were still difficult to communicate to our French nurses who spoke English as a second language. For example, “May I have a stool softener?” was met with a puzzled expression, but the nurse understood what I meant when I asked for “something to make my poop soft” (I’m laughing out loud as I write this!). Asking for a “hot pack” was complicated as well. Every language has small nuances that are fun (or frustrating, depending on how you look at it) to work through with a non-native speaker.
My husband and I were sorry we did not know more French to effectively communicate with staff, but were grateful to speak in our native language. We always made sure to thank staff (“Merci beacoup! Merci pour tout!”) multiple times to show our gratitude.
Rounding
One of the most obvious differences in the French hospital was the amount of rounding completed by healthcare workers. In the US, we tend to pride ourselves on the amount of “rounding” each patient receives. In many US hospitals, staff enter a patient’s room at least once an hour to see if they need help using the restroom, controlling pain, reaching items, being repositioned, or if privacy is needed (like pulling a curtain or shutting the door).
“Rounding” is especially helpful on a surgical floor where people are often in pain or immobile. It also allows staff to attempt working proactively instead of reactively. Though it is an evidence-based way to reduce patient falls and pressure injuries and improve patient and nurse satisfaction, it can be quite disruptive to a patient who simply needs rest.
Around the same time I gave birth in France, about five other friends or family members gave birth in the United States. “How was it?!?!” I’d ask them. “How are you doing!?!?”.
“We’re great!” They’d say, “...but we’re tired… and these people are making us crazy. They are constantly coming into our room and interrupting us or waking us! We can’t get any rest. We can’t wait to go home.”
The story was the same with nearly each person (though some would also complain about the food… more on that later). On the other side of the world, my husband and I were surprised by how little we saw staff in our room.
The nursing staff worked 12 hour shifts. One came in at the beginning of her shift to assess me and bring medications. A nurse assistant would visit us shortly after to get a set of vital signs (blood pressure, temperature, heart rate, etc.). A third person would come by a few times a day to ask me how long and at what intervals I was breastfeeding.
We suspected that we were being allowed to rest by the staff, but a few nights into our stay a nurse confirmed it. “Just so you know, I am not going to come in and interrupt you,” she said. “This is protected time for you to rest and get to know your baby. Call me if you need me, okay?”.
She said it in a caring yet matter-of-fact way. We welcomed the rest and lack of interruptions, and even though we didn’t call her, she still popped in a time or two before her shift was over if our door was open.
One Nurse for Mom, One Nurse for Bébé
I found it fascinating that two different nurses cared for our bébé and me (I don’t think this is common in the US, but labor and delivery nurses, please correct me if I’m wrong!). I could press a call light to contact the nurse who cared for me. A second nurse could be contacted by telephone, and she helped with anything related to the baby.
We used the baby nurse for questions about breastfeeding, swaddling, using the car seat, and help changing our very first diaper!
Hello, You Called?
In my experience as a nurse, I often could not visit my patient (who called and requested me) for what felt like a very long time. I know that on more than a few occasions they waited an hour for me. This was nearly always due to caring for another patient or being overwhelmed with other tasks.
Nursing staff at The American Hospital in Paris came promptly; staff members came within minutes of asking for help. Was it due to better patient-staffing ratios? Less patient acuity? Luck? I’m not sure, but it was very clear that we would get help nearly immediately after requesting it.
Medication Administration
Possibly the most surprising experience was the process of giving medications to patients. In the US, medication administration is a lengthy, multi-step procedure and is highly scrutinized by hospital leadership (including the legal team).
A US nurse brings medication to a patient, requests his or her name and birthdate, scans the medication (with a scanner, much like at a grocery store) and wristband (a barcode on the patient’s wrist with healthcare information), and documents this in the computer. The nurse must watch any oral medications actually be swallowed; any medications not taken that moment were removed.
In contrast, my nurses at The American Hospital brought all the medications I could potentially need for the next 12 hours at the beginning of their shift. They didn’t scan my wristband, nor did they electronically document exactly when I took a medicine (I imagine they used paper charting… the French love paper and paperwork!). Instead, they left all medications bedside for me: a proton pump inhibitor, two types of over the counter pain medications, stool softeners, and another medication that could be used for gas pain.
By the second day, I had four cups of pills stacked on top each other as I didn't feel I needed them (hilariously, my poor husband had knee pain at the time and ended up taking ibuprofen I wasn't using!). Most nurses seemed surprised that I didn't need the medications, but all I needed was a hot pack (my neck was sore from looking down at my beautiful baby while he was feeding!).
There was one unfortunate similarity when it came to medication administration. In the United States, it can take quite a long time to get a medication delivered to a patient if the medication is not already ordered.
For example, if a patient needs pain medication but none is ordered, a nurse calls the provider to request it. The provider then places an order for the medication. The order goes to a pharmacist to verify it, then the medication is either sent to the nurses station (which can take up to two hours), or a machine at the nurses station dispenses it (best case scenario!).
If that weren't complicated enough, sometimes the provider is performing surgery or otherwise unavailable and can't physically write the medication order for hours.
The process must have been similar at The American Hospital, as I requested a cough drop a few times (my throat was sore from grunting during labor!). I never received the cough drop; a nurse later apologized, stating it was a difficult request as my physician had left for the day.
The Perks
A Relaxation Room
The hospital had a special room on the maternity unit that was available for women in pre-labor or recovering mothers. It was a relaxation room with calming music and a heated bed. I never got to use it - when I had arrived to the hospital I was already in labor, and there was virtually nothing that could have removed me from the room where my precious newborn was sleeping post labor. However, I imagine it would have been a great place to begin the labor experience!
A 3 Star Michelin Menu
Yes… you read that right! A 3-star Michelin Chef (Yannick Alleno) designed menus for the hospital. Granted, I hear that anything eaten after giving birth tastes amazing (after hours of hard physical labor, one can develop quite an appetite!), but our food was especially amazing.
I remember posting pictures of most of our meals on social media before eating them. I already love talking about food, but… this was an especially fun experience! As a nurse, the number one complaint I heard in the hospital was about the food (I’m happy to report that this changed a few years ago as the hospital upgraded their food quality and ordering process).
Not so in The American Hospital. For breakfast we had hot chocolate, fresh squeezed orange juice, a croissant with jam and butter, some fruit, and coffee or tea. You could special request oatmeal (which I did daily). Lunch and dinner were incredible too. Here’s a sample day of lunch and dinner (and check out the photo)!
Lunch: Tabouleh salad, baked trout with almonds, pumpkin puree, slice of cheese, fruit salad, and rustic bread roll
Dinner: Artichoke salad, vegetable ragout, pasta, camembert cheese, fresh fruit, and a bread roll
Needless to say, we ate almost our entire tray of food at each meal and enjoyed it tremendously!
Bébé’s Birth Certificate
Another experience that felt unique as an American living in France was the requirement to get bébé’s birth certificate within the first few days of his life. This meant that Chris had to leave us during the second day of our stay to visit the mairie of the city (City Hall).
He brought paperwork provided by the hospital as well as our passports and was given ten copies of the birth certificate; we would need copies as we complete other paperwork throughout his life (see what I mean when I say the French love paper? 😊). Chris says this was an easy, quick process!
Wait, You’re Leaving Already?
We were expected to stay 3 days. I gave birth at 10:31am, and this day counted as day zero (this surprised us, but maybe shouldn’t have; Europeans also consider the first floor in a building the ground floor or floor zero). By the time day 2 (which felt like day 3) rolled around, we were eager to go home. My parents were already in Paris and were waiting for us in our apartment, and we had mistakenly thought day 2 was day 3 – so mentally, we were ready to go!
The staff allowed us to do this after my physician assessed me and the pediatrician assessed our little one. Bébé was taken out of our room for assessments and vital signs every morning, and our last day the pediatrician returned with him. He announced ‘So, Bébé tells me he is ready to go home”, which we found hilarious (probably partly due to sleep deprivation and partly due the delirious happiness surging through us).
My mid-wife (you can read more about my experiences with her here) and I had been texting on WhatsApp, and she told me she would visit us the following day at home. We were ready to go!
After two attempts at getting little one into the car seat, a nurse helped us figure out how to use it correctly. We received our discharge paperwork (minimal but included important information such as post partum depression, when to call a provider, and signs of bleeding) and stepped out into the world for the first time as parents.
Our birth experience was incredible, and we fell so blessed to receive such great nutrition, rest, and support while in the hospital!
Do you have questions about our hospital experience, or did any of the above resonate with you? I'd love to hear your thoughts in the comments section!
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