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Category: Health, International, Reproductive Rights

In Defense of the French Health System: Having a Baby in Paris

| September 29, 2009

As the U.S. Senate struggles to produce health-care reform legislation that can win the votes of 60 members, cost issues rise to the forefront of the debate. Poet Carolyn Forché’s experience suggests that universal access to health care is not only the right thing to do morally but financially as well.

In 1986, our right to live in the Republic of South Africa was terminated by the apartheid state, and we left on a flight for Paris, France. I was eight months’ pregnant. I remember the wheels tucking into the belly of the plane, and re-fueling in Madagascar, and the long journey that brought us to Paris, where our son would be born a month later. My husband had been working for Time magazine, and we had been accused of breaking unjust laws, among them publishing photographs of “unrest” in South Africa.

It was the case then, and perhaps still is, that commercial airlines would not accept a passenger who was more than eight months’ pregnant, and so I flew on the last possible day. I had received pre-natal care in the Republic of South Africa as an “elderly prima gravida” and was somewhat concerned about transferring to a Parisian obstetrician when I was so far along in the pregnancy, but we were recommended to a wonderful doctor, who was affiliated with a birthing hospital in Paris. I was unfamiliar with such hospitals, as none, to my knowledge, existed in the United States at that time. These were facilities for delivering babies. Nothing else.

So when my labor began, I arrived at this hospital—an immaculate, technologically advanced clinic that was nevertheless homey and comfortable—and was checked into my room and introduced to the two midwives who would assist me in my labor. For 24 hours I labored and failed “to progress”— that is, to dilate enough to allow for the birth. The physician was called, and after consulting with the two very kind and supportive midwives, it was decided, in consultation with me, that I would have a caesarean. This was not a common practice in France at that time, as it already was in the United States. The obstetrician assured me that I could have an epidural, and would be awake for the birth, and could hold my son immediately.

Forty-five minutes later, my son was in my arms. The surgical team was excellent and supportive. The atmosphere in the operating room was joyful. My son was bathed and dressed, placed in an incubator to keep him warm, and we were both taken to a private room, where we spent a week. My bed was near a window with an iron grillwork balcony. It was April, and so the window was almost always stippled with rain. I was allowed to have my son with me, and my husband was permitted to stay with us in the room as much as he liked—all night if he wished. I was served excellent meals, and for lunch and dinner, was encouraged to drink red wine, which would be, I was assured, good for me. It would build up my strength and my blood, or some such thing. I really think that the nurses hoped the wine would put me to sleep, as well as my nursing baby.

They kept us for a week because I had had a caesarean, because I needed time to convalesce and to bond with the baby without worry or stress. Every morning they brought Sean to me, bathed and dressed, and as we settled in, they showed me videos about how to care for an infant. On one morning, a masseuse came by and asked if I would like a back massage, which was, she assured me, included as part of my stay. On another, a hairdresser appeared, asking if I would like my hair shampooed and styled—again, included, as a gift to the young mother. A photographer arrived to take pictures of the baby and me.

After a few weeks, we visited the obstetrician, who sat at his desk and wrote out by hand our medical bill, apologizing for having to bill us at all, but we were, after all, tourists. We had no residence permit, so he would have to charge us a fee for his services: the hospital stay, the nurse, the midwives, the anesthesiologist, the lab-work, and so on. He scribbled the total fee on a piece of paper: $1,500. “I’m so sorry,” he said, “to have to charge you. If you had a residence card …”

We gazed at the bill in utter disbelieve. Perhaps zeroes were missing? No. The charge was accurate, and to the doctor’s mind, unfortunate. The problem was simply that we weren’t French. Among other things, he said by way of explanation, “French people do not sue other French people.” But for the rest of the difference between what we were charged here and what we would pay at home, he had no explanation. If you were French, he added, you would have not had to pay anything, but as we were not, there was a small charge. In fact, had you been French, he added, the French government would have given you a stipend for having contributed a new French citizen.

I wrote to my women friends in the United States: If you get pregnant, buy a ticket to Paris! Have your baby there. You can afford to stay for a month for what you will save! And that, my friends, is the French health system. That is what, I’m told, we can’t have—and, moreover, don’t want!—in the United States.