Expecting a baby

The Hôpital Foch maternity ward is one of the largest in West Paris. Since it was first opened in 1949, it has seen the birth of over 125,000 babies, including 3,300 births in 2016 alone. In March 2011 the department was moved to a new building complete with the latest high-performance facilities.

 

The department has four main missions: to provide constant support, to monitor pregnancies and births, to intervene as necessary and to successfully cope with unexpected situations as they arise.

 

Our medical and midwifery staff are available on a 24 hour basis to intervene in a high performance medical/surgical environment. These teams always include an obstetrician, an anaesthetist and paediatrician.

 

Our staff our devoted to maintaining a human, attentive and supportive contact with patients and their families.

 

But of course being pregnant is not just a question of medical organisation. We ensure the constant care of mother and baby through the professionalism and excellence of our nursing staff who also take every care to maintain the truly magical aspect of having a baby.
Along with the whole of my team, I genuinely hope that you will have a pleasant stay in our department.

 

Professor Jean-Marc AYOUBI

Gynaecology-obstetrics department head

Administrative formalities

Registration for the Maternity Ward

We strongly recommend that you register as early as possible. Once registration is complete our staff will make an appointment with you to complete your medical file and finalise your registration.

 

There are 4 different ways to register:

 

  • In person, at the maternity ward (at the prenatal consultation reception office)
  • By telephone: 01 46 25 22 86
  • By email: a.pmi@hopital-foch.org or by completing the on-line form on our web-site
  • By completing the on-line form, click here to access it.

 

Once the administrative formalities are complete you will need to visit us for a consultation. The first appointment will be with one of the maternity ward's midwives or doctors and the following appointments, up to the 8th month, will be with your regular gynaecologist.

 

Do not forget to bring the following with you for your first appointment at the Hospital:

 

  • National Identity Card
  • Your health record book or marriage certificate
  • French Social Security Card (Carte vitale)
  • Proof of CMU or AME affiliation

 

Photocopies of the following:

 

  • any ultrasound scans already completed for this pregnancy along with the reports.
  • any lab tests completed since the start of the pregnancy.
  • the future mum's vaccination certificates.
  • any screening tests pre-dating the pregnancy (toxoplasmosis, rubella) even if they are old.
  • any blood test, x-rays, post-op reports that may be pertinent to the pregnancy.
  • a letter from your regular gynaecologist where possible.

Informing your employer

and social security organisation

Before the end of the 14th week of pregnancy, you will need to inform your health insurance provider, regardless of whether you are an employee or not, and the family benefits office. This must be completed so that they can assess your rights to services and/or benefits.

Aid and benefits

Benefits will be paid by the family benefits office and calculated on the basis of your income, the number of children and any other specific situations.

Declaring the birth

of the child

The declaration of birth must be made at the town-hall nearest to the place of birth, within 3 days (from the day after the date of birth). We recommend that you bring the certificate of recognition, if this has been done, to the delivery room. This is especially recommended for common-law couples. This can be completed by the couple at their local town-hall; they just need to take their identity cards.

 

In the maternity ward rooms, we provide the necessary forms and documents that you will need to complete and take to the Civil Registry office of the Suresnes town-hall. You must have you proof of identity and a healthcare record book, if you have one.

Parental leave

In addition to the 3 days leave provided by rights by the employer, parental leave provides the father with 11 days of paid leave financed by the social security office which can be taken during the 4 months immediately following the birth.

Find out more

When you prepare for a hospital stay with us, you must designate a person of confidence; this can be someone other than your emergency contact.

This person (parent, friend, GP, etc.) will be consulted in the event that the mother's state of health renders them unable to express their decisions or receive the necessary information.

Any address changes should be declared as soon as possible.

 

 

DID YOU KNOW?

 

Suresnes civil registry opening hours: 8:30am to 11:30am and 1:30pm to 5:30pm (6pm on Thursdays) Monday to Friday, 8:30pm to 11:30pm on Saturdays.

 

The department has a social worker who is available to help future parents with any questions they may have, such as the choice of name, social security, maternity leave, etc. You can meet with her (preferably by appointment) throughout the duration of the pregnancy or when you come to the Hospital for your other appointments. You can contact her by telephone at 01 46 25 23 90

Your stay at the maternity ward

Your stay

at the Maternity Ward

The mum-to-be may need to come to the hospital during the pregnancy on a number of occasions for various reasons and to different departments. Here are some answers to the most frequently asked question.

When should I come to the hospital

as an emergency?

If you are worried about your pregnancy it is always better to come in than to telephone us. Whatever the reason, go to the gynaecological and maternity emergency ward on level -2 of the M building.

 

  • I feel repeated contractions.
  • Any sudden bleeding.
  • Unusual discharges.
  • Unusual reduction of baby movement.
  • A burning sensation when urinating.
  • Fever over 38°C.
  • Severe stomach pain.
  • Severe headache, buzzing in the ear, blurred or flashing vision.
  • Weight increase of more than 2kg in 3 days.
  • Suffered a sudden impact to the abdomen.
  • A sharp pain in the calf.
  • Abdomen always resistant to touch.
  • Vomiting.
  • Sudden swelling to the face, feet or hands.

What should I bring with me?

When you come to the delivery room, try not to be wearing jewellery, nail varnish or any piercings. We recommend that you prepare your maternity bag well in advance. (link to the section with the same name)

How should I organise getting to maternity in advance?

Generally there will be no hurry to get to us, you will have the time to get to maternity. Try not to call the emergency services, they are very busy and can only take you to the nearest maternity ward. In the event of a serious emergency you can call the SAMU (ambulance) by dialling 15.

How do things happen in the delivery room when I am in labour?

You will be received by a mixed gender team who will take turns to survey you constantly. Throughout labour, you will be accompanied by a medical and paramedical team including:

  • A mid-wife (pink top, white trousers)
  • A nurse (in white with blue hemlines)
  • A care assistant or child-care auxiliary nurse

Which doctors could

intervene?

  • An obstetrician-gynaecologist
  • An anaesthesiology-intensive care specialist with an anaesthetist nurse
  • An obstetrics intern, a medical student
  • A paediatrician

 

Hôpital Foch has its own midwifery school. Its students are therefore often present at the maternity ward.

What happens when

I arrive at maternity?

Only one companion (preferably your partner) will be allowed in the delivery room.

No information will be provided by telephone, to protect your privacy and maintain professional secrecy.

During labour, you will be comfortably installed in a delivery bed with constant surveillance of your baby's heart rate.

Anaesthesiologists are present in the maternity ward 24 hours a day. They will propose treatment to reduce the pain of contractions using an epidural pain-killer, unless reasons against this have been established during the anaesthesiology consultation and/or on the day. Remember to tell staff if you have a dental prosthetic or wear contact lenses.

And what happens

at the time of birth?

As is most common at our maternity ward, if your child requires no immediate medical care we will suggest that the mother immediately takes the child in her arms for a "reasonable" period of time.

 

This moment of intimacy, the duration of which will depends on any immediate treatment that the mother may require as a result of giving birth, is a moment of enormous importance for the new-born child as it adapts to its new surroundings. This is why we regularly monitor baby's health as discreetly as possible, allowing you to make the most of this essential moment with total peace of mind.

 

In most cases the father can cut the umbilical cord if they wish. We will then place an identity bracelet on the baby's wrist and ankle. After the necessary treatment you will be given the chance to spend time in direct contact.

 

Your child will then be clinically examined and bathed before being dressed. You can then breastfeed or bottle-feed them before leaving the delivery room.

And then?

Mother and child will be monitored in the delivery room for a period of two hours before being transferred to your room in post-partum on the 2nd floor. If necessary, your child will be looked after in the neonatal unit or transferred to intensive care.

Your pregnancy

Your pregnancy

During the 9 months of their pregnancy the mum-to-be will undergo
a number of medical tests and consultations. Here, you will find all you need to know
about pregnancy and the medical tests organised at the Hôpital Foch maternity ward.

Consultations and

appointments

Most future mums will not just see their GP during their pregnancy.
Most of them will see a number of different healthcare professionals:

 

  • their gynaecologist,
  • the mid-wife,
  • the gynaecologist-obstetrician
  • the Hospital anaesthetist.

 

 

If you want to give birth at the Hôpital Foch Maternity ward we recommend that you
make an appointment via the appointments centre.

 

 

If you have any specific questions or would like to organise a consultation, you can contact
the department in question directly:

 

  • ultra-sound imaging,
  • assistance with tobacco,
  • psychology,
  • parental aid,
  • endocrinology.

 

Just one telephone number: le 01 46 25 25 25

Birthing preparation

sessions

Birthing preparation sessions with independent mid-wives can be followed,
either at Hôpital Foch, or nearer to your home.

 

The birthing preparation sessions at Hôpital Foch
are held by 4 independent mid-wives, ask the consultations
reception for their contacts when you register at the
maternity ward.

 

It is up to the future mum, if she chooses to take the sessions at Hôpital Foch, to contact these mid-wives to make an appointment.

 

Only the Saturday morning session (information session) is organised through the consultation reception service. You can do this by telephone at 01 46 25 25 25.

 

An obstetrician, paediatrician, anaesthetist and a mid-wife will be present for this information session.

Ultra-sound scans

The ultra-sound scan involves no radiation.
The ultra-sound waves are reflected by tissues and provide an image of the area being examined.

Ultra-sound scans can be combined with a system similar to radar to scan blood vessels. This is called a Doppler scan.

 

The ultra-sound scans can be completed at Hôpital Foch or at another clinic nearer to your home.
We recommend that you refrain from using skin creams during the week before
the scan.

 

Ultra-sound scans during pregnancy explore four different dimensions, the importance of which vary as pregnancy advances.

 

  • Assessment of foetal vitality. (Heart activity, movement, etc.)
  • Biometric study involving the specifically defined measurements to evaluate the date of conception (1st trimester) and to monitor the growth of the baby.
    (2nd and 3rd trimester)
  • Morphological evaluation through the observation of certain foetal structures (organs, organ parts), used to screen for certain common
    and/or serious pathologies.
  • Observation of the environment surrounding the foetus. (Amniotic fluid, placenta,
    blood circulation, etc.)

 

These elements are brought together to make up a complete report of the baby's health which cannot be compiled by any other means. The ultra-sound scan provides a lot of information on the baby's current condition as well as providing an evaluation of the risk of other pathologies which may arise later during the pregnancy or even after birth.

 

We highly recommend that you respect the schedule suggested by the doctor. Generally the routine examinations are completed at 12, 22 and 32 weeks of gestational age.

 

Evidently under certain circumstances these examinations may have to be completed more frequently or at different dates. The time required to complete the examination may vary in terms of local conditions and the complexity of the evaluation required.

Admission to the maternity ward

To validate your registration in administrative terms you will need to go to the admissions office in the Hospital's main entrance.

 

The admissions office is open from 7:30am to 5:30pm.

 

For this procedure you will need to bring the following documents:

 

  • Proof of identity (passport, identity card or residency permit)
  • French Social Security Card (Carte vitale)
  • Private (top-up) health insurance registration card
  • A means of payment
  • CMU or AME coverage certificate (for those concerned)
  • Details of treatment already received

 

Hospitalisation during

pregnancy

Medical issues that arise during pregnancy
may require hospitalisation.

 

In the event of any medical problems you must come to the maternity emergency ward which is on level -2 of the new building (Orange Sector) or call 01 46 25 20 29.

Pre-natal

What is it?

 

The gynaecology-obstetrics consultation department is located on level -1 of the A building.
This is where the ultra-sound scans and obstetric, gynaecological, paediatric, tobacco assistance, psychology, parental aid and pregnancy monitoring consultations are held.

 

During a normal pregnancy, pre and post natal consultations with an independent midwife nearer to your home can be organised. This way you are sure to have an individualised follow-up in relation with the Hôpital Foch's services.

 

 

Obligatory consultations and tests

 

If the pregnancy presents no particular risks, follow-up consultations after initial registration at Hôpital Foch can be completed by a gynaecologist or mid-wife nearer to your home.

 

As a result the obligatory medical tests can be completed either at Hôpital Foch or in laboratories located nearer to your home. For the most part they will concern:

 

  • The identification of your blood group,
  • Screening,
  • Screening for Down's Syndrome,
  • Ultra-sound scans…)

 

For each consultation you will need to bring the copies of all previous tests and your medical file.

Seven consultations with either a doctor or a mid-wife are covered in full by the social security during pregnancy.

Only the last two consultations (for the 8th and 9th month) need to be completed at the Hospital. This is when the type of delivery will be decided. It is also during the 8th month that you will have the obligatory consultation with the anaesthetist.

 

 

Optional appointments

 

  • You can make an appointment with one of our psychologists.
  • A parental support consultation is available to all future mums and/or dads. One of our mid-wives will receive them for an interview, to discuss any difficulties that they may encounter in relation to their current and past obstetric background.
  • A social worker is also available for consultations by appointment.
  • A tobacco support consultation with a mid-wife is available to all pregnant women who would like help to stop smoking. These consultations aim you with the support and accompaniment you need to help stop smoking, not to make you feel guilty.
  • Birthing preparation: an initial general information session is held at the Hôpital Foch by the Department Head, a paediatrician, an anaesthetist and a mid-wife. One of the sessions is more concentrated on breast-feeding.

 

Future dads are not forgotten, there is a session specially for them.
And they are evidently free to come to all of the birthing preparation sessions.

 

 

How is the pre-natal interview organised?

 

This is a 45 minute interview for the mother or the couple, with a mid-wife or a doctor near to your home.

This is time for exchange. This interview is a chance to express your needs, expectations (specifically concerning your family project), raise any potential psychological, material, social or family issues.

This interview is an opportunity to get some answers to these questions.

For external consultations the consultations reception office can provide you with contact information.

Your childbirth

Your childbirth

The department has four main missions: to provide constant support, to monitor pregnancies and births, to intervene as necessary and to successfully cope with unexpected situations as they arise.

Breast-feeding

How to prepare for breast-feeding your baby?

 

The nursing staff of Hôpital Foch assists mothers who wish to breast-feed. Before giving birth, a breast-feeding session is proposed to help you to prepare and answer your questions. This session is held by a child-care specialist from the maternity ward.

 

 

And after giving birth...

 

The baby will be introduced to breastfeeding in the delivery room (allowing for the condition of the mother and baby) to make the most of the suckling reflex. This is when a rapid stimulation of milk production will be possible.

During post-partum the child-care nurse (child-care nurse or mid-wife) will be there to help the mother with breast-feeding.

In the neonatal unit of the maternity department, the nursing staff pay particular attention to breast-feeding premature or underweight new-born babies. It will be possible to stimulate lactation using a breast-pump. In this way the baby will be able to have the mother's milk even before they are able to breast-feed naturally. This process will be supervised by the unit's child-care nurses throughout the hospitalisation.

 

Some information about breast-feeding

 

Around 50% of mothers choose to breast-feed. Although many start to breast-feed but give up after a few weeks.

Breast-feeding is entirely the mother's personal choice.
What are the benefits for mother and baby?
Mother's milk has many advantages; it protects against infection and is hypo-allergenic. Not forgetting the privileged contact that it develops between mother and baby.

 

 

70 %

 

Breast-feeding is now at 70% when mothers leave the maternity ward.

Caesarean section

What is it?

 

A Caesarean section is a means to deliver the baby through an incision made in the abdomen and uterus, this is used when the condition of the mother and/or baby do not favour natural child-birth.

Caesarean sections can be programmed in advance or decided during labour.
It can be performed either in an operating theatre or the delivery room.

 

The Hôpital Foch maternity ward has a dedicated room laid out as a delivery room to ensure that Caesarean sections can be completed rapidly.

 

The father can be present for Caesarean sections which have been programmed in advance and where an epidural anaesthetic is used, provided the doctors present agree to this.
The recovery room is on the same level as the Caesarean section delivery room such that the mother and baby can be together.

 

 

The operation procedure

 

Before the operation, the doctor must be informed of any medical antecedents (personal or family) and any treatment in place. The intervention generally involves a local anaesthetic. (epidural or spinal).
However, sometimes a general anaesthetic is necessary. This will be decided by the surgeon and the anaesthesiologist in terms of the mother's condition.

The abdomen is generally opened with a horizontal incision. Sometimes a vertical incision is preferred depending on certain specific antecedents or circumstances.
Once the uterus is opened the child can be removed and handed over to a mid-wife or paediatrician.
The uterus and abdomen walls are then stitched up.

The mother will then be hospitalised for a period of 4 days (as of the day after the birth).
A shorter stay can be envisaged if followed by home care.

 

 

What happens after a Caesarean section?

 

The monitoring and hospitalisation period for a Caesarean section is usually a bit longer than for natural childbirth. However it will be possible to breast-feed and look after the baby in the same way as after a natural birth.

Future pregnancies are evidently possible after a Caesarean section. And in many cases these future child births can be natural. After the operation, the first 24 hours are often painful and a strong analgesic medication will be required.

 

Epidural

Why would an epidural be proposed?

 

The obstetric pain involved during child-birth can be vary variable. This can depend enormously on physical, cultural or psychological factors.
It increases as labour advances and reaches a peak as the baby enters the birth canal. 70% of mothers feel this as a very intense pain. In this case an epidural may be proposed. There is no obligation: the mum-to-be is free to accept or refuse an epidural.

 

 

Epidural: how does it work?

 

The nerves which control muscles and transmit pain information are located in the marrow of the spinal column. They transport a fluid: the cerebrospinal fluid.
They then cross a membrane called the "dura-mater" which "contains" this fluid, and then pass into the epidural space (around the dura-mater) before reaching the organs such as the uterus.

A drug called a "local anaesthetic" is placed in contact with these nerves and temporarily stops the neural transmission within the nerves. It can be introduced into the cerebrospinal fluid, this is a spinal anaesthetic, or into the epidural space, this is an "epidural".
These 2 locations are accessed via an injection between 2 vertebrae in the lower back.

 

 

Placing the epidural

 

An epidural is put in place between two contractions under regular blood pressure monitoring. A local anaesthetic applied to the skin ensures that the insertion of the epidural needle is painless.
The anaesthetic is injected into the catheter producing a complete analgesic effect within 10 to 20 minutes, depending on the dosage.

Epidural analgesics can be adjusted in strength and duration during the labour and can be "transformed" into a stronger analgesic ("anaesthetic") if a caesarean section becomes necessary. It is eliminated from the system in 1 to 3 hours (depending on the dosage); after which it is possible to return to your hospital room.

Once the epidural has been put in place, the mother-to-be can use the maternity ward's pool at the start of labour if they wish to do so.

 

 

Other ways of treating obstetrical pain

 

  • Good mental and physical preparation is a way to avoid fear of the unknown, to be aware of one's body and to know how to relax. Future mums can learn, get answers to their questions and do suitable physical exercise thanks to the sessions provided by the Hospital's mid-wives. However,
  • Hôpital Foch does not propose yoga, sophrology or haptonomy sessions. These additional
  • relaxation techniques can be very useful to prepare for giving birth, especially when an epidural is not possible or desired.
    These kinds of sessions can be found outside of the hospital. More information can be obtained from local mother and baby care centres (PMI).
  • Intravenous analgesic medication can be used in cases where an epidural
    cannot be used for medical reasons.
  • Local anaesthetics can be used for the suturing of tears or an episiotomy
    if an epidural is not used.

 

 

 

Maternity bag

Baby-suits, romper-suits, sleep-suits and sleep-bags… What will you need to dress your new born baby?
What documents will you need on the big day? And what will you need for the following days after that?

 

 

Maternity bag for the delivery room

A separate bag with the following:

 

  • 1 water mister
  • 1 pair of socks for mum
  • THE bag of baby clothes (max size: 1 month): 1 hat, 1 pair of socks and slippers, 1 pyjama, 1 under-shirt, 1 woollen vest or jacket

 

 

Bag for the stay in post-partum

 

  • For mum: personal clothes, essential toiletries, sanitary towels, disposable underwear, 1 pen, 1 thermometer.

 

For breastfeeding: 2 breastfeeding bras (two cup sizes larger), breast-feeding pads and maybe a breast-feeding pillow.

 

  • For baby: (we recommend that you wash any new clothes before bringing them to the maternity ward)
  • 6 to 8 bodysuits
  • 6 to 8 romper-suits or pyjamas or small outfits, size 1 to 3 months
  • 3 wool or acrylic vests or jackets
  • 4 pairs of socks or slippers
  • 6 cotton bibs or baby blankets
  • 1 size 1 sleep bag
  • 1 hair-brush
  • 1 bath-towel per day
  • 1 bath thermometer
  • 1 bottle of nappy changing milk
  • 1 pack of large cotton squares
  • 1 pack of nappies for newborns
  • 1 leaving outfit with hat
  • 1 approved car-seat "rear-facing"

 

 

Find out more

 

The French Highway Code insists that an approved car-seat be present in all cars transporting a child. No baby will be allowed to leave the maternity ward without a "rear-facing" car-seat.

Post-partum hospitalisation

Post-partum hospitalisation

In cases of natural childbirth without problems you will stay at the maternity ward for a further 2 days, as of the day after giving birth, this will be extended to 4 days for caesarian sections.

 

The Hôpital Foch maternity staff includes gynaecologist-obstetricians, paediatricians, mid-wives, care assistants, child-care nurses and auxiliaries.
All of these will supervise the condition of mother and baby.

Caring for baby

During the few days of hospitalisation the mid-wife will provide all of the advice you need for during your stay and for when you get home.

 

The auxiliary nurse will be present to show how to bathe baby and treat the umbilical cord. She will provide assistance and support for breast or bottle feeding. This will be the ideal time to ask all of your questions. The baby's heath record book will be established during a consultation with the paediatrician.

Visits

It is better, and probably more agreeable, to present your baby to your friends and family at home. It is better to use your stay at the maternity ward to recover. Visits for persons other than the father are authorised between 1pm and 8pm. Children are not allowed in the maternity ward except for the brothers and/or sisters of the baby if they are not ill.

Declaring the birth

The administrative officer will bring the birth notification to your room along with the declaration form for you to complete.
This needs to be done at the Suresnes town-hall within 72 hours of birth by either the father, the mother or a third party. To do this you will need the father and the mother's identity cards and your family health record book if possible.

What is immediate post-partum care?

The mother and baby remain in the delivery room for immediate post-partum care, this is the first two hours after birth.

During this period intense medical surveillance is maintained with constant monitoring of arterial blood pressure, heart-rate, the condition of the uterus and any blood loss. At the same time the baby receives any immediate necessary medical care.

And finally there is a little clean-up before the mother returns to her hospital bed.

Your departure

Leaving the

Hospital?

 

What formalities need to

be completed?

You will be allowed to leave when the medical staff authorise this.

 

Departure will be organised by the department depending on the mother's health condition.
In all cases, the medical staff are there to help complete the procedures and ensure that you leave under the best possible conditions.

 

However, if you leave without medical authorisation you must sign a waiver to free the hospital from any responsibility for the risks to the health of the patient.

 

Early departures (less than 3 days after normal childbirth, or less than 4 days after a caesarean section) can be envisaged under certain circumstances. In this case medical care will be continued at home by a team of mid-wives.

 

 

Find out more

 

For caesarean section births you must make an appointment with an obstetrician-gynaecologist 5 weeks after giving birth.

 

For natural child birth you should also organise a future consultation with a gynaecologist.