Victoria Jelinek


The Baby Diaries – 11

Never go to a doctor whose office plants have died. Erma Bombeck

071030 DVD SAGES FEMMES.inddThe sage-femmes (mid-wives) at the hospital were great. Through them, I learned to nurse and to bathe my child, as well as to take his temperature. They were also the ones who would come and relieve me, or check on us during the night, making me feel that my baby boy and I were tended to.

But the sage-femme assigned to me by the obstetrician for pre-and-post-birth care was useless. Before my boy was born my husband and I went into her office, and sitting before her little desk, waited for several moments to see what she would do because we had no idea what we were to do. She didn’t say a word. Finally, we asked some tentative questions about the care in the hospital that we should expect, which had already been answered by my good doctor, but we wanted to be polite. She would answer them as an adolescent might, with as few words as possible and giving no opportunity for elaboration. It was a struggle and that 15-minute appointment seemed to last an hour.

Post birth, however, one is meant to go to the sage-femme for ten visits in order to properly recuperate. It’s actually prescribed by the paediatrician at the hospital before you leave, and the l’Assurance Medicale, the health bureau, reimburses you for the visits 100%. This is a very good and holistic approach to the birthing process that I highly commend about the French system in theory, but I’ve gone to this sage femme a few times now, and I still find it useless. On one such visit she put a long towel, sheet type-of-thing around my lower back and near my pelvis, and pulled it tightly around the area. I asked what this was for and she told me it would help ‘reshape’ my womb. On another visit, she pulled out an appliance that looked like a combination between an electric razor and a vibrator and proceeded to put it into my vagina. I asked her what this was for and she told me that it sent out electrical currents that would help ‘reshape’ my vagina and womb. On another visit she had me practice getting down and up off of the floor and doing sit ups. I’d ask her questions that I thought she might know that were relevant to me, such as about the blood blisters on the breasts, and the left breast’s drying up, and the lack of sleep, and doctor’s visits, and she was not able to provide any answers. She doesn’t have children. I could be her mother. Oh! I did find the visit in which she took out the stitches from my caesarean very useful.

Perhaps finding a good sage femme is akin to finding a good psychologist? This is very American of me, the land of people who seek to discuss their problems (and why not? I think the world would be a better place if one could unload all their worries and problems on a person they paid to listen to them and to keep quiet about it all, and who then eliminated the need to unload on your friends and family). Anyway. Perhaps it’s like a psychologist in the sense that if you get a bad one, an incompetent one, then it will turn you off of ever going again to one. I would have stopped going to this sage femme, but at the end of every visit I had with her I felt bullied into making the next appointment, so I would make one in order to get out of the room. After several visits, I decided I didn’t want to go anymore and tried to tell her that it just wasn’t ‘my cup of tea’ and it ‘doesn’t seem to be working for me,’ and I don’t want her to ‘waste’ her time on me anymore. She gave me an angry lecture on how irresponsible I am being to my body by giving up the visits before they’re over! I listened to her quietly, and then suggested we call it ten visits, as prescribed, submit it to the relevant authorities for her to be reimbursed, and I’ll give her the co-pay in cash. To her credit, she immediately agreed.

As much as I’ve appreciated other medical care in France, I’ve found my sage femme visits the least helpful. I will presume that she is an anomaly.



The Baby Diaries – 10

The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not. Mark Twain

FR pharmacieToday I went to the doctor with my boy for a check-up and we had an interesting conversation. She is a ‘stand-in’ for our regular doctor. Originally from Marseille, she loves the mountains and her husband works for the mountain rescue. Normally, she does research on frostbite for a national study and she’s also six months pregnant (and looks great. Unlike the bulk I was, and remain – I’m still wearing my maternity clothes!).

After she’d checked my boy’s weight, vitals, and head circumference, etc., we got to chatting about life in Southern France (I hold onto the idea that I will live there one day, put perhaps it won’t be until I’m in my 50’s, like Colette). From there, we began talking about the state of French industry. Recently, France has lost two manufacturing company contracts, which were employing/would employ thousands of workers because of inefficiency and the demand for guaranteed lifetime contracts, respectively. After that, we segued into the dire state of the French healthcare system. I’m a great admirer of their system – a winning combination of socialist and capitalist care – and I’ve been the grateful recipient of many medical services in France. Nonetheless, I am aware the system is bankrupt. That it has been so for thirty years. It seems to me that to raise the cost of doctor’s visits, hospital stays, and long term care, SLIGHTLY, would help the system immeasurably. It may even save it. Aren’t the French meant to be collectively oriented? Why isn’t this happening?

What she told me was surprising. Particularly from a French person. She said that the French complain about the 23e or 28e they must pay for each doctor’s visit, which is the amount one pays before being partially reimbursed. In reality, only about 10e per visit goes to the doctor. Unlike their American counterparts, for example, doctors here are not getting rich through their vocation. She told me that when the doctor is unable to process a Carte Vitale (one’s personal health card which is registered with the health authorities, is run through a machine at the chemist, the hospital, by doctors at every visit, and then is automatically reimbursed for a given treatment) and must give them a brown form to fill out and send to the l’Assurance Maladie (health office) for reimbursement, instead, the French patients complain about having to pay for the price of a stamp in sending the form in for reimbursement.

She is very pessimistic that anything will change in France, despite the dire state of affairs within the medical arena and the economic problems for the country as a whole. She believes that in general, the French believe that they are “entitled.” They do not care whence their rebates, subsidies, incentives, reimbursements, and retirement plans come from, only that they receive them and pay as little toward them as is possible. She believes that short of a huge philosophical shift in thinking, which is not likely to happen as the general population in France refuses to accept that there is a problem that requires everyone to adapt, the French medical and economic systems are doomed. I want to believe this is not so.



The Baby Diaries – 8

I like children – fried. W.C. Fields

deep fryerIt may be difficult to get a place in the crèche for your child, but it’s even harder to find an assistante maternelle, literally translated as a mother’s assistant, or nanny.

The way the assistante maternelle system works is that she can take from one to three children between the ages of one and three into her home for childcare. At three, the child will ostensibly go to the local ‘maternelle,’ or public nursery school. The assistante maternelle is a person who has been certified and registered by the government to tend to children. The cost of an assistante maternelle is generally about six to ten times more expensive than a place in the local crèche. Being rather enlightened in the way of childcare, however, the French government subsidises the expense of an assistante maternelle for those who pay their taxes. At the end of each month, the employer of the assistante maternelle (that’s the parent of a given child) registers all of the hours, days and ‘indemnities’ the assistante maternelle has charged, on an online system for the entity Paje.fr (the entity that takes care of the subsidies). Shortly thereafter, the Paje partially reimburses the employer based on their taxable earnings and the cost of the given assistante maternelle.

The tricky bit is to find an assistante maternelle. There are ‘x’ amounts of them in a given area, and it is likely that a given child will be in the care of a given assistante maternelle from infancy until they are able to go to the local school. Because the law states an assistante maternelle can only have a few children being cared for in their home at a given time, there is little movement and timing is everything. My husband and I went down to the mairie (mayor’s office) and asked for a list of the registered assistante maternelles in the area. There were about 40. We then marked the nearest to us and called each of them to enquire about a spot for our son in the autumn. Not one had a place. We ended up calling every single assistante maternelle on the list – near and far- and only one had a space available in the autumn or, indeed, at any time over the next year. We went over to her house to meet her. She was French and nice enough, very patient with us as she explained her hours, her holidays, her rights and the time in which one must drop off and collect one’s child. Unlike the stereotype that French women are fit and slender, this one was rather heavy set. I noticed that there was a deep fryer on the counter, which probably meant lots of fatty foods. The assistante maternelle’s husband came in while we were there and he greeted my husband but did not meet my eyes or acknowledge me. I am a mere woman. Later, my husband and I discussed it and to be honest, we didn’t feel the house was very comfortable, and we both felt a little bad that our boy might spend days on end there, but we didn’t know what else was available or what the French households are really like, and we have to work sometimes without our boy and we can’t afford a private nanny. In the end, we rationalised that we liked that the household was French because it would be good for our baby’s assimilation into the culture…and perhaps in a year a place in the crèche would open up? Ultimately, ‘beggars can’t be choosers.’

Or can they? It turns out that there is a woman in my book club who was an assistante maternalle. She’s Welsh and married to a Frenchman who is a fourth generation local. She’s taken three years out to tend to her youngest child, utilising the French system of famille garder, which is a very civilised scheme that allows a woman who has worked and paid her taxes to take up to three years off of work after having a baby and still receive monies from the government. Apparently, her son will be going to school in the autumn and she may then resume her assistante maternelle activities. We phoned her and set up a meeting at her house. She has two little boys, a friendly three-legged dog, chickens, a huge garden, and the parents, grandparents, and cousins all live on plots neighbouring her house and land. She cooks from the garden, believes in organic food and creative compositions, and she speaks both English and French fluently…which is a help, to be honest, as we can then discuss in nitty gritty detail, what happens with our child each day…she’s not sure that she will resume her previous profession, but she’s thinking about it and we’re to contact her shortly. Oh dear, I hope that she decides to return to being an assistante maternalle and, moreover, that she decides to accept our little boy. I know everyone would be happy with that placement…I’ll cross my fingers and hope for the best…