Pregnant in London: How a French Gynaecologist Can Complement Your NHS Maternity Care

Pregnancy is a time when the differences between French and British healthcare feel most acute. In France, your gynaecologist follows your pregnancy closely — monthly consultations, three ultrasounds, extensive blood testing, and a reassuring sense that someone who knows you is watching every step. In London, you discover that the NHS maternity pathway is midwife-led, that you may never see a consultant unless a complication arises, and that the rhythm of monitoring feels markedly different from what you expected.

I want to be clear about something at the outset: the NHS midwifery system is excellent for routine, uncomplicated pregnancies. Midwife-led care in the UK is supported by strong evidence and produces good outcomes. What I am describing here is not a replacement for NHS maternity care, but a complement — an option for women who want additional reassurance, more frequent monitoring, or simply the comfort of seeing a French-speaking specialist who understands both systems.

The NHS maternity pathway: what to expect

If you are pregnant in England and registered with a GP, your maternity care will typically follow this structure, guided by NICE guidelines on antenatal care:

Booking appointment (around 8–12 weeks): Your first antenatal appointment is with a midwife. She takes your medical history, discusses your options, arranges blood tests (blood group, rhesus status, haemoglobin, hepatitis B, HIV, syphilis), and books your first scan.

Dating scan (11–14 weeks): An ultrasound to confirm gestational age, check for multiple pregnancy, and offer combined screening for Down’s syndrome, Edwards’ syndrome, and Patau’s syndrome (the nuchal translucency measurement combined with blood markers).

Anomaly scan (18–21 weeks): A detailed ultrasound that checks for structural abnormalities in the baby. This is typically the last routine scan in an uncomplicated pregnancy.

Antenatal appointments: For a first pregnancy without complications, NICE recommends around ten antenatal contacts. These are predominantly with your midwife. You will have your blood pressure, urine, and fundal height (bump measurement) checked at each visit. A consultant obstetrician is involved only if risk factors are identified — such as gestational diabetes, pre-eclampsia, or a previous caesarean section.

No routine third-trimester scan. Unless there is a clinical indication, a growth scan in the third trimester is not part of the standard NHS pathway.

The French maternity pathway: what you were used to

In France, the HAS recommends a more intensive monitoring schedule. The typical French pregnancy pathway includes:

• Monthly consultations with your gynaecologist or midwife from confirmation of pregnancy until delivery — seven mandatory prenatal consultations in total
• Three mandatory ultrasounds: at approximately 12 weeks (dating and first-trimester screening), 22 weeks (morphological scan), and 32 weeks (growth and position scan)
• Monthly blood tests for non-immune women: toxoplasmosis serology is checked every month if you are not immune, a practice that does not exist in the UK
• Routine glucose screening for gestational diabetes (typically between 24 and 28 weeks)
• Regular urine testing for proteinuria and glycosuria
• A preparatory consultation with the anaesthetist in the third trimester

For a French woman, this level of monitoring feels normal. The monthly consultations, the three scans, the regular blood work — they provide a structured reassurance that everything is progressing as it should. When you arrive in London and are offered two scans and a series of midwife appointments, the gap between expectation and reality can feel unsettling.

What French women find most disconcerting

In my conversations with French patients who are pregnant or planning a pregnancy in London, certain differences come up repeatedly:

Fewer scans. Two ultrasounds instead of three (or more) can feel like insufficient monitoring, particularly in the third trimester when French women are accustomed to a growth scan around 32 weeks.

No toxoplasmosis screening. This is perhaps the single most surprising difference for French women. In France, monthly toxoplasmosis serology is standard for non-immune pregnant women — with strict dietary advice about raw meat, unpasteurised cheese, and unwashed vegetables. In the UK, the National Screening Committee has reviewed the evidence and concluded that routine screening does not meet the criteria for a national programme. The reasoning is that the incidence of congenital toxoplasmosis in the UK is low and that screening would lead to unnecessary anxiety and intervention. This is an evidence-based position, but it can feel alarming to a French woman who has been taught from childhood to be vigilant about toxoplasmosis during pregnancy.

Midwife-led rather than doctor-led care. In France, your gynaecologist manages your pregnancy. In the UK, a midwife leads your care unless you are classified as high-risk. For a straightforward pregnancy, you may never see an obstetrician. This is not a deficit — UK midwives are highly trained and autonomous practitioners — but the shift from specialist-led to midwife-led care feels like a significant change for women accustomed to the French model.

No routine vaginal examinations. In France, vaginal examinations (including cervical length assessment) are a standard part of antenatal care. In the UK, they are not performed routinely during pregnancy. Again, this reflects different evidence interpretations rather than a lower standard of care, but it can feel unfamiliar.

How private care can complement the NHS

I want to emphasise that I am not suggesting you should replace your NHS maternity care. The NHS provides safe, evidence-based maternity services, and your midwife will be your primary contact throughout your pregnancy. What private care can offer is an additional layer of monitoring and reassurance for women who feel they need it.

In my practice, I can offer:

Early pregnancy scans. If you have had a previous early pregnancy loss, or if you are anxious in the early weeks before your NHS dating scan, an early reassurance scan (from around 7 weeks) can provide peace of mind. This includes confirmation of a viable pregnancy, checking the heartbeat, and dating the pregnancy.

Additional ultrasounds between NHS scans. If you would like a growth scan in the third trimester — the one that would have been routine in France — this can be arranged privately. It assesses foetal growth, amniotic fluid, and placental position, and can identify potential concerns that might otherwise go undetected until the final weeks.

Reassurance consultations. A consultation between your NHS appointments to discuss symptoms, answer questions, or simply have a thorough check-up with a specialist who speaks your language and understands your expectations. For French women who find the NHS schedule too sparse, these appointments fill a genuine gap.

A French-speaking specialist perspective. Pregnancy is an emotional time, and being able to discuss your concerns, your symptoms, and your care plan in your mother tongue matters. I understand both systems — the French expectations and the UK reality — and I can help you navigate the differences with confidence.

A note on what private care does not replace

To be transparent: private gynaecological consultations during pregnancy are supplementary. Your NHS midwife remains responsible for your overall maternity care pathway, your birth plan, your delivery, and your postnatal follow-up. If complications arise, NHS hospital care — with its 24-hour consultant cover, neonatal units, and multidisciplinary teams — is where you will be managed, and rightly so. The NHS excels in this domain.

What I provide is the in-between: the reassurance scans, the additional monitoring, the specialist conversations, and the continuity of a doctor who knows you. For French women in London, this combination — NHS safety net plus private supplementary care — often feels like the right balance.