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HEALTH

Reader question: Can I have a home birth in France?

Giving birth at home is an option in France - but it’s rare, it’s not encouraged and it might not be easy to access. Here's how the system works.

Reader question: Can I have a home birth in France?
A mother in the delivery room at a French maternity ward. (Photo by Christophe ARCHAMBAULT / AFP)

Home births are rare in France. Between 1980 and 2016, less than 2 percent of all births took place outside hospitals, according to national statistics body Insee. Most of those were because of medical necessity, it was reported – mostly women who didn’t have time to get to the hospital. 

However “women are free to choose where and with whom they wish to give birth,” the French home birth association Association professionnelle de l’accouchement accompagné à domicile (Apaad), points out on its website.

“(Home birth) is legal, reimbursed by Social Security and by certain mutuelle insurance companies,” Apaad said.

In total, 1,439 women in France opted for home births in 2022, according to the association. The majority of those labours progressed without problem, allowing 83 percent of those women to give birth as planned. 

READ ALSO EXPLAINED: How much time can parents in France take off for sick children?

Even so, health authorities in France do not encourage home births, because of the higher risk of complications compared to hospital births, where the full spectrum of medical support is available on tap.

To give birth at home, the mother must be in perfect health and have no notable risk factors. A mother’s wishes will be considered when discussing the birth plan, but midwives will strongly recommend hospital care.

Doctors and medical associations also recommend expectant mothers who do opt to give birth ‘at home’ are no more than 30 to 45 minutes from a maternity ward, in case of complications.

And there’s another practical obstacle to home birth intentions. Apaad lists around 100 midwives in the whole country willing and able to support home births.

And the spread of available professional care is far from uniform – there are entire départements that are not included on the list. This is not to say that home births would be impossible in those départements, just that a major association does not list any professional care for home births.

In general, foreigners in France often report that the whole experience of having a baby is more medicalised in France than it is in the US or the UK – there’s more of an emphasis on doctors and midwives deciding what is safe, rather than the mum-to-be getting involved in her birth plan.

That’s not to say that the system is bad in France, just that it’s likely to be different to what you have experiences before.

READ ALSO What to expect if you’re having a baby in France

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STRIKES

Pharmacists in France to strike at the end of May

Unions representing French pharmacists have called for walkouts at the end of May in protest over drug shortages, wages and the sale of medication on the internet.

Pharmacists in France to strike at the end of May

The primary union, the union for community pharmacists (Union des syndicats de pharmaciens d’officine, or USPO) has called for on-call pharmacists to walk out during the Pentecost long-weekend (May 18th to 20th), and for all pharmacies across France to close on Thursday, May 30th.

On-call pharmacists (pharmacie de garde) are those working on Sundays and bank holidays (like Pentecost), as most other pharmacies close on these dates.

While it is still not clear how many pharmacists will walk out, the call for strikes is nationwide and it may be best to plan to pick up any important medicine ahead of time.

Why the strike?

Drug shortages are a large part of the problem because they reportedly force pharmacists to spend more of their working hours doing drug research to be able to offer alternatives to patients. 

Pierre-Olivier Variot, the head of the union for community pharmacists, told Franceinfo that this has led to an extra 12 hours of research time for the average pharmacy.

“These are 12 hours during which we cannot take care of patients. We’re also dealing with tired patients who are frustrated we do not have their treatment,” he said.

Variot also explained that wages have not kept up with inflation, and as a result some pharmacies have had to close. 

Unions are also calling for the French government to better regulate the sale of medication on the internet, in order to ensure quality and safety standards.

Why the shortage of medicines?

The issue has been longstanding, and the situation was made worse during the Covid-19 pandemic.

The French Medicines Safety Agency (ANSM) reported that, in 2023, it had 4,925 medicines either out of stock or at risk of being out of stock, an increase of 30.9 percent in medicine shortages compared to 2022.

You can find the list of medications in short supply here.

A spokesperson from ANSM told Le Point in February that there are several things causing the problem, with many of them taking place on a global level.

“There are challenges with the manufacture of raw materials and finished products, as well as qualify defects in the drugs, insufficient production capacity, and division within the manufacturing stages,” the ANSM said.

On top of that, many factories dealing with raw materials are located outside of Europe.

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