Baby in Finland – Healthcare – Private Hospital

Since our baby does not have a KELA card, we had to look for a private hospital for his vaccination.  We found Mehilainen located in Toolo (Bus/Tram stop Apolonkatu).

Mehilainen in Toolo

Children’s healthcare is on the second floor.  The waiting area is nicely decorated.  There are sofa, stroller parking, lockers, and many toys.

Mehilainen waiting area stroller
Mehilainen waiting area stroller parking
Mehilainen waiting area locker
Mehilainen waiting area lockers
Mehilainen registration
Mehilainen registration

Firstly, we went to the registration so that they can put in all the information.  The ID number is required.  Then, they told us the room number where we would go later.  We just needed to wait in the hallway, and the nurse would come find us.  There is another waiting area if you walk down the hallway – it’s on your right side.  There is one chair that I really like!  While feeding, the baby is less likely to be distracted.

Mehilainen nursing chair
Mehilainen nursing chair

Meeting the nurse

Soon the nurse came out, and invited us into the room.  She also has a lot of toys.  Our baby immediately liked her.  She checked the strength of neck, and measured weight and height.  Since it’s our first visit, we chatted a lot about how we were taking care of our baby.  Then she went out to see if the doctor was ready.

Mehilainen nurse room 2
Mehilainen nurse room

Meeting the doctor

We moved to another room to see the doctor.  Basically we discussed about the vaccination plan.  Since we don’t have a plan to go out of  Europe this year, we decided to just follow the Finnish program.  The doctor then further checked his heart, eye, etc.

Vaccination

Lastly, we went back to the nurse for vaccination: PCV13, Infanrix Hib Polio, and Rota.  The first two are injections.  Rota is oral.  After the vaccination, we were asked to wait for ~15 min to see if there was allergy.

About the payment

We just found out yesterday when we did the second Rota.  For the two visits, the total bill is over 500 euro!    That explains why it’s so easy to make an appointment – no waiting line at all.

Here’s the price list: Doctor 30 min – 125 euro.  Nurse – ~50 euro.  Registration – 19.5 euro.  Rota – 73 euro.  Infanrix polio + hib – 26.5 euro.  PCV13 – 91.7 euro.

The doctor gave a bill right away, but the nurse’s bill would come in mail.  The bills can be paid at the registration, or through IBAN (additional fees may be required).

 

 

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Baby in Finland – Vaccination – What if No KELA Card

Kela Card needed for service at the public neuvola

When we moved from France to Finland, our baby was only six weeks old.  When we realized that it’s time for vaccination, he was almost ten weeks.  In Finland, the vaccination program includes a Rotavirus vaccine at two months.  Therefore, I went to the close-by health station to figure out how to get the vaccine.  I was told to call a number, later I realized the number was for making an appointment at the public neuvola.  After I made the phone call, actually several calls, I found a big issue – our son can not use the public neuvola without the KELA card!  It seems that they also called the KELA office to find out my husband’s situation to determine whether our son has the right to use the public neuvola.  And the answer was, unfortunately, NO.

Finnish ID needed even for private hospitals

They suggested me to look for private hospitals.  I called one (Terveystalo) that is not very far from our home.  I found another issue – they require ID number!  Our son only had a Japanese passport at that time.  We planned to apply for the residence permit (which has the ID number) for him in Finland.  Somehow I thought that he did not need a residence permit, that we just needed to register him at the Population Register Centre (Maistraatti).  I was WRONG!  He needs a residence permit!  Unlike in Paris, the queue is very long.  The earliest appointment we could get is six weeks after.  (So, if you want to apply for a residence permit in Finland, you’d better plan early!)

To get the Finnish ID without residence permit

Anyway, can we register our son, in other words, get the ID number without a residence permit?  Yes, but they require a legalized birth certificate – Apostille stamped birth certificate.  We did Apostille before, for the Japanese family book.  Since the language is Japanese, it was done in Japan.  And it’s very expensive!  The Apostille itself costed about $300, not to say the shipping and waiting. Unfortunately, that family book was done before our son was born 🙁   Should we do the Apostille in the same way again?  If so, we have to translate the French birth certificate into Japanese first…  Long waiting, and another $300!  Why don’t we get Apostille from France?  Our friends in France helped us to ask the local office, and told us how to get the Apostille, for free!  It was actually very simple.  We just had to request the Apostille from the Hotel de Ville where we got the birth certificate.  They won’t charge anything, and they would even mail the Apostille to us.  Sounds terrific!  So we did it.  After just one week we got the letter from the French office.  Without checking carefully, we immediately went to the Maistraatti in Helsinki.  Who would know that the French office forgot to stamp the Apostille?!  What a surprise!  But… emmm… probably not that surprising considering who they are.  They often make me speechless.  Luckily, our friends in France also requested Apostille for us, and he got it right!  So he mailed the correct copy to us.  Another week passed by, and the Apostille stamped birth certificate was finally in my hand.

Got the Finnish ID without waiting for three weeks

Again, we immediately took the Apostille to the Maistraatti.  This time, we could register our son (finally!).  The problem was it would take about three weeks for us to get the ID number.  In that case, our son would miss the first a few vaccinations.   I wrote a short note explaining why we needed the ID number as quick as possible.  The clerk said she would ask the manager.  With hope, we left.  While I was feeding my son in Kamppi Center, they called me! I was very excited.  Yes!  They processed my son’s application right away, so the registration paper (which has the ID number) was ready to be picked up! Yeah!  After I got the ID number, I called the private hospital, but it’s already too late.  OK, tomorrow then.

Not every private hospital has the vaccines for babies

The next day, I called the private hospital again, with the ID number at hand.  I thought everything was ok now.  However, the nurse answering my call was not sure whether they had the vaccine.  After serval phone calls, they and I were clear that they could not do vaccination for little babies!  I wish I found this out earlier.

So foreigners’ babies can not get vaccines in Finland?  I don’t believe that. Obviously I was not alone.  Somebody out there also came across with this issue before.  Finally, I found Mehilainen.  Their site in Toolo can do the vaccination!  I will describe our visit in another post.

Conclusion

If your baby needs vaccines, make sure s/he has the ID number.  If s/he does not have the KELA card, try Mehilainen.

 

 

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Stuffs to prepare for the delivery day and hospital stay

First of all, documents:

  1. Passport, ID
  2. Family book
  3. Social security card (Carte Vitale) and complementary health insurance (mutuelle)
  4. Residence permit (carte de sejour)
  5. Blood type card (carte de groupe sanguin)
  6. Echographies, medical results
  7. Forms to be sent to social security for the baby (to be added under your social security)

 

Secondly, stuffs for the baby:

Stuffs to prepare for baby

The delivery day                                           The following days

  1. One body                                                           Six
  2. One pajama                                                      Six
  3. One sweater                                                    Four
  4. One hat                                                              Two
  5. One sleeping bag
  6.                                                                                 One bag of diapers (2-5 kg)
  7.                                                                                 One bag of cotton pads
  8.                                                                                 One thermometer

+ socks + comforter                                      + socks + comforter

.                                                                                + thermometer for bath

.                                                                                + clothes for leaving

 

Thirdly, stuffs for the mom:

 

Stuffs to prepare for mom on the delivery day

The delivery day                                           The following days

  1. Water spray
  2.                                                                                 Sanitary napkin (night)
  3.                                                                                 Maternity disposable briefs

+ nightwear                                                       + things for the restroom

 

Based on what’s available in the hospital, different hospitals ask for different things.   The list I described above is from my hospital (CHU Grenoble).

 

Lastly, some additional stuffs that I prepared:

Additional stuffs for the stay in the hospital

  1. Cream for nipples (for breastfeeding)
  2. Cotton breast pads (for breastfeeding)
  3. Antispasmodic drugs to deal with contractions (to tell if it’s labor)
  4. Dry shampoo

 

Yes quite a lot of stuffs!  And there are more for the home… I probably need to write another blog 😉

 

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8 classes of preparation for the childbirth – one benefit of being pregnant in France

Comparing to most other European countries, France has a higher birth rate.  This is partly due to the maternity benefits that French families are enjoying.  Social security covers all the cost beginning from the 6th month of pregnancy (unless you choose private hospitals/clinics). Besides that, pregnant women get one time free dental examination, and 8 lessons of preparation for the childbirth, which is the focus of this post.

I just finished all the 8 lessons earlier this week!  In my case, my sage-femme (midwife) in the hospital referred me to this SF liberal who gives lessons (most importantly, she speaks English).  It’s a one-on-one class.  I don’t know if it’s always like this in Grenoble, or it’s because I don’t speak French.  Each class is one hour.  The first class, or meeting, was for the SF to gather information of us, and to schedule the other 7 classes.  I had two classes every week.  The topics were:

  • When to go to the hospital (for delivery), signs of the labor
  • Breastfeeding
  • What will happen in the hospital (on the delivery day), the process of labor
  • Breathing, exercises using the birthing ball
  • What can go wrong
  • Practice how to push
  • Life after the childbirth, the recovery, what will my body be like

Of course, we also discussed the questions and concerns that I had.  For example, she also helped me to look through the list of things to prepare for the delivery day (I will talk about the list in another post).  One hour is actually very short.  We often finish before we notice 🙂

I think the classes are very helpful, because she’s familiar with that hospital, and she can explain everything to me in English!  Before the classes, I knew nothing, and I was a little scared.  Especially that there’s the language barrier… what if I could not understand them, and I did not know what to do… what if there’s a decision to be made…  Now I feel much better!  After finishing the classes and watching a video of the maternity at the hospital, I have an idea of the whole process, who will be there with me, and where it will take place.  In addition, now I have confidence that they will do the best for me, that they will keep the delivery as natural as possible, that they will only do what’s necessary, and that they will not push me to do the cesarean section just because of their personal schedules.

Again, the classes are covered by social security, so don’t miss out this benefit.    You will always learn something!  Of course, it will be better if the husband can be there as well, especially for the exercises using the birthing ball.  The SF is right – it makes a bit difference if the husband hears things from other people.

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Declaration of pregnancy and CAF

CAF stands for caisses d’allocations familiales, and it belongs to social security system.  Declaration of pregnancy to CAF (and to the health insurance company if you have mutuelle) is necessary.  Theoretically it needs to be done before 14 weeks, but sometimes it’s just impossible.   For me, it’s almost 25 weeks.  The form, so called “nous attendez un enfant”, was from the sage femme or midwife.   She wrote the DDG and signed it.  Then I filled the personal information including the temporary social security number, and mailed the form to CAF.  (BTW, two copies of the form mailed to CAF, and one copy mailed to the health insurance company.)  Actually the distance from our home to CAF and to La Poste is similar.  But I suppose going through La Poste is faster than making a RDV (appointment).

About two weeks after mailing out the form, we got our CAF number.  And since then, our “conversation” with CAF has been going on and on.  They have requested these information/documents in separate mails:   (1) more personal information (declaration de situation); (2) birth certificate; (3) declaration of income in 2015; (4) residence permit (sejour).  I always try to respond as soon as I can, then there’s long wait.  Now I am still waiting for them to process the documents I sent three weeks ago, and I don’t know what they will ask for next time.  Anyway, it’s interesting.

CAF is slow, but who is not?  At least CAF helps people.  It gives financial help to families in need.  Students without income can get assistance on housing (Aides au lodgment).  And in the case of pregnancy, CAF gives “prime a la naissance” to families to welcome their babies, and babies can get monthly allowance afterwards!  These benefits are granted and calculated based on the situation of the family.  We are not expecting anything, because we are very grateful for the health insurance already.

 

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In France, Laboratory and Pharmacy are independent from Hospitals

Here is what I know about the healthcare system in France.  Everybody register with a family doctor – a généraliste.  In most cases, people go through the family doctor for treatments so that the cost will be properly reimbursed.  I heard it’s also easier to get an appointment with a specialist through the family doctor.  In the case of maternity, however, it’s not necessary to go through the family doctor.  We don’t have a family doctor, and we went directly to see a sage-femme (midwife).

People go to laboratories to do various tests and scans requested by doctors or other healthcare professionals.  There may or may not be laboratories in or close to the hospital.   Seems like laboratories are independent from hospitals.  People can have their own choices of laboratories to have the tests done.  In my case, the SF gives me a paper, which lists the blood test and urine test to be done.  She uses a hospital stamp, and also signs on the paper.  In the laboratory, I give that paper and my health insurance card to the register.  And then, they will take samples for the tests, and give me an instruction about how to get the results online.  By the way, they will confirm my birthday, because it’s the password to access the results online.

Similar to the laboratories, pharmacies are also independent from hospitals.  There are so many pharmacies around the city.  Just show them the prescription paper and the health insurance card.  Depends on the type of medicine, the reimbursement percentage varies.  I have had Fe and vitamin D supplement, which are 100% covered by social security and mutuelle.  In comparison, for the pain reliever (to take during the irregular contractions at home), only 15% is covered.

One important thing if you do not have the carte vitale yet.  After all, it takes months to get the carte vitale, even with best luck!  The temporary social security number on the health insurance card (from mutuelle company) should work as well!  But some people in the laboratories and pharmacies may not know that!  For me, the first visit to the laboratory took me more than half an hour to register.  Partly due to the language barrier, but mainly because she did not know about the temporary social security number.  At last I took out the form of Declaration of Pregnancy that I was about to mail to CAF, and somehow she believed in that form (filled by us) more than the health insurance card.  After that, my visit to the same laboratory has been easy and fast, although they still ask me whether I have the carte vitale every time I go.  Similar things also happened to me in a pharmacy.  People in one pharmacy insist to see the carte vitale.  So I went to a different pharmacy, where people (not all) there know what to do.

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Echographie in France: Un garçon!

In France, échographie is typically done three times during the whole pregnancy.  First in the 3rd month; second in the 5/6th month; third in the 8th month.  I did the first échographie in China.  Actually I did three times in China… within one and a half months.  They only checked very briefly though (a couple of minutes), probably because it’s the early stage.

After the first meeting with my sage-femme (SF), it’s the right time for me to do the second échographie.  It was done in the same hospital, CHU.  The purpose was to estimate the delivery day, and to examine if there’s any abnormality.  A SF and a student performed the échographie.  The student speaks some English 🙂

It took more than half an hour!  They did very careful examination, and explained to us what we were looking at.  Suddenly, they asked us whether we wanted to know the sex of the baby.  We nodded.  Un garçon!  A boy!  Although we were not sure how they could tell, we were quite excited.  In the end, they provided a detailed report containing many photos.  Due to the positioning of the baby, they could not get everything that they needed.  Plus, the size of the baby seemed smaller than expected (based on DDR).  Therefore, they suggested to do another échographie, which was done in the following week.  Also, they said the first échographie done in China should be more accurate to estimate the DDG, so a translated report would be helpful.  In fact, there’s only one measurement in the Chinese report – LCC.  Based on that LCC, the SF estimated a new DDG, and she thought the size of the baby was okay.  We were kinda relieved.

I did the third échographie at 33w+3d.   Again, the SF measured a lot of things, and everything seemed normal.  The calculated weight of the baby was ~1900g (25~50% in their database).  The positioning of the baby was good, which I was very pleased to know.

Oh, I forgot to mention that after the second échographie, they somehow could construct a photo of the baby’s face.  Will our baby truly look like that?

 

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Meetings with the sage-femme – monthly checks during the pregnancy

After getting our temporary social security numbers and mutuelle numbers, the first thing we did was to make an appointment with a sage-femme (SF) in the hospital.  A friend helped us with that as we cannot speak French.  Grenoble is not very big, so we could get an appointment pretty soon (a week from the call).

It took us 10 minutes to find the hospital… Then, we went to the Accueil.  The lady there cannot speak English, but we slowly got what we needed to do.  There’s a room with several counters, and they are calling numbers (later we knew it’s the registration place, where the payment is taken care of).  People outside are waiting to be called in.  So we also got a number.  When it’s our turn, we went in and showed that we had an appointment with XXX.  There’s a young lady who speaks English, so she helped to put in all the information.  Basically she only asked for my passport and the health insurance info.  After that, she printed out a paper that has many stickers with my name and date of birth.   We were glad that we could use the health insurance (social security takes care of 70%, and mutuelle pays for the rest).

Paperwork was done.  We went to the consultation section.  There’s a small Accueil.  Again we said we were here to see XXX, and we showed the paper with stickers.  We were then pointed to a waiting area.  Around the agreed time, somebody came to the waiting area, and called my last name.  She was the SF!  Luckily she speaks a little English!  Since it’s our first meeting, she asked a lot of questions about our medical history and our families.  She also checked my condition (blood pressure etc.).  In the end, she gave me a list of tests need to be done in a laboratory, scheduled the next meeting, and asked us to go to that small Accueil to schedule an echography.

After that first meeting, we are kinda familiar with the hospital and the processes: where to register, where to wait, and where to schedule for appointments.  Then, after the pregnancy proceeded to the seventh month, the registration place put a pink note on the paper with stickers.  They told me that I did not need to register any more – just go to see the SF or doctor.  So, it seems like the registration place only deal with payment.  Since social security covers all the cost after the 6th month of pregnancy, no registration is needed.  For each meeting, the SF takes away one sticker, not the whole paper.

Up till now, we have had four meetings with the SF.  During the meetings, she checks my weight, blood pressure, tummy, and listens to the heart beat of the baby.  She logs all the information and the results of laboratory tests into the computer.  For me, I ask questions, and I tell her how I feel.  She prescribes Fe (every month), vitamin D (once), blood test -sugar (once), urine test -sugar/protein (every month after the 6th month), and blood test -toxoplasmose (every month).  Everything seems going well.  She also introduced us to a SF liberal for the classes (100% covered by social security), and gave us a lot of information on how to prepare for the big day, for example, what number to call when the time comes.  She is really helpful!

 

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Public or private hospital for my baby?

Although our choice is a public hospital (Centre Hospitalier Universitaire Grenoble Alpes), we still don’t know whether it’s a good choice or not.  All I can say now is that I found that hospital so far so good 🙂

We did a lot of research online, and we asked a few friends about their opinions.  Private hospitals, or clinics,  tend to have better services such as single rooms and faster appointments (less patients).  More importantly, you will have designated sages-femmes and/or doctors, so you will be taken care of by somebody you are familiar with during the whole pregnancy.  In comparison, sages-femmes and doctors in public hospitals work in shifts.  You cannot guess who will be receiving your baby.  You might even be surprised by the presence of students in case of a university hospital.  Public hospitals cannot guarantee you a single room either.

In terms of money, the cost in public hospitals is almost fully covered by the social security in France.  Private hospitals/clinics are more expensive, but I don’t know how much more.  Actually, we have complementary health insurance (mutuelle), so even if we chose a private hospital/clinic, the cost would be largely covered, I guess.  The cost is not a deciding factor for us.

What makes public hospitals stand out and made us decide to go to a public hospital is that they are more capable of dealing with emergencies.  In fact, private hospitals/clinics do transfer you to public hospitals when something unexpected happens.  This transferring process just does not sound good to me.

To us, safety is far more important than better service.  However, I sometimes think that *maybe* the private hospitals/clinics do a better job in tracking the pregnancy because they can and do spend more time with the patient.  But don’t forget that sages-femmes/doctors in public hospitals may be more experienced as they receive much more babies every year.

Nevertheless, luck is important!  People get good or bad experience everywhere.  Right now, I feel good.

 

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Health insurance in France: Social Security (Carte Vitale) and Mutuelle

We came to France in the end of November, 2017.  At that time, I was already more than four months pregnant.  We worried about getting health insurance in France, because the work contract is only six months.  But we came anyway.

One of the first things we did after arriving at Grenoble was making an appointment with the insurance company on campus.  For whatever reason (could be a mistake?), they approved our application!  That lady gave us a list of documents to be prepared, and asked us to go back in two weeks.  One of the requested documents is the birth certificate.  Of course, it has to be in French.  Therefore, my husband needed to have his family book translated by a court translator.  Other documents are easy to prepare.  After two weeks, we submitted all the documents to that lady.  Things seemed going well.

Another week went by.  One day, we received letters from that insurance company.  Each of us got a carte d’adherente, which contains the temporary social security number and the mutuelle number.

At some point, the insurance company requested the birth certificate again.  And this time, in addition to my husband’s birth certificate, I also submitted mine, which is prepared in China (translated and legalized).

The insurance company mailed us a few time – about my pregnancy.  They introduced all kinds of benefits we have.  They kept us well informed!  They have our bank account number, but we did not see any charge – until about two months after getting the carte d’adherente, we received the bill.  It turns out that the first three months is free, and they will start to charge in March.  In the same letter, they also included the payment that they made to the hospital and the laboratory from where I received service.  Not a penny from our own pocket ~

Ten days after the bill, my husband got a letter, which says he has been assigned a new social security number.  So not a temporary number any more.  A few days later, another letter came in to request a photo for making the Carte Vitale (the so called green card).  We mailed out the photo as soon as we can.  Last Saturday (2~3 weeks after mailing out the photo), we got the card!  However, I have not been assigned a new social security number, yet.

So, for my husband, it took like three months to finally get the Carte Vitale.  I guess it is fast?

 

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